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Changes in Disparity in County-Level Diagnosed Diabetes Prevalence and Incidence in the United States, between 2004 and 2012

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  • Sundar S Shrestha
  • Theodore J Thompson
  • Karen A Kirtland
  • Edward W Gregg
  • Gloria L Beckles
  • Elizabeth T Luman
  • Lawrence E Barker
  • Linda S Geiss

Abstract

Background: In recent decades, the United States experienced increasing prevalence and incidence of diabetes, accompanied by large disparities in county-level diabetes prevalence and incidence. However, whether these disparities are widening, narrowing, or staying the same has not been studied. We examined changes in disparity among U.S. counties in diagnosed diabetes prevalence and incidence between 2004 and 2012. Methods: We used 2004 and 2012 county-level diabetes (type 1 and type 2) prevalence and incidence data, along with demographic, socio-economic, and risk factor data from various sources. To determine whether disparities widened or narrowed over the time period, we used a regression-based β-convergence approach, accounting for spatial autocorrelation. We calculated diabetes prevalence/incidence percentage point (ppt) changes between 2004 and 2012 and modeled these changes as a function of baseline diabetes prevalence/incidence in 2004. Covariates included county-level demographic and, socio-economic data, and known type 2 diabetes risk factors (obesity and leisure-time physical inactivity). Results: For each county-level ppt increase in diabetes prevalence in 2004 there was an annual average increase of 0.02 ppt (p

Suggested Citation

  • Sundar S Shrestha & Theodore J Thompson & Karen A Kirtland & Edward W Gregg & Gloria L Beckles & Elizabeth T Luman & Lawrence E Barker & Linda S Geiss, 2016. "Changes in Disparity in County-Level Diagnosed Diabetes Prevalence and Incidence in the United States, between 2004 and 2012," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-16, August.
    • Handle: RePEc:plo:pone00:0159876
    DOI: 10.1371/journal.pone.0159876
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    References listed on IDEAS

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    1. Zijun Wang, 2009. "The convergence of health care expenditure in the US states," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 55-70, January.
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