Background:
The commitment to promoting equity in health is derived from the notion that all human beings have the right to the best attainable health. However, disparities in health care are well-documented. The objectives were To explore disparities in diabetes prevalence, care and control among diabetic patients. The study was conducted by Maccabi Healthcare Services (MHS), an Israeli HMO (health care plan).
Methods:
Retrospective study. The dependent variables were diabetes prevalence, uptake of follow-up examinations, and disease control. The independent variables were socio-economic rank (SER), ethnicity (Arab vs non Arab), supplementary voluntary health insurance (SVHI), and immigration from Former Soviet Union (FSU) countries . Chi Square and Logistic Regression Models were estimated.
Results:
We analyzed 74,953 diabetes patients. Diabetes was more prevalent in males, lower SER patients, Arabs, immigrants and owners of SVHI. Optimal follow up was more frequent among females, lower SERs patients, non Arabs, immigrants and SVHI owners. Patients who were female, had higher SERs, non Arabs, immigrants and SVHI owners achieved better control of the disease. The multivariate analysis revealed significant associations between optimal follow up and age, gender (males), SER (Ranks 1-10), Arabs and SVHI (OR 1.02, 0.95, 1.15, 0.85 and 1.31, respectively); poor diabetes control (HbA1C >9gr%) was significantly associated with age, gender (males), Arabs, immigrants, SER (Ranks1-10) and SVHI (OR 0.96, 1.26, 1.38, 0.72, 1.37 and 0.57, respectively); significant associations with LDL control (<100gr%) were revealed for age, gender (males) and SVHI (OR 1.02, 1.30 and 1.44, respectively).
Conclusion:
Disparities in diabetes prevalence, care and control were revealed according to population sub-group. MHS has recently established a comprehensive strategy and action plan, aimed to reduce disparities among members of low socioeconomic rank and Arab ethnicity, sub-groups identified in our study as being at risk for less favorable health outcomes.
Disparities in diabetes care: role of the patient’s socio-demographic characteristics
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Identifying Psychosocial Stressors of Well-Being and Factors Related to Substance Use Among Latino Day Laborers
Abstract
Day labor is largely comprised of young Latino immigrant men, many of who are undocumented, and thus vulnerable to a myriad
of workers’ rights abuses. The difficult work and life conditions of this marginalized population may place them at heightened
risk for mental health problems and substance use and abuse. However, factors related to Latino day laborers’ well-being and
substance misuse are largely unknown. This article utilizes ethnographic and focus group methodology to elucidate participant
identified factors associated to well-being and substance use and abuse. This study has implications for informing public
health and social service programming as it provides thick description regarding the context and circumstances associated
to increased vulnerability to substance abuse and lack of well-being among this hard-to-reach population of Latino immigrants.
of workers’ rights abuses. The difficult work and life conditions of this marginalized population may place them at heightened
risk for mental health problems and substance use and abuse. However, factors related to Latino day laborers’ well-being and
substance misuse are largely unknown. This article utilizes ethnographic and focus group methodology to elucidate participant
identified factors associated to well-being and substance use and abuse. This study has implications for informing public
health and social service programming as it provides thick description regarding the context and circumstances associated
to increased vulnerability to substance abuse and lack of well-being among this hard-to-reach population of Latino immigrants.
- Content Type Journal Article
- DOI 10.1007/s10903-010-9413-x
- Authors
- Nalini Junko Negi, School of Social Work, University of Maryland, Baltimore, 525 West Redwood Street, Baltimore, MD 21201, USA
- Journal Journal of Immigrant and Minority Health
- Online ISSN 1557-1920
- Print ISSN 1557-1912