Race and Neighborhood SES Differences in the Development Trajectories of Type 1 Diabetes Management of Caucasian and Ethnic Minority Youth

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Title: Race and Neighborhood SES Differences in the Development Trajectories of Type 1 Diabetes Management of Caucasian and Ethnic Minority Youth
Author: Wang, Jenny Tzu-Mei
Abstract: Pediatric diabetes is a chronic illness that significantly impacts the lives of children and adolescents and their families . Poor metabolic control increases the risks for severe long -term consequences with debilitating effects in adulthood . Adolescence is a particularly difficult period of time for Caucasian youth as they evidence characteristic declines in metabolic control . There is some cross -sectional evidence that racial disparities in pediatric diabetes exist . However , only one study has evaluated racial disparities longitudinally and no studies have evaluated these differences across the critical period of adolescence . The aims of this retrospective study were to replicate age -related declines in metabolic control in a sample of African American youth and to characterize racial differences in the developmental trajectories of metabolic control between African American and Caucasian youth . This study also aimed to evaluate whether race effects remained beyond neighborhood SES . The sample consisted of 162 Caucasian and African American subjects matched on gender and age seen at the Children's Medical Center Dallas endocrinology outpatient clinic during 2007 . Retrospective medical record reviews were conducted for sociodemographic information and retrospective health data . Neighborhood SES variables were obtained through publicly available census databases . This retrospective investigation revealed age -related declines in metabolic control regardless of race . African American youth had higher HbA1c levels compared to Caucasian counterparts throughout ages 10 through 18 . However , African American and Caucasian youth evidenced parallel trajectories (similar rates of change ) in metabolic control across this critical period . Race retained unique explanatory effects beyond that of neighborhood SES while family structure was not a predictive variable . These results suggest that African American youth experience significant risks prior to adolescence that place them at poorer levels of metabolic control and these risks are maintained across adolescence . Adolescence may be an equally risky period for African American and Caucasian youth , highlighting the need for further research on how African American youth and their families cope with diabetes . These results provide evidence that adolescence may be a critical period for both African American and Caucasian youth and unique interventions should be developed to prevent declines in metabolic control during adolescence in both racial groups .
URI: http : / /hdl .handle .net /2152 .5 /569
Date: 2009-09-04

Citation

Race and Neighborhood SES Differences in the Development Trajectories of Type 1 Diabetes Management of Caucasian and Ethnic Minority Youth. Graduate School of Biomedical Sciences. Available electronically from http : / /hdl .handle .net /2152 .5 /569 .

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