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Disparities in preventative diabetic foot examination
Sarah Ali Fermawi1, Jeffrey P Tolson2, Shannon M Knapp3
1Division of General Surgery, Memorial Healthcare System, Pembroke Pines, FL.
Seminars in Vascular Surgery
|March 23, 2023
Summary
Hispanic adults with diabetes receive fewer preventive foot exams than White adults. This disparity highlights the need to address inequities in diabetic foot care among minority groups.
Area of Science:
- Public Health
- Health Disparities
- Diabetology
Background:
- Diabetic foot ulceration is a significant complication of diabetes, leading to morbidity and mortality.
- Preventive foot care, including regular examinations, is crucial for early detection and management of foot problems in diabetic patients.
- Racial and ethnic disparities in healthcare access and quality are well-documented, potentially impacting preventive care utilization.
Purpose of the Study:
- To evaluate differences in preventive foot care standards for patients at risk of diabetic foot ulceration.
- To identify demographic factors, specifically race and ethnicity, influencing these healthcare practices.
Main Methods:
- Analysis of data from the National Health and Nutrition Examination Survey (2011-2018).
- Inclusion of adult participants (20+ years) with diabetes, categorized by self-reported race and ethnicity.
- Logistic regression used to assess the impact of race and ethnicity on annual diabetic foot examinations, controlling for age, gender, and insurance status.
Main Results:
- A total of 2,836 participants with diabetes were analyzed; 71.6% received an annual foot examination.
- Hispanic participants were significantly less likely to receive an annual foot examination compared to White participants (aOR=0.685).
- Older age (65+ years) and health insurance were positively associated with receiving a foot examination (aOR=1.42 and aOR=3.02, respectively).
Conclusions:
- Hispanic adults with diabetes experience lower rates of preventive foot care compared to White adults.
- Significant variations in the standard of care underscore the need to investigate factors contributing to disparities in preventive services for racial and ethnic minority groups.
- Addressing these disparities is essential for improving outcomes and reducing the burden of diabetic foot complications.
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