Health Psychology
Volume 37, Issue 1, 2018, Pages 61-69

Associations between immigrant status and pharmacological treatments for diabetes in U.S. adults (Article)

Hsueh L. , Vrany E.A. , Patel J.S. , Hollingshead N.A. , Hirsh A.T. , de Groot M. , Stewart J.C.*
  • a Department of Psychology, Indiana University-Purdue University Indianapolis, United States
  • b Department of Psychology, Indiana University-Purdue University Indianapolis, United States
  • c Department of Psychology, Indiana University-Purdue University Indianapolis, United States
  • d Department of Psychology, Indiana University-Purdue University Indianapolis, United States, Department of Psychiatry and Behavioral Medicine, Ohio State University Wexner Medical Center, United States
  • e Department of Psychology, Indiana University-Purdue University Indianapolis, United States
  • f Diabetes Translational Research Center, Indiana University School of Medicine, United States
  • g Department of Psychology, Indiana University-Purdue University Indianapolis, United States

Abstract

Objectives: Although treatment disparities in diabetes have been documented along racial/ethnic lines, it is unclear if immigrant groups in the United States experience similar treatment disparities. Our objective was to determine whether immigrant status is associated with differences in pharmacological treatment of diabetes in a nationally representative sample of adults with diabetes. We were specifically interested in differences in treatment with oral hypoglycemic agents (OHA) and insulin. Method: Respondents were 2,260 adults from National Health and Nutritional Examination Survey (NHANES) 2003-2012 with a self-reported diabetes diagnosis. Immigrant status was indicated by birth within (U.S.-born) or outside (foreign-born) the 50 U.S. States or Washington, DC. Multinomial logistic regression analyses examined associations between immigrant status and (a) treatment with OHAs only and (b) treatment with insulin only or insulin and OHA combination therapy, using no treatment as the reference group. Results: Adjusting for demographics, diabetes severity and duration, cardiovascular disease (CVD), and CVD risk factors, being foreign-born versus U.S.-born was not associated with treatment with OHAs only (odds ratio [OR] = 1.59; 95% confidence interval [CI] [0.97, 2.60]). However, being foreign-born was associated with decreased odds (OR = 0.53; 95% CI [0.28, 0.99]) of treatment with insulin. Conclusions: Pharmacological treatment of diabetes differs along immigrant status lines. To understand these findings, studies capturing the processes underlying treatment differences in diabetes among immigrants are needed. Findings raise the possibility that integrating information about a patient's immigrant status, in addition to racial/ethnic identity, may be an important component of culturally sensitive diabetes care. © 2017 American Psychological Association.

Author Keywords

Health care disparities emigrants and immigrants Diabetes mellitus Hypoglycemic agents

Index Keywords

immigrant cardiovascular risk demography oral antidiabetic agent human middle aged diabetes mellitus controlled study pathology disease duration United States insulin social status migrant psychology cardiovascular disease Humans male Emigrants and Immigrants female Article organization and management major clinical study adult insulin treatment disease severity Healthcare Disparities health care disparity
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85030690185&doi=10.1037%2fhea0000552&partnerID=40&md5=0f5a23d1c4d2dbf478fa507784799196
DOI: 10.1037/hea0000552
ISSN: 02786133
Cited by: 1
Original Language: English