HRQOL in Diverse Ethnic Groups with Diabetes: Findings from the 2014 BRFSS
The study’s objective is to examine differences in mental and physical health-related quality of life (HRQOL) in non-Hispanic Whites, non-Hispanic Blacks, and Hispanics adults with diabetes.
A secondary analysis of 2014 Behavioral Risk Factor Surveillance System (BRFSS) data was conducted. A total of 26 states participated in the 2014 BRFSS core and optional diabetes models (n = 17,923). HRQOL was measured by the number of mentally and physically unhealthy days during the past month, respectively. A series of regression models were developed to assess differences in HRQOL without and with inclusion of demographic (age, marital status, income, gender, and education) and diabetes-related (depression, sleep time, insulin use, complications, age of diabetes diagnosis, BMI, smoking, and exercise) factors.
In the fully adjusted models (inclusion of demographic and diabetes-related factors), non-Hispanic Whites had more mentally (β = 0.88, p = 0.03) and physically (β = 1.35, p = 0.01) unhealthy days per month compared to Hispanics. Non-Hispanic Blacks (β = 1.42, p < 0.0001) also had more mentally unhealthy days per month in relation to Hispanics when adjusting for demographic and diabetes-related factors. Depression emerged as a potent predictor of mentally (β = 8.60; p < 0.0001) and physically (β = 4.43; p < 0.0001) unhealthy days in the multivariate models.
Non-Hispanic Black and White adults with diabetes may be more vulnerable to poor HRQOL compared to their Hispanic counterparts. Increased, widened application of diabetes interventions targeting depression appears warranted to improve HRQOL outcomes.
KeywordsHealth-related quality of life Diabetes Ethnic minorities
- 1.Centers for Disease Control (CDC). Age-adjusted percentage of people with diabetes aged 35 years or older reporting heart disease or stroke, by race/ethnicity, United States, 1988–2006. 2014.Google Scholar
- 2.American Diabetes Association: Standards of medical care in diabetes–2017. Diabetes Care 2017;(Suppl 1):S1-S129.Google Scholar
- 38.Tomas-Carus P, Ortega-Alonso A, Pietilainen K, Santos V, Goncalves H, Ramos J, et al. Randomized controlled trial on the effects of combined aerobic-resistance exercise on muscle strength and fatigue, glycemic control and health-related quality of life of type 2 diabetes patients. J Sports Med Phys Fitness. 2015;56(5):572–8.Google Scholar
- 42.CDC. Behavioral Risk Factor Surveillance System (BRFSS): Overview BRFSS 2014. Available at https://www.cdc.gov/brfss/annual_data/2014/pdf/overview_2014.pdf. Accessed 16 May 2017.
- 43.CDC. BRFSS 2014 Modules by state by data set & weight. Available at https://www.cdc.gov/brfss/questionnaires/state2014.htm. Accessed 16 May 2017.
- 44.CDC. BRFSS 2014 Codebook report: landline and cell-phone data. Available at https://www.cdc.gov/brfss/annual_data/2014/pdf/codebook14_llcp.pdf. Accessed 16 May 2017.
- 45.CDC. Calculated variables in the data file of the 2014 behavioral risk factor surveillance system. Available at https://www.cdc.gov/brfss/annual_data/2014/pdf/2014calculated_variables_version8pdf.. Accessed 16 May 2017.
- 46.CDC. Behavioral risk factor surveillance system module data for analysis for 2014 BRFSS. Available at https://www.cdc.gov/brfss/annual_data/2014/pdf/2014moduleanalysis.pdf. Accessed 16 May 2017.