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The Influence of Racial/Ethnic and Gender Concordance on Care Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus: an Analysis of the Medical Expenditure Panel Survey, 2010–2019

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Abstract

Introduction

This study examined associations between patient-provider race/ethnicity concordance and gender concordance on overall healthcare ratings, self-efficacy, and diabetes care monitoring in non-pregnant women of childbearing age with diabetes mellitus before and after adjusting for sociodemographic factors.

Methods

We analyzed longitudinal data from the 2010–2019 Medical Expenditure Panel Survey. The sample was limited to non-pregnant women of childbearing age (18–45 years) diagnosed with diabetes (unweighted n = 327; weighted n = 566,504). Bivariate analysis, logistic regression, and latent variable modeling were performed.

Results

Few racially minoritized women reported racial/ethnic and gender concordance with their healthcare provider. Only 2.9% of Hispanic women reported having a Hispanic provider and 12.1% of non-Hispanic Black women reported seeing a non-Hispanic Black provider compared to 81.1% of non-Hispanic White women who reported seeing a non-Hispanic White provider (p < .0001). Among Hispanic women, 15.3% reported seeing a female provider compared to 25.2% of non-Hispanic Black and 53.5% of non-Hispanic White women. Patient-provider race/ethnicity and gender concordance were not statistically significantly associated with overall healthcare ratings, self-efficacy, or diabetes care monitoring.

Conclusions

This study revealed a large disparity in race/ethnicity and gender concordance among minority women of reproductive age with diabetes compared to their non-Hispanic White counterparts. There is a need for larger, more robust studies to examine the influence of provider and other healthcare characteristics on diabetes-related outcomes in this understudied population.

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Data Availability

The data reported in the final manuscript are publicly available (https://meps.ahrq.gov/mepsweb/). All companion files for this study are publicly available: https://doi.org/10.3886/E182923V1.

Notes

  1. We use the term “women” when citing literature that uses this term to describe their study sample. We recognize that there are patients who have a potential for pregnancy who do not identify as “woman.” Therefore, we use the term ‘patients who have a potential for pregnancy’ to refer to individuals with DM, regardless of gender identity, who have the potential to become pregnant.

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Acknowledgements

The authors acknowledge Bala Yadu Vamsi Sankuratri, BDS, MPH, who helped on this project to fulfil his Master of Public Health program requirements. The authors also acknowledge the efforts of the Agency for Healthcare Research and Quality/Medical Expenditure Panel Survey (MEPS) in the creation of the database. The interpretation and reporting of these data are the sole responsibilities of the authors.

Funding

This work was supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under the Maternal and Child Health R50 MCH Secondary Data Analysis Research (SDAR) Program [1 R40MC41752-01–00].

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Authors and Affiliations

  1. Department of Kinesiology, The University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA

    Tiffany B. Kindratt, Godfred O. Boateng & Kyrah K. Brown

  2. Department of Communication, The University of Texas at Arlington, 700 W. Greek Row Drive, Arlington, TX, 76019, USA

    Grace Ellen Brannon

  3. School of Global Health, York University, 4700 Keele St, Toronto, M3J 1P3, Canada

    Godfred O. Boateng

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Correspondence to Tiffany B. Kindratt.

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Kindratt, T.B., Brannon, G.E., Boateng, G.O. et al. The Influence of Racial/Ethnic and Gender Concordance on Care Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus: an Analysis of the Medical Expenditure Panel Survey, 2010–2019. J. Racial and Ethnic Health Disparities (2023). https://doi.org/10.1007/s40615-023-01779-z

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