Assessing widening disparities in HbA1c and systolic blood pressure retesting during the COVID-19 pandemic in an LGBTQ+-focused federally qualified health center in Chicago: a retrospective cohort study using electronic health records
Introduction To assess disparities in retesting for glycated hemoglobin (HbA1c) and systolic blood pressure (SBP) among people with diabetes mellitus (DM) and hypertension (HTN), respectively, we analyzed medical records from a lesbian, gay, bisexual, transgender, queer-specialized federally qualifi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-12-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/10/6/e002990.full |
| _version_ | 1797780210200870912 |
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| author | Adovich S Rivera Matthew J Feinstein Megan Plank Ash Davis Laura K Rusie Lauren B Beach |
| author_facet | Adovich S Rivera Matthew J Feinstein Megan Plank Ash Davis Laura K Rusie Lauren B Beach |
| author_sort | Adovich S Rivera |
| collection | DOAJ |
| description | Introduction To assess disparities in retesting for glycated hemoglobin (HbA1c) and systolic blood pressure (SBP) among people with diabetes mellitus (DM) and hypertension (HTN), respectively, we analyzed medical records from a lesbian, gay, bisexual, transgender, queer-specialized federally qualified health center with multiple sites in Chicago.Research design and methods We identified people with DM seen in 2018 and 2019 then assessed if individuals had HbA1c retested the following year (2019 and 2020). We repeated this using SBP for people with HTN. Rates of retesting were compared across gender, sexual orientation, and race and ethnicity and across the 2 years for each categorization with adjustment for socioeconomic indicators.Results Retesting rates declined from 2019 to 2020 for both HbA1c and SBP overall and across all groups. Cisgender women and transgender men with DM (vs cisgender men) and straight people (vs gay men) had significantly lower odds of HbA1c retesting for both years. There was evidence of widening of HbA1c retesting disparities in 2020 between gay men and other orientations. Cisgender women, straight people, and black people (vs white) with HTN had significantly lower odds of SBP retesting for both years. There was evidence of narrowing in the retesting gap between black and white people with HTN, but this was due to disproportionate increase in no retesting in white people rather than a decline in no retesting among black people with HTN.Conclusions Disparities in DM and HTN care according to gender, race, ethnicity, and sexual orientation persisted during the pandemic with significant widening according to sexual orientation. |
| first_indexed | 2024-03-12T23:41:12Z |
| format | Article |
| id | doaj.art-fbbfbf5b2fa04dea9c3ecd46a975c47c |
| institution | Directory Open Access Journal |
| issn | 2052-4897 |
| language | English |
| last_indexed | 2024-03-12T23:41:12Z |
| publishDate | 2022-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj.art-fbbfbf5b2fa04dea9c3ecd46a975c47c2023-07-14T18:00:07ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972022-12-0110610.1136/bmjdrc-2022-002990Assessing widening disparities in HbA1c and systolic blood pressure retesting during the COVID-19 pandemic in an LGBTQ+-focused federally qualified health center in Chicago: a retrospective cohort study using electronic health recordsAdovich S Rivera0Matthew J Feinstein1Megan Plank2Ash Davis3Laura K Rusie4Lauren B Beach5Center for Education in Health Sciences, Institute for Public Health and Management, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USADepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USAData, Evaluation, and Epidemiology, Howard Brown Health Center, Chicago, Illinois, USAData, Evaluation, and Epidemiology, Howard Brown Health Center, Chicago, Illinois, USAData, Evaluation, and Epidemiology, Howard Brown Health Center, Chicago, Illinois, USADepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USAIntroduction To assess disparities in retesting for glycated hemoglobin (HbA1c) and systolic blood pressure (SBP) among people with diabetes mellitus (DM) and hypertension (HTN), respectively, we analyzed medical records from a lesbian, gay, bisexual, transgender, queer-specialized federally qualified health center with multiple sites in Chicago.Research design and methods We identified people with DM seen in 2018 and 2019 then assessed if individuals had HbA1c retested the following year (2019 and 2020). We repeated this using SBP for people with HTN. Rates of retesting were compared across gender, sexual orientation, and race and ethnicity and across the 2 years for each categorization with adjustment for socioeconomic indicators.Results Retesting rates declined from 2019 to 2020 for both HbA1c and SBP overall and across all groups. Cisgender women and transgender men with DM (vs cisgender men) and straight people (vs gay men) had significantly lower odds of HbA1c retesting for both years. There was evidence of widening of HbA1c retesting disparities in 2020 between gay men and other orientations. Cisgender women, straight people, and black people (vs white) with HTN had significantly lower odds of SBP retesting for both years. There was evidence of narrowing in the retesting gap between black and white people with HTN, but this was due to disproportionate increase in no retesting in white people rather than a decline in no retesting among black people with HTN.Conclusions Disparities in DM and HTN care according to gender, race, ethnicity, and sexual orientation persisted during the pandemic with significant widening according to sexual orientation.https://drc.bmj.com/content/10/6/e002990.full |
| spellingShingle | Adovich S Rivera Matthew J Feinstein Megan Plank Ash Davis Laura K Rusie Lauren B Beach Assessing widening disparities in HbA1c and systolic blood pressure retesting during the COVID-19 pandemic in an LGBTQ+-focused federally qualified health center in Chicago: a retrospective cohort study using electronic health records BMJ Open Diabetes Research & Care |
| title | Assessing widening disparities in HbA1c and systolic blood pressure retesting during the COVID-19 pandemic in an LGBTQ+-focused federally qualified health center in Chicago: a retrospective cohort study using electronic health records |
| title_full | Assessing widening disparities in HbA1c and systolic blood pressure retesting during the COVID-19 pandemic in an LGBTQ+-focused federally qualified health center in Chicago: a retrospective cohort study using electronic health records |
| title_fullStr | Assessing widening disparities in HbA1c and systolic blood pressure retesting during the COVID-19 pandemic in an LGBTQ+-focused federally qualified health center in Chicago: a retrospective cohort study using electronic health records |
| title_full_unstemmed | Assessing widening disparities in HbA1c and systolic blood pressure retesting during the COVID-19 pandemic in an LGBTQ+-focused federally qualified health center in Chicago: a retrospective cohort study using electronic health records |
| title_short | Assessing widening disparities in HbA1c and systolic blood pressure retesting during the COVID-19 pandemic in an LGBTQ+-focused federally qualified health center in Chicago: a retrospective cohort study using electronic health records |
| title_sort | assessing widening disparities in hba1c and systolic blood pressure retesting during the covid 19 pandemic in an lgbtq focused federally qualified health center in chicago a retrospective cohort study using electronic health records |
| url | https://drc.bmj.com/content/10/6/e002990.full |
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