Diabetes Care
Volume 35, Issue 4, 2012, Pages 754-761

Diabetes screening among immigrants: A population-based urban cohort study (Article) (Open Access)

Creatore M.I.* , Booth G.L. , Manuel D.G. , Moineddin R. , Glazier R.H.
  • a Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
  • b Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Department of Medicine, University of Toronto, Toronto, ON, Canada
  • c Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Ottawa Hospital Research Institute, Ottawa, ON, Canada, Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
  • d Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
  • e Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Institute of Medical Science, University of Toronto, Toronto, ON, Canada, Department of Family and Community Medicine, University of Toronto, ON, Canada, Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada

Abstract

OBJECTIVE - To examine diabetes screening, predictors of screening, and the burden of undiagnosed diabetes in the immigrant population and whether these estimates differ by ethnicity. RESEARCH DESIGN AND METHODS - A population-based retrospective cohort linking administrative health data to immigration fileswas used to follow the entire diabetes-free population aged 40 years and up in Ontario, Canada (N = 3,484,222) for 3 years (2004-2007) to determine whether individuals were screened for diabetes. Multivariate regression was used to determine predictors of having a diabetes test. RESULTS - Screening rates were slightly higher in the immigrant versus the general population (76.0 and 74.4%, respectively; P < 0.001), with the highest rates in people born in South Asia, Mexico, Latin America, and the Caribbean. Immigrant seniors (age ≥65 years) were screened less than nonimmigrant seniors. Percent yield of new diabetes subjects among those screened was high for certain countries of birth (South Asia, 13.0%; Mexico and Latin America, 12.1%; Caribbean, 9.5%) and low among others (Europe, Central Asia, U.S., 5.1-5.2%). The number of physician visits was the single most important predictor of screening, and many high-risk ethnic groups required numerous visits before a test was administered. The proportion of diabetes that remained undiagnosed was estimated to be 9.7% in the general population and 9.0% in immigrants. CONCLUSIONS - Overall diabetes-screening rates are high in Canada's universal health care setting, including among high-risk ethnic groups. Despite this finding, disparities in screening rates between immigrant subgroups persist and multiple physician visits are often required to achieve recommended screening levels. © 2012 by the American Diabetes Association.

Author Keywords

[No Keywords available]

Index Keywords

urban population immigrant mass screening Health Status Disparities human sex difference risk assessment middle aged Cohort Studies diagnostic accuracy diabetes mellitus ethnic group controlled study Aged population risk Humans male Emigrants and Immigrants female Aged, 80 and over prediction high risk population sensitivity and specificity Article Retrospective Studies Ontario major clinical study adult outcome assessment ethnicity retrospective study Healthcare Disparities health care disparity
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84862104143&doi=10.2337%2fdc11-1393&partnerID=40&md5=052b74580bc27d01d1a2c9b43240d3ac
DOI: 10.2337/dc11-1393
ISSN: 01495992
Cited by: 25
Original Language: English