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. 2013 Jun;33(6):398-406.

Small area variation in diabetes prevalence in Puerto Rico

Edward F Tierney  1 , Nilka R Burrows, Lawrence E Barker, Gloria L Beckles, James P Boyle, Betsy L Cadwell, Karen A Kirtland, Theodore J Thompson
Affiliations

Small area variation in diabetes prevalence in Puerto Rico

Edward F Tierney et al. Rev Panam Salud Publica. 2013 Jun.

Abstract

Objective: To estimate the 2009 prevalence of diagnosed diabetes in Puerto Rico among adults ≥ 20 years of age in order to gain a better understanding of its geographic distribution so that policymakers can more efficiently target prevention and control programs.

Methods: A Bayesian multilevel model was fitted to the combined 2008-2010 Behavioral Risk Factor Surveillance System and 2009 United States Census data to estimate diabetes prevalence for each of the 78 municipios (counties) in Puerto Rico.

Results: The mean unadjusted estimate for all counties was 14.3% (range by county, 9.9%-18.0%). The average width of the confidence intervals was 6.2%. Adjusted and unadjusted estimates differed little.

Conclusions: These 78 county estimates are higher on average and showed less variability (i.e., had a smaller range) than the previously published estimates of the 2008 diabetes prevalence for all United States counties (mean, 9.9%; range, 3.0%-18.2%).

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Figures

FIGURE 1
FIGURE 1
Unadjusted prevalence of diabetes among adults 20 years of age and older in Puerto Rico by county, 2009
See this image and copyright information in PMC

References

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    1. United States Centers for Disease Control and Prevention . National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. CDC, United States Department of Health and Human Services; Atlanta, Georgia: [20 November 2012]. Available from: http://www.cdc.gov/diabetes/pubs/factsheet11.htm.
    1. United States Centers for Disease Control and Prevention . National Diabetes Surveillance System. CDC, United States Department of Health and Human Services; Atlanta, Georgia: 2011. [20 November 2012]. Available from: http://www.cdc.gov/diabetes/surveillance/index.htm.
    1. Cadwell BL, Thompson TJ, Boyle JP, Barker LE. Bayesian small area estimates of diabetes prevalence by U.S. county, 2005. JDS. 2010;2010;8:173–88.
    1. United States Institute of Medicine, Committee for the Study of the Future of Public Health . The future of public health: summary and recommendations. National Academy Press; Washington, D.C.: 1988.

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