Dear Colleagues
Attached info on paper in latest issue of Ethnicity and Health, which may be of interest to some of you
Best wishes
David McDaid
LSE Health and Social Care
Volume 8, Number 2 / May 2003 ; 121 - 133
http://taylorandfrancis.metapress.com/link.asp?id=fjlem5qhpw95fh9a
Evaluation of Equity in Diabetes Health Care in Relation to African and Caribbean Ethnicity
JAMES E.C. SEDGWICK A1, ALISON J. PEARCE A1, MARTIN C. GULLIFORD A1
A1 Department of Public Health Sciences, King's College London, UK
Abstract:
Objective. Many US studies have shown that ethnic minority groups have less access to health care. We evaluated whether black African and black Caribbean people with diabetes in the UK gain access to diabetes health care on an equitable basis compared with white people.
Design. Cross-sectional questionnaire survey set in 29 general practices in south London. Main measures were self-reported morbidity, SF-36 scores and utilisation of health care. Analyses of utilisation variables were adjusted for age, sex, ethnic group, duration of diabetes, and socio-economic and health status.
Results. There were 1,899 respondents (64%) from 2,983 individuals registered with diabetes. These included 799 white, 522 black Caribbean, 163 black African and 415 other subjects with type 2 diabetes. After adjusting for need, black Caribbeans reported higher utilisation of health care than white subjects for four of nine utilisation variables, and black Africans for two. For the remaining variables utilisation was equivalent in different ethnic groups. Black Caribbean subjects were more likely to be treated for hypertension if hypertensive (odds ratio 1.84, 95% CI 1.05 to 3.22), to use blood or urine self-monitoring (1.40, 1.04 to 1.88) and to have attended a diabetes nurse (1.34, 1.04 to 1.74) or dietician (1.49, 1.19 to 1.86). Black Africans were more likely to have attended a dietician (2.15, 1.40 to 3.29) or an ophthalmologist (1.72, 1.10 to 2.70) in the past year.
Conclusion. There was no evidence from this study that black African or black Caribbean subjects had less access to diabetes health care in relation to need.
Keywords:
diabetes mellitus, ethnic groups, delivery of health care, health services accessibility
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