Racial/Ethnic, Regional, and Rural/Urban Differences in Receipt of Diabetes Education

Abstract

Purpose The objective of this study is to examine the differences in receipt of diabetes education according to risk factors that are associated with the disease, including race/ ethnicity, region, and rural/urban location. Methods National data from the 2007 Medical Expenditure Panel Survey (MEPS) were analyzed to examine likelihood of receipt of diabetes education in terms of race, urban/rural location, and region. Results Of 1747 adults with type 2 diabetes, 65.6% were white, 15% black, and 19.4% other. In addition, 49.3% were male, 50.6% female; 46.9% were under age 64; 39.8% had more than high school; 34.1% were from low-income households, 35.1% middle income, and 30.8% high income; 39.5% lived in the South while other regions were equally represented; 80.6% lived in rural areas; 63.7% did not receive any type 2 diabetes education. Patients in the South were least likely to receive education (67.5% did not). Logistic regression demonstrated that being black (odds ratio [OR] = 1.38, 95% confidence interval [CI], 1.03-1.84) and living in an urban area (OR = 1.40, 95% CI, 1.00-1.97) were associated with a higher likelihood of receiving diabetes education. By contrast, being 65 or older was associated with lower probability of receiving education (OR = 0.59, 95% CI, 0.40-0.87), as was lack of insurance (OR = 0.54, 95% CI, 0.33-0.88) Conclusions Being black independently increased likelihood of receiving diabetes education, but living in rural areas, being uninsured, and living in the South reduced chances one would receive this helpful information. Therefore, further research should examine benefits of leveraging technology such as telemedicine to improve delivery of diabetes education to those living in rural areas.