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OBJECTIVES/SPECIFIC AIMS: Research on social determinants of health (SDHs) in type 2 diabetes have largely examined disease etiology rather than severity. To find factors associated with complications, we investigated socio-demographics, healthcare access, and healthcare utilization in individuals w...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2017-09-01
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| Series: | Journal of Clinical and Translational Science |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2059866117002746/type/journal_article |
| _version_ | 1811156764376170496 |
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| author | Scott Cohen Jasmine Mack Catherine Striley Linda Cottler |
| author_facet | Scott Cohen Jasmine Mack Catherine Striley Linda Cottler |
| author_sort | Scott Cohen |
| collection | DOAJ |
| description | OBJECTIVES/SPECIFIC AIMS: Research on social determinants of health (SDHs) in type 2 diabetes have largely examined disease etiology rather than severity. To find factors associated with complications, we investigated socio-demographics, healthcare access, and healthcare utilization in individuals with type 2 diabetes with respect to related comorbidity. METHODS/STUDY POPULATION: Community health workers assessed 8494 participants for type 2 diabetes (n=939; 11%) through HealthStreet, a community-engagement model implemented in North Central Florida. Comorbidities were defined as neuropathy, retinopathy, high cholesterol, hypertension, and kidney failure. We conducted multivariate analyses to test the association of socio-demographic factors and comorbidity status. RESULTS/ANTICIPATED RESULTS: Of 939 members with type 2 diabetes, 164 (17%), 272 (29%), 370 (39%), and 133 (14%) reported having 0, 1, 2, and 3+ comorbidities, respectively. There is a smaller proportion of African-Americans reporting 3+ comorbidities compared with other comorbidity groups (p=0.003). Those with more comorbidity are less employed (p<0.0001) and are more likely to have Medicare/Medicaid (p=0.03) than those without comorbidity. Those with no comorbidity are more likely to be uninsured compared to those with comorbidity (p=0.0297). Adjusting for age, race, gender, and BMI, those that have at least 1 comorbidity are 1.4 times more likely to be food insecure (p=0.004) and are 1.9 times more likely to have seen a doctor in the past 12 months (p=0.002) compared to those without comorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: Although there is complexity among the relationships between SDHs and diabetic comorbidity, results suggest significant sociodemographic and healthcare-related disparities among individuals living with type 2 diabetes. Members with more comorbidity utilize healthcare, but are more likely to be food insecure among other factors. Those with no comorbidity are least likely to see a physician, which could imply a gap in the care continuum. This analysis gives insight into the importance of efficient diabetes management, focused on disparities in economic stability and healthcare access and utilization. |
| first_indexed | 2024-04-10T04:56:45Z |
| format | Article |
| id | doaj.art-2d85e660d809477cb73a3d3ed3e3edf0 |
| institution | Directory Open Access Journal |
| issn | 2059-8661 |
| language | English |
| last_indexed | 2024-04-10T04:56:45Z |
| publishDate | 2017-09-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Clinical and Translational Science |
| spelling | doaj.art-2d85e660d809477cb73a3d3ed3e3edf02023-03-09T12:30:06ZengCambridge University PressJournal of Clinical and Translational Science2059-86612017-09-011777810.1017/cts.2017.2742423Scott CohenJasmine MackCatherine StrileyLinda CottlerOBJECTIVES/SPECIFIC AIMS: Research on social determinants of health (SDHs) in type 2 diabetes have largely examined disease etiology rather than severity. To find factors associated with complications, we investigated socio-demographics, healthcare access, and healthcare utilization in individuals with type 2 diabetes with respect to related comorbidity. METHODS/STUDY POPULATION: Community health workers assessed 8494 participants for type 2 diabetes (n=939; 11%) through HealthStreet, a community-engagement model implemented in North Central Florida. Comorbidities were defined as neuropathy, retinopathy, high cholesterol, hypertension, and kidney failure. We conducted multivariate analyses to test the association of socio-demographic factors and comorbidity status. RESULTS/ANTICIPATED RESULTS: Of 939 members with type 2 diabetes, 164 (17%), 272 (29%), 370 (39%), and 133 (14%) reported having 0, 1, 2, and 3+ comorbidities, respectively. There is a smaller proportion of African-Americans reporting 3+ comorbidities compared with other comorbidity groups (p=0.003). Those with more comorbidity are less employed (p<0.0001) and are more likely to have Medicare/Medicaid (p=0.03) than those without comorbidity. Those with no comorbidity are more likely to be uninsured compared to those with comorbidity (p=0.0297). Adjusting for age, race, gender, and BMI, those that have at least 1 comorbidity are 1.4 times more likely to be food insecure (p=0.004) and are 1.9 times more likely to have seen a doctor in the past 12 months (p=0.002) compared to those without comorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: Although there is complexity among the relationships between SDHs and diabetic comorbidity, results suggest significant sociodemographic and healthcare-related disparities among individuals living with type 2 diabetes. Members with more comorbidity utilize healthcare, but are more likely to be food insecure among other factors. Those with no comorbidity are least likely to see a physician, which could imply a gap in the care continuum. This analysis gives insight into the importance of efficient diabetes management, focused on disparities in economic stability and healthcare access and utilization.https://www.cambridge.org/core/product/identifier/S2059866117002746/type/journal_article |
| spellingShingle | Scott Cohen Jasmine Mack Catherine Striley Linda Cottler 2423 Journal of Clinical and Translational Science |
| title | 2423 |
| title_full | 2423 |
| title_fullStr | 2423 |
| title_full_unstemmed | 2423 |
| title_short | 2423 |
| title_sort | 2423 |
| url | https://www.cambridge.org/core/product/identifier/S2059866117002746/type/journal_article |
| work_keys_str_mv | AT scottcohen 2423 AT jasminemack 2423 AT catherinestriley 2423 AT lindacottler 2423 |