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Research Article

Health Care Disparities in Diabetes and Diabetic Retinopathy

ORCID Icon, , , , , & ORCID Icon show all
Pages 453-461 | Received 07 Apr 2022, Accepted 06 Jan 2023, Published online: 27 Jan 2023
 

ABSTRACT

Purpose

To investigate prevalence of diabetes (DM), diabetic retinopathy (DR), and areas with highest rates of undetected DR. To quantify and map locations of disparities as they relate to poverty and minority populations.

Methods

Retrospective cohort study from large regional health data repository (HealthLNK). Geographic Information System (GIS) analysis mapped rates of DM and DR in Chicago area ZIP Codes.

Results

Of 1,086,921 adults who met the inclusion criteria, 143,790 with DM were identified. ZIP Codes with higher poverty rates were correlated with higher prevalence of DM and DR (Pearson’s correlation coefficient 0.614, p < .05, 0.333, p < .05). Poverty was negatively correlated with likelihood of DR diagnosis (−0.638, p < .05). Relative risks of DM and DR were calculated in each ZIP Code and compared to actual rates. 36 high-risk ZIP Codes had both high-risk of DM and low DR detection. In high-risk ZIP Codes 85.4% of households self-identified as ethnic minority and 33.0% were below the Federal Poverty Level (FPL). Both percentages were significantly higher than the Chicago average of 50.5% minority and 19.9% below FPL (p < .05). 67 ideal ZIP Codes had both low risk of DM and high DR detection. In ideal ZIP Codes 32.6% of households self-identified as minority, and 10.2% were below the FPL (p < .05).

Conclusions

A health care disparity exists with regards to DM and DR. High-risk ZIP Codes are associated with higher poverty and higher minority population, and they are highly concentrated in just 17% of the ZIP codes in the Chicago area.

Acknowledgments

The authors would like to acknowledge Jess Behrens MS, Kathryn Jackson MS, and Theresa Walunas PhD for their assistance with data acquisition and analysis.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institutes of Health [1R21EY024050-01A]. “Understanding Diabetic Eye Disease in the Underserved Using Health Data Exchange”.Supported by an unrestricted grant from Research to Prevent Blindiness, New York, NY.

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