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Population-Based Assessment of Diabetes Care and Self-management Among Puerto Rican Adults in New York City

From the Bureau of Chronic Disease Epidemiology and Surveillance, New York State Department of Health, Albany (Dr Hosler, Dr Melnik), and the Department of Epidemiology, University at Albany School of Public Health, Rensselaer, New York (Dr Hosler).

Correspondence to Akiko S. Hosler, Bureau of Chronic Disease Epidemiology and Surveillance, New York State Department of Health, 565 Corning Tower, ESP, Albany, NY 12237-0679 (ash05{at}health.state.ny.us).

Purpose

The purpose of this study was to assess the status of diabetes medical care and self-management among adult Puerto Ricans in New York City.

Methods

A random-digit-dialing telephone survey with a dual-frame sampling design was employed to obtain a probability sample of adult Puerto Ricans with diagnosed diabetes (n = 606). Demographic characteristics, health status, and indicators of diabetes medical care and self-management were collected using the standard Behavioral Risk Factor Surveillance System (BRFSS) questionnaire. A statewide sample of adults with diagnosed diabetes (n = 232) was obtained from the BRFSS for comparison.

Results

Compared to New York State adults, Puerto Ricans were significantly less likely to receive annual A1C testing (72.7% vs 84.9%), cholesterol testing (67.5% vs 87.2%), blood-pressure-lowering medication (82.4% vs 91.9%), and pneumococcal vaccination (19.3% vs 28.5%, among those aged 18 to 64 years). Puerto Ricans were also less likely to take aspirin every day or every other day to prevent cardiovascular complications (30.6% vs 40.7%). Puerto Ricans were younger and more likely to have lower educational attainment and lower income than New York State adults, but they were not significantly disadvantaged in access to health care indicated by ratesof health insurance coverage, having a particular place for medical care, and frequencies of seeing a provider for diabetes.

Conclusions

These findings support the need to introduce culturally sensitive and linguistically appropriate diabetes education programs for Puerto Ricans and continue system-based diabetes care quality improvement efforts in the areas of prevention and control of cardiovascular complications, adult immunization, and A1C testing.

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