Ethnic and language disparities in diabetes care among California residents

Abstract

Objective: We examined ethnic and language disparities in diabetes care and management among California residents with type 2 diabetes based on ethnicity and English-language proficiency.

Methods: Data were drawn from the 2007 California Health Interview Survey with a total of 3,531 Asian, Latino, and Caucasian adults with diabetes. Latino and Asian groups were subdivided by their limited English proficiency (LEP) level. Population-weighted regression analyses were conducted to examine group differences, controlling for socioeconomic and clinical variables.

Results: Latino English Proficient (EP) and Latino LEP respondents received fewer hemoglobin A1c checks (EP: b = -0.11, P < .05; LEP: b = -0.27, P < .01) than Caucasians. Latino and Asian LEP respondents checked their glucose less frequently than Caucasians (Latino LEP: b = -0.49, P < .05; Asian LEP: b = -0.79, P < .01). Asian LEP respondents were less likely to receive feet checks than Caucasians (Asian LEP: b = -.52, P < .001). Asian LEP respondents received significantly fewer feet checks than Asian EP respondents (P < .05).

Conclusions: Ethnic disparities in disease management exist among California residents. However, beyond ethnicity, English proficiency should be taken into account when examining diabetes management among minority groups. Diabetic Californians who belong to ethnic minorities and speak limited English, particularly Asians, are less likely to receive the standard of care for diabetes than English proficient Caucasians. From a policy perspective, care should be taken to ensure that adequate information about diabetes management is available in multiple languages for patients with limited English skills.