Racial and ethnic disparities in diabetes-related healthcare service use

Compared to non-Hispanic White adults, racial/ethnic minority adults have a higher risk of developing diabetes and its complications. Proper use of healthcare services is important for reducing the prevalence of diabetes and the risk of complications. However, minority populations tend to receive a lower quality of healthcare service and have greater barriers to diabetes self-management. This study aims to determine racial/ethnic disparities in the utilization of diabetes-related healthcare services and estimate factors that are associated with the utilization.

This study used the 2016-2021 Behavioral Risk Factor Surveillance System data. Accomplishment of diabetes-related healthcare services (annual clinical care, self-care) among patients with diabetes and diabetes screening rates among adults at risk of developing diabetes were assessed. Chi-square tests explored associations between race/ethnicity and healthcare service use. Weighted logistic regression models estimated factors independently associated with utilization, controlling for covariates.

Patients with diabetes who reported fully completing annual clinical care exams were less than 50% for all racial and ethnic groups. Asian American patients reported the lowest percentage of fully completing self-care practices (1.2%). Compared to non-Hispanic White patients, Hispanic and Latino patients had the lowest odds of fully completing all annual exams (OR = 0.10, 95% CI, 0.07, 0.14) and self-care practices (OR = 0.63, 95% CI, 0.43, 0.92). Except for non-Hispanic Black adults, asymptomatic adults at risk from other racial and ethnic minority groups had significantly lower odds of having screening, and Asian American adults had the lowest odds of screening uptake (OR = 0.55, 95% CI, 0.52, 0.59) compared to non-Hispanic White adults. Healthcare insurance coverage, access to healthcare, self-rated general health status, and alcohol consumption were significantly associated with diabetes-related healthcare utilization status.

Racial and ethnic disparities exist in diabetes-related healthcare service utilization. These findings underscore an urgent need to improve diabetes-related healthcare service use for racial and ethnic minority groups.