Gaps in health care found in low-income, poorly educated women with diabetes

American Association of Diabetes Educators 36th Annual Meeting

Researchers at the CDC have identified several gaps in health care for women with diabetes, particularly with income and education level. New survey results indicate that low-income, poorly educated women with diabetes are not receiving recommended care.

"The implementation of recommendations for diabetes care has improved since 1995, but the research tells us that the quality of care remains suboptimal," Michelle D. Owens-Gary, PhD, behavioral scientist at the CDC, said during a presentation at the American Association of Diabetes Educators 36th Annual Meeting. "The public health implications of our study show that some groups may be vulnerable to not receiving preventive care services."

Researchers pooled data from the Medical Expenditure Panel Survey, National Health and Nutrition Examination Survey and National Health Interview Survey to assess and compare the quality of health care in women aged 18 years and older. The researchers assessed data on diabetes-specific, cardiovascular disease-specific and cancer-specific preventive care, dental care, vaccinations and demographics.

Of the women with diabetes, 67% had an annual dilated eye exam, about 70% had an annual foot exam and about 92% had an annual HbA1c testing. Despite this, only 45% of women reported receiving all three services within the past year.

Women who were younger and had a lower educational level were less likely to receive recommended care. Older women (mean age, 75 years) with diabetes were less likely to receive a mammogram when compared to women aged younger than 75.

Screenings for colorectal, breast or cervical cancer were more likely to occur in women with at least some college education or high income levels when compared with women who had lower levels - regardless of diabetes status. Women with a high income were more likely to report receiving an influenza or pneumococcal vaccination when compared with their lower income counterparts.

"Oftentimes we think about race and ethnicity when we strive to target groups for diabetes care, but our findings show that we need to begin to think about other groups as well, including people of low income and low education levels," Owens-Gary said.

The researchers concluded that further research is needed to identify the modifiable factors that may be utilized to design interventions aimed at minimizing the number of missed opportunities for delivery of comprehensive health care for women with diabetes. - by Jennifer Southall

For more information:

Owens-Gary MD. #F11b. Presented at: The American Academy of Diabetes Educators 36th Annual Meeting; August 5-8, 2009; Atlanta.