Skip to main content

Advertisement

Log in

The economic consequences of diabetes and cardiovascular disease in the United States

  • Published:
Reviews in Endocrine and Metabolic Disorders Aims and scope Submit manuscript

Abstract

Diabetes-related care and complications constitute a significant proportion of the United States’ (US) health care expenditure. Of these complications, cardiovascular disease (CVD) is a major component. Higher morbidity and mortality rates translate to higher costs of care in patients with diabetes compared to those who do not have the disease. Minorities bear a disproportionate burden of diabetes and CVD. We review this disparity and examine potential etiologies for it in Hispanics and African-Americans, the two largest minority groups in the US. We examine strategies in these populations that may improve outcomes in diabetes and CVD, potentially decreasing health care costs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kaiser Family Foundation. Snapshots: Healthcare Spending in the United States and OECD Countries. 2007(August 31).

  2. Centers for Medicare and Medicaid Services. National Health Expenditures 2007 Highlights. 2007(09/01).

  3. Office of the Actuary, Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services. National Health Expenditure Data Highlights. 2009; Available at: http://www.cms.hhs.gov/NationalHealthExpendData/downloads/highlights.pdf. Accessed 08/25, 2009.

  4. National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007 fact sheet. 2008(08/28).

  5. American Diabetes Association. Economic costs of diabetes in the U.S. in 2007. Diabetes Care. 2008;31(3):596–615.

    Google Scholar 

  6. Centers for Disease Control and Prevention (CDC). Self-reported heart disease and stroke among adults with and without diabetes—United States, 1999-2001. MMWR—Morb Mort Wkly Rep. 2003;52(44):1065–70.

    Google Scholar 

  7. Kannel WB, McGee DL. Diabetes and cardiovascular risk factors: the Framingham study. Circulation. 1979;59(1):8–13.

    CAS  PubMed  Google Scholar 

  8. Natali A, Vichi S, Landi P, Severi S, L’Abbate A, Ferrannini E. Coronary atherosclerosis in Type II diabetes: angiographic findings and clinical outcome. Diabetologia. 2000;43(5):632–41.

    CAS  PubMed  Google Scholar 

  9. Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the multiple risk factor intervention trial. Diabetes Care. 1993;16(2):434–44.

    CAS  PubMed  Google Scholar 

  10. Fu AZ, Qiu Y, Radican L, Wells BJ. Health care and productivity costs associated with diabetic patients with macrovascular comorbid conditions. Diabetes Care. 2009;32(12):2187–92.

    PubMed  Google Scholar 

  11. O’Brien JA, Shomphe LA, Kavanagh PL, Raggio G, Caro JJ. Direct medical costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care. 1998;21(7):1122–8.

    PubMed  Google Scholar 

  12. Caro JJ, Ward AJ, O’Brien JA. Lifetime costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care. 2002;25(3):476–81.

    PubMed  Google Scholar 

  13. Kaiser Family Foundation. Trends in Health Care Costs and Spending. 2007; Available at: http://www.kff.org/insurance/upload/7692.pdf. Accessed 08/25, 2009.

  14. Russo CA, Jiang HJ. Hospital Stays among Patients with Diabetes, 2004. HCUP Statistical Brief #17. 2006; Available at: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb17.pdf. Accessed 08/25, 2009.

  15. Nichols GA, Brown JB. The impact of cardiovascular disease on medical care costs in subjects with and without type 2 diabetes. Diabetes Care. 2002;5(3):482.

    Google Scholar 

  16. Clark MA, Bakhai A, Lacey MJ, Pelletier EM, Cohen DJ. Clinical and economic outcomes of percutaneous coronary interventions in the elderly: an analysis of Medicare claims data. Circulation. 2004;110(3):259–64.

    PubMed  Google Scholar 

  17. Franco OH, Steyerberg EW, Hu FB, Mackenbach J, Nusselder W. Associations of diabetes mellitus with total life expectancy and life expectancy with and without cardiovascular disease. Arch Intern Med. 2007;11(11):1145–51.

    Google Scholar 

  18. Bradshaw D, Norman R, Pieterse D, Levitt NS, South African Comparative Risk Assessment Collaborating Group. Estimating the burden of disease attributable to diabetes in South Africa in 2000. South African Medical Journal. 2007;97(8 Pt 2):700–6.

    PubMed  Google Scholar 

  19. Cowie CC, Rust KF, Ford ES, Eberhardt MS, Byrd-Holt DD, Li C, et al. Full accounting of diabetes and pre-diabetes in the U.S. population in 1988–1994 and 2005–2006. Diabetes Care. 2009;32(2):287–94.

    PubMed  Google Scholar 

  20. Levitan EB, Song Y, Ford ES, Liu S. Is nondiabetic hyperglycemia a risk factor for cardiovascular disease? A meta-analysis of prospective studies. Arch Intern Med. 2004;164(19):2147–55.

    PubMed  Google Scholar 

  21. Selvin E, Coresh J, Golden SH, Brancati FL, Folsom AR, Steffes MW. Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study. Arch Intern Med. 2005;165(16):1910–6.

    PubMed  Google Scholar 

  22. Nichols GA, Brown JB. Higher medical care costs accompany impaired fasting glucose. Diabetes Care. 2005;28(9):2223–9.

    PubMed  Google Scholar 

  23. Diabetes Prevention Program Research Group. Within-trial cost-effectiveness of lifestyle intervention or metformin for the primary prevention of type 2 diabetes. Diabetes Care. 2003;26(9):2518–23.

    Google Scholar 

  24. Herman WH, Hoerger TJ, Brandle M, Hicks K, Sorensen S, Zhang P, et al. The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance. Ann Intern Med. 2005;142(5):323–32.

    PubMed  Google Scholar 

  25. CDC Diabetes Cost-effectiveness Group. Cost-effectiveness of intensive glycemic control, intensified hypertension control, and serum cholesterol level reduction for type 2 diabetes. JAMA. 2002;287(19):2542–51.

    Google Scholar 

  26. Narayan KM, Boyle JP, Geiss LS, Saaddine JB, Thompson TJ. Impact of recent increase in incidence on future diabetes burden: U.S., 2005–2050. Diabetes Care. 2006;29(9):2114–6.

    PubMed  Google Scholar 

  27. U.S. Census Bureau, Population Division, Population Projections Branch. National Population Projections. 2008;2009(08/25).

  28. Gu K, Cowie CC, Harris MI. Diabetes and decline in heart disease mortality in US adults. JAMA. 1999;281(14):1291–7.

    CAS  PubMed  Google Scholar 

  29. Sundquist J, Winkleby MA, Pudaric S. Cardiovascular disease risk factors among older black, Mexican-American, and white women and men: an analysis of NHANES III, 1988-1994. Third National Health and Nutrition Examination Survey. J Am Geriatr Soc. 2001;49(2):109–16.

    CAS  PubMed  Google Scholar 

  30. Centers for Disease Control and Prevention (CDC). National Diabetes Fact Sheet: general information and national estimates on diabetes in the United States, 2007. 2009; Available at: http://www.cdc.gov. Accessed 10/22, 2009.

  31. Perez Gomez G, Huffman FG. Risk factors for type 2 diabetes and cardiovascular diseases in Hispanic adolescents. J Adolesc Health. 2008;43(5):444–50.

    PubMed  Google Scholar 

  32. Mitchell BD, Almasy LA, Rainwater DL, Schneider JL, Blangero J, Stern MP, et al. Diabetes and hypertension in Mexican American families: relation to cardiovascular risk. Am J Epidemiol. 1999;149(11):1047–56.

    CAS  PubMed  Google Scholar 

  33. West SK, Klein R, Rodriguez J, Munoz B, Broman AT, Sanchez R, et al. Diabetes and diabetic retinopathy in a Mexican-American population: Proyecto VER. Diabetes Care. 2001;24(7):1204–9.

    CAS  PubMed  Google Scholar 

  34. Lindeman RD, Romero LJ, Hundley R, Allen AS, Liang HC, Baumgartner RN, et al. Prevalences of type 2 diabetes, the insulin resistance syndrome, and coronary heart disease in an elderly, biethnic population. Diabetes Care. 1998;21(6):959–66.

    CAS  PubMed  Google Scholar 

  35. Residori L, Garcia-Lorda P, Flancbaum L, Pi-Sunyer FX, Laferrere B. Prevalence of co-morbidities in obese patients before bariatric surgery: effect of race. Obes Surg. 2003;13(3):333–40.

    PubMed  Google Scholar 

  36. Hertz RP, Unger AN, Ferrario CM. Diabetes, hypertension, and dyslipidemia in Mexican Americans and non-Hispanic whites. Am J Prev Med. 2006;30(2):103–10.

    PubMed  Google Scholar 

  37. Harris MI. Racial and ethnic differences in health care access and health outcomes for adults with type 2 diabetes. Diabetes Care. 2001;24(3):454–9.

    CAS  PubMed  Google Scholar 

  38. Haffner SM. Hypertension in the San Antonio Heart Study and the Mexico City diabetes Study: clinical and metabolic correlates. Public Health Rep. 1996;111 Suppl 2:11–4.

    PubMed  Google Scholar 

  39. Rewers M, Shetterly SM, Hamman RF. Hypertension among rural Hispanics and non-Hispanic whites: the San Luis Valley Diabetes Study. Public Health Rep. 1996;111 Suppl 2:27–9.

    PubMed  Google Scholar 

  40. Lorenzo C, Serrano-Rios M, Martinez-Larrad MT, Gabriel R, Williams K, Gonzalez-Villalpando C, et al. Prevalence of hypertension in Hispanic and non-Hispanic white populations. Hypertension. 2002;39(2):203–8.

    CAS  PubMed  Google Scholar 

  41. Budoff MJ, Nasir K, Mao S, Tseng PH, Chau A, Liu ST, et al. Ethnic differences of the presence and severity of coronary atherosclerosis. Atherosclerosis. 2006;187(2):343–50.

    CAS  PubMed  Google Scholar 

  42. Cowie CC, Harris MI. Ambulatory medical care for non-Hispanic whites, African-Americans, and Mexican-Americans with NIDDM in the U.S. Diabetes Care. 1997;20(2):142–7.

    CAS  PubMed  Google Scholar 

  43. Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW. Are health care professionals advising patients with diabetes or at risk for developing diabetes to exercise more? Diabetes Care. 2006;29(3):543–8.

    PubMed  Google Scholar 

  44. Correa-de-Araujo R, Stevens B, Moy E, Nilasena D, Chesley F, McDermott K. Gender differences across racial and ethnic groups in the quality of care for acute myocardial infarction and heart failure associated with comorbidities. Women’s Health Issues. 2006;16(2):44–55.

    PubMed  Google Scholar 

  45. Baumann LC, Chang MW, Hoebeke R. Clinical outcomes for low-income adults with hypertension and diabetes. Nurs Res. 2002;51(3):191–8.

    PubMed  Google Scholar 

  46. Mainous III AG, Diaz VA, Koopman RJ, Everett CJ. Quality of care for Hispanic adults with diabetes. Fam Med. 2007;39(5):351–6.

    Google Scholar 

  47. Wendel CS, Shah JH, Duckworth WC, Hoffman RM, Mohler MJ, Murata GH. Racial and ethnic disparities in the control of cardiovascular disease risk factors in Southwest American veterans with type 2 diabetes: the Diabetes Outcomes in Veterans Study. BMC Health Serv Res. 2006;6:58.

    PubMed  Google Scholar 

  48. Ting HH, Bradley EH, Wang Y, Lichtman JH, Nallamothu BK, Sullivan MD, et al. Factors associated with longer time from symptom onset to hospital presentation for patients with ST-elevation myocardial infarction. Arch Intern Med. 2008;168(9):959–68.

    PubMed  Google Scholar 

  49. Swenson CJ, Trepka MJ, Rewers MJ, Scarbro S, Hiatt WR, Hamman RF. Cardiovascular disease mortality in Hispanics and non-Hispanic whites. Am J Epidemiol. 2002;156(10):919–28.

    PubMed  Google Scholar 

  50. Akerblom JL, Costa R, Luchsinger JA, Manly JJ, Tang MX, Lee JH, et al. Relation of plasma lipids to all-cause mortality in Caucasian, African-American and Hispanic elders. Age Ageing. 2008;37(2):207–13.

    PubMed  Google Scholar 

  51. Winkleby MA. Concerns and misconceptions about cardiovascular disease risk factors: a focus group evaluation with low-income hispanic women. Hisp J Behav Sci. 1998;20(2):192–211.

    Google Scholar 

  52. Kington RS, Smith JP. Socioeconomic status and racial and ethnic differences in functional status associated with chronic diseases. Am J Public Health. 1997;87(5):805–10.

    CAS  PubMed  Google Scholar 

  53. Lorenzo C, Williams K, Gonzalez-Villalpando C, Stern MP, Hazuda HP, Haffner SM. Lower hypertension risk in Mexico City than in San Antonio. Am J Hypertens. 2005;18(3):385–91.

    PubMed  Google Scholar 

  54. Kandula NR, Diez-Roux AV, Chan C, Daviglus ML, Jackson SA, Ni H, et al. Association of acculturation levels and prevalence of diabetes in the multi-ethnic study of atherosclerosis (MESA). Diabetes Care. 2008;31(8):1621–8.

    PubMed  Google Scholar 

  55. Nettleton JA, Steffen LM, Ni H, Liu K, Jacobs Jr DR. Dietary patterns and risk of incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. 2008;31(9):1777–82.

    PubMed  Google Scholar 

  56. Alexander H, Lockwood LP, Harris MA, Melby CL. Risk factors for cardiovascular disease and diabetes in two groups of Hispanic Americans with differing dietary habits. J Am Coll Nutr. 1999;18(2):127–36.

    CAS  PubMed  Google Scholar 

  57. California Medi-Cal Type 2 Diabetes Study Group. Closing the gap: effect of diabetes case management on glycemic control among low-income ethnic minority populations: the California Medi-Cal type 2 diabetes study. Diabetes Care. 2004;27(1):95–103.

    Google Scholar 

  58. Benjamin EM, Schneider MS, Hinchey KT. Implementing practice guidelines for diabetes care using problem-based learning. A prospective controlled trial using firm systems. Diabetes Care. 1999;22(10):1672–8.

    CAS  PubMed  Google Scholar 

  59. Eamranond PP, Legedza AT, Diez-Roux AV, Kandula NR, Palmas W, Siscovick DS, et al. Association between language and risk factor levels among Hispanic adults with hypertension, hypercholesterolemia, or diabetes. Am Heart J. 2009;157(1):53–9.

    PubMed  Google Scholar 

  60. Cheng EM, Chen A, Cunningham W. Primary language and receipt of recommended health care among Hispanics in the United States. J Gen Intern Med. 2007;22 Suppl 2:283–8.

    PubMed  Google Scholar 

  61. Rosal MC, Goins KV, Carbone ET, Cortes DE. Views and preferences of low-literate Hispanics regarding diabetes education: results of formative research. Health Educ Behav. 2004;31(3):388–405.

    PubMed  Google Scholar 

  62. Hazuda HP. Hypertension in the San Antonio Heart Study and the Mexico City Diabetes Study: sociocultural correlates. Public Health Rep. 1996;111 Suppl 2:18–21.

    PubMed  Google Scholar 

  63. Sarkar U, Fisher L, Schillinger D. Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy? Diabetes Care. 2006;29(4):823–9.

    PubMed  Google Scholar 

  64. Schillinger D, Barton LR, Karter AJ, Wang F, Adler N. Does literacy mediate the relationship between education and health outcomes? A study of a low-income population with diabetes. Public Health Rep. 2006;121(3):245–54.

    PubMed  Google Scholar 

  65. Powell CK, Hill EG, Clancy DE. The relationship between health literacy and diabetes knowledge and readiness to take health actions. Diabetes Educ. 2007;33(1):144–51.

    PubMed  Google Scholar 

  66. Cavanaugh K, Huizinga MM, Wallston KA, Gebretsadik T, Shintani A, Davis D, et al. Association of numeracy and diabetes control. Ann Intern Med. 2008;148(10):737–46.

    PubMed  Google Scholar 

  67. Kuo YF, Raji MA, Markides KS, Ray LA, Espino DV, Goodwin JS. Inconsistent use of diabetes medications, diabetes complications, and mortality in older Mexican Americans over a 7-year period: data from the Hispanic established population for the epidemiologic study of the elderly. Diabetes Care. 2003;26(11):3054–60.

    PubMed  Google Scholar 

  68. Black SA. Increased health burden associated with comorbid depression in older diabetic Mexican Americans. Results from the Hispanic Established Population for the Epidemiologic Study of the Elderly survey. Diabetes Care. 1999;22(1):56–64.

    CAS  PubMed  Google Scholar 

  69. Quatromoni PA, Milbauer M, Posner BM, Carballeira NP, Brunt M, Chipkin SR. Use of focus groups to explore nutrition practices and health beliefs of urban Caribbean Latinos with diabetes. Diabetes Care. 1994;17(8):869–73.

    CAS  PubMed  Google Scholar 

  70. Lipton RB, Losey LM, Giachello A, Mendez J, Girotti MH. Attitudes and issues in treating Latino patients with type 2 diabetes: views of healthcare providers. Diabetes Educ. 1998;24(1):67–71.

    CAS  PubMed  Google Scholar 

  71. Caban A, Walker EA. A systematic review of research on culturally relevant issues for Hispanics with diabetes. Diabetes Educ. 2006;32(4):584–95.

    PubMed  Google Scholar 

  72. Galvez MP, Morland K, Raines C, Kobil J, Siskind J, Godbold J, et al. Race and food store availability in an inner-city neighbourhood. Public Health Nutr. 2008;11(6):624–31.

    PubMed  Google Scholar 

  73. Piette JD, Bibbins-Domingo K, Schillinger D. Health care discrimination, processes of care, and diabetes patients’ health status. Patient Educ Couns. 2006;60(1):41–8.

    PubMed  Google Scholar 

  74. Kaushik VP, Al Snih S, Ray LA, Raji MA, Markides KS, Goodwin JS. Factors associated with seven-year incidence of diabetes complications among older Mexican Americans. Gerontology. 2007;53(4):194–9.

    PubMed  Google Scholar 

  75. Wei M, Gaskill SP, Haffner SM, Stern MP. Effects of diabetes and level of glycemia on all-cause and cardiovascular mortality. The San Antonio Heart Study. Diabetes Care. 1998;21(7):1167–72.

    CAS  PubMed  Google Scholar 

  76. Lisabeth LD, Smith MA, Sanchez BN, Brown DL. Ethnic disparities in stroke and hypertension among women: the BASIC project. Am J Hypertens. 2008;21(7):778–83.

    PubMed  Google Scholar 

  77. Zahuranec DB, Brown DL, Lisabeth LD, Gonzales NR, Longwell PJ, Eden SV, et al. Differences in intracerebral hemorrhage between Mexican Americans and non-Hispanic whites. Neurology. 2006;66(1):30–4.

    CAS  PubMed  Google Scholar 

  78. Sacco RL, Boden-Albala B, Abel G, Lin IF, Elkind M, Hauser WA, et al. Race-ethnic disparities in the impact of stroke risk factors: the northern Manhattan stroke study. Stroke. 2001;32(8):1725–31.

    CAS  PubMed  Google Scholar 

  79. Frey JL, Jahnke HK, Bulfinch EW. Differences in stroke between white, Hispanic, and Native American patients: the Barrow Neurological Institute stroke database. Stroke. 1998;29(1):29–33.

    CAS  PubMed  Google Scholar 

  80. Ottenbacher KJ, Ostir GV, Peek MK, Markides KS. Diabetes mellitus as a risk factor for stroke incidence and mortality in Mexican American older adults. J Gerontol A Biol Sci Med Sci. 2004;59(6):M640–5.

    PubMed  Google Scholar 

  81. Otiniano ME, Du XL, Ottenbacher K, Markides KS. The effect of diabetes combined with stroke on disability, self-rated health, and mortality in older Mexican Americans: results from the Hispanic EPESE. Arch Phys Med Rehabil. 2003;84(5):725–30.

    PubMed  Google Scholar 

  82. Young BA, Maynard C, Reiber G, Boyko EJ. Effects of ethnicity and nephropathy on lower-extremity amputation risk among diabetic veterans. Diabetes Care. 2003;26(2):495–501.

    PubMed  Google Scholar 

  83. Fraser-Bell S, Wu J, Klein R, Azen SP, Hooper C, Foong AW, et al. Cardiovascular risk factors and age-related macular degeneration: the Los Angeles Latino Eye Study. Am J Ophthalmol. 2008;145(2):308–16.

    PubMed  Google Scholar 

  84. Cotter SA, Varma R, Ying-Lai M, Azen SP, Klein R, Los Angeles Latino Eye Study Group. Causes of low vision and blindness in adult Latinos: the Los Angeles Latino Eye Study. Ophthalmology. 2006;113(9):1574–82.

    PubMed  Google Scholar 

  85. Bronner YL. Nutritional status outcomes for children: ethnic, cultural, and environmental contexts. J Am Diet Assoc. 1996;96(9):891–903.

    CAS  PubMed  Google Scholar 

  86. Metghalchi S, Rivera M, Beeson L, Firek A, De Leon M, Balcazar H, et al. Improved clinical outcomes using a culturally sensitive diabetes education program in a Hispanic population. Diabetes Educ. 2008;34(4):698–706.

    PubMed  Google Scholar 

  87. Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L, et al. Meta-analysis: chronic disease self-management programs for older adults. Ann Intern Med. 2005;143(6):427–38.

    PubMed  Google Scholar 

  88. Bjorsen SS. Review: group-based education in self-management strategies improves outcomes in type 2 diabetes mellitus. Evid Based Med. 2005;10(6):173.

    Google Scholar 

  89. Mauldon M, Melkus GD, Cagganello M. Tomando Control: a culturally appropriate diabetes education program for Spanish-speaking individuals with type 2 diabetes mellitus—evaluation of a pilot project. Diabetes Educ. 2006;32(5):751–60.

    PubMed  Google Scholar 

  90. Peek ME, Cargill A, Huang ES. Diabetes health disparities: a systematic review of health care interventions. Med Care Res Rev. 2007;64(5 Suppl):101S–56S.

    PubMed  Google Scholar 

  91. Brown SA, Garcia AA, Kouzekanani K, Hanis CL. Culturally competent diabetes self-management education for Mexican Americans: the Starr County border health initiative. Diabetes Care. 2002;25(2):259–68.

    PubMed  Google Scholar 

  92. Corkery E, Palmer C, Foley ME, Schechter CB, Frisher L, Roman SH. Effect of a bicultural community health worker on completion of diabetes education in a Hispanic population. Diabetes Care. 1997;20(3):254–7.

    CAS  PubMed  Google Scholar 

  93. Fanning EL, Selwyn BJ, Larme AC, DeFronzo RA. Improving efficacy of diabetes management using treatment algorithms in a mainly Hispanic population. Diabetes Care. 2004;27(7):1638–46.

    PubMed  Google Scholar 

  94. Davidson MB. Effect of nurse-directed diabetes care in a minority population. Diabetes Care. 2003;26(8):2281–7.

    PubMed  Google Scholar 

  95. Walker EA, Schechter CB, Caban A, Basch CE. Telephone intervention to promote diabetic retinopathy screening among the urban poor. Am J Prev Med. 2008;34(3):185–91.

    PubMed  Google Scholar 

  96. Wheeler LA, Wheeler ML, Ours P, Swider C. Evaluation of computer-based diet education in persons with diabetes mellitus and limited educational background. Diabetes Care. 1985;8(6):537–44.

    CAS  PubMed  Google Scholar 

  97. Gerber BS, Brodsky IG, Lawless KA, Smolin LI, Arozullah AM, Smith EV, et al. Implementation and evaluation of a low-literacy diabetes education computer multimedia application. Diabetes Care. 2005;28(7):1574–80.

    PubMed  Google Scholar 

  98. Volandes AE, Ariza M, Abbo ED, Paasche-Orlow M. Overcoming educational barriers for advance care planning in Latinos with video images. J Palliat Med. 2008;11(5):700–6.

    PubMed  Google Scholar 

  99. Dannenbaum D, Verronneau M, Torrie J, Smeja H, Robinson E, Dumont C, et al. Comprehensive computerized diabetes registry. Serving the Cree of Eeyou Istchee (eastern James Bay). Can Fam Physician. 1999;45:364–70.

    CAS  PubMed  Google Scholar 

  100. Campion FX, Tully GL, Barrett JA, Andre P, Sweeney A. Improving quality of care using a diabetes registry and disease management services in an integrated delivery network. Dis Manag. 2005;8(4):245–52.

    PubMed  Google Scholar 

  101. Zgibor JC, Orchard TJ, Saul M, Piatt G, Ruppert K, Stewart A, et al. Developing and validating a diabetes database in a large health system. Diabetes Res Clin Pract. 2007;75(3):313–9.

    PubMed  Google Scholar 

  102. Bindon J, Dressler WW, Gilliland MJ, Crews DE. A cross-cultural perspective on obesity and health in three groups of women: the Mississippi Choctaw, American Samoans, and African Americans. Coll Antropol. 2007;31(1):47–54.

    PubMed  Google Scholar 

  103. Sundquist J, Winkleby MA, Pudaric S. Cardiovascular disease risk factors among older black, Mexican-American, and white women and men: an analysis of NHANES III, 1988-1994. Third National Health and Nutrition Examination Survey. J Am Geriatr Soc. 2001;49(2):109–16.

    CAS  PubMed  Google Scholar 

  104. Diaz VA, Mainous 3rd AG, Koopman RJ, Geesey ME. Undiagnosed obesity: implications for undiagnosed hypertension, diabetes, and hypercholesterolemia. Fam Med. 2004;36(9):639–44.

    PubMed  Google Scholar 

  105. Wilson DM, Wang Y, Cullen KW, Baranowski T, Himes JH, Gross M, et al. Assessing weight-related biochemical cardiovascular risk factors in African-American girls. Obes Res. 2004;12(Suppl):73S–83S.

    PubMed  Google Scholar 

  106. Schneider EC, Zaslavsky AM, Epstein AM. Racial disparities in the quality of care for enrollees in medicare managed care. JAMA. 2002;287(10):1288–94.

    PubMed  Google Scholar 

  107. Carter JS, Pugh JA, Monterrosa A. Non-insulin-dependent diabetes mellitus in minorities in the United States. Ann Intern Med. 1996;125(3):221–32.

    CAS  PubMed  Google Scholar 

  108. Feinglass J, Abadin S, Thompson J, Pearce WH. A census-based analysis of racial disparities in lower extremity amputation rates in Northern Illinois, 1987-2004. J Vasc Surg. 1001;47(5):1001–7. discussion 1007.

    Google Scholar 

  109. Brothers TE, Robison JG, Elliott BM. Diabetes mellitus is the major risk factor for African Americans who undergo peripheral bypass graft operation. J Vasc Surg. 1999;29(2):352–9.

    CAS  PubMed  Google Scholar 

  110. Davis SK, Liu Y, Gibbons GH. Disparities in trends of hospitalization for potentially preventable chronic conditions among African Americans during the 1990s: implications and benchmarks. Am J Public Health. 2003;93(3):447–55.

    PubMed  Google Scholar 

  111. Asher CR, Topol EJ, Moliterno DJ. Insights into the pathophysiology of atherosclerosis and prognosis of black Americans with acute coronary syndromes. AmHeart J. 1999;138(6 Pt 1):1073–81.

    CAS  PubMed  Google Scholar 

  112. Vaccaro O, Stamler J, Neaton JD. Sixteen-year coronary mortality in black and white men with diabetes screened for the Multiple Risk Factor Intervention Trial (MRFIT). Int J Epidemiol. 1998;27(4):636–41.

    CAS  PubMed  Google Scholar 

  113. Rosenberg L, Palmer JR, Rao RS, Adams-Campbell LL. Risk factors for coronary heart disease in African American women. Am J Epidemiol. 1999;150(9):904–9.

    CAS  PubMed  Google Scholar 

  114. Stevens J, Plankey MW, Williamson DF, Thun MJ, Rust PF, Palesch Y, et al. The body mass index-mortality relationship in white and African American women. Obes Res. 1998;6(4):268–77.

    CAS  PubMed  Google Scholar 

  115. Okosun IS, Cooper RS, Rotimi CN, Osotimehin B, Forrester T. Association of waist circumference with risk of hypertension and type 2 diabetes in Nigerians, Jamaicans, and African-Americans. Diabetes Care. 1998;21(11):1836–42.

    CAS  PubMed  Google Scholar 

  116. Qureshi AI, Suri MF, Zhou J, Divani AA. African American women have poor long-term survival following ischemic stroke. Neurology. 2006;67(9):1623–9.

    PubMed  Google Scholar 

  117. Dwyer EM, Asif M, Ippolito T, Gillespie M. Role of hypertension, diabetes, obesity, and race in the development of symptomatic myocardial dysfunction in a predominantly minority population with normal coronary arteries. Am Heart J. 2000;139(2 Pt 1):297–304.

    CAS  PubMed  Google Scholar 

  118. Ettinger LM, Freeman K, DiMartino-Nardi JR, Flynn JT. Microalbuminuria and abnormal ambulatory blood pressure in adolescents with type 2 diabetes mellitus. J Pediatr. 2005;147(1):67–73.

    CAS  PubMed  Google Scholar 

  119. Smith GL, Shlipak MG, Havranek EP, Masoudi FA, McClellan WM, Foody JM, et al. Race and renal impairment in heart failure: mortality in blacks versus whites. Circulation. 2005;111(10):1270–7.

    PubMed  Google Scholar 

  120. Young BA, Maynard C, Boyko EJ. Racial differences in diabetic nephropathy, cardiovascular disease, and mortality in a national population of veterans. Diabetes Care. 2003;26(8):2392–9.

    PubMed  Google Scholar 

  121. Emanuele N, Sacks J, Klein R, Reda D, Anderson R, Duckworth W, et al. Ethnicity, race, and baseline retinopathy correlates in the Veterans’ Affairs Diabetes Trial. Diabetes Care. 2005;28(8):1954–8.

    PubMed  Google Scholar 

  122. Harris MI, Klein R, Cowie CC, Rowland M, Byrd-Holt DD. Is the risk of diabetic retinopathy greater in non-Hispanic blacks and Mexican Americans than in non-Hispanic whites with type 2 diabetes? A U.S. population study. Diabetes Care. 1998;21(8):1230–5.

    CAS  PubMed  Google Scholar 

  123. Tanaka M, Jaamaa G, Kaiser M, Hills E, Soim A, Zhu M, et al. Racial disparity in hypertensive disorders of pregnancy in New York State: a 10-year longitudinal population-based study. Am J Public Health. 2007;97(1):163–70.

    PubMed  Google Scholar 

  124. Ruland S, Raman R, Chaturvedi S, Leurgans S, Gorelick PB, AAASPS Investigators. African American Antiplatelet Stroke Prevention Study. Awareness, treatment, and control of vascular risk factors in African Americans with stroke. Neurology. 2003;60(1):64–8.

    CAS  PubMed  Google Scholar 

  125. Cook CB, Ziemer DC, El-Kebbi IM, Gallina DL, Dunbar VG, Ernst KL, et al. Diabetes in urban African-Americans. XVI. Overcoming clinical inertia improves glycemic control in patients with type 2 diabetes. Diabetes Care. 1999;22(9):1494–500.

    CAS  PubMed  Google Scholar 

  126. Blanchard MA, Rose LE, Taylor J, McEntee MA, Latchaw LL. Using a focus group to design a diabetes education program for an African American population. Diabetes Educ. 1999;25(6):917–24.

    CAS  PubMed  Google Scholar 

  127. Diez-Roux AV, Northridge ME, Morabia A, Bassett MT, Shea S. Prevalence and social correlates of cardiovascular disease risk factors in Harlem. Am J Public Health. 1999;89(3):302–7.

    CAS  PubMed  Google Scholar 

  128. Frank D, Grubbs L. A faith-based screening/education program for diabetes, CVD, and stroke in rural African Americans. ABNF J. 2008;19(3):96–101.

    PubMed  Google Scholar 

  129. Snella KA, Canales AE, Irons BK, Sleeper-Irons RB, Villarreal MC, Levi-Derrick VE, et al. Pharmacy- and community-based screenings for diabetes and cardiovascular conditions in high-risk individuals. J Am Pharm Assoc (2003). 2006;46(3):370–7.

    Google Scholar 

  130. Becker DM, Yanek LR, Johnson Jr WR, Garrett D, Moy TF, Reynolds SS, et al. Impact of a community-based multiple risk factor intervention on cardiovascular risk in black families with a history of premature coronary disease. Circulation. 2005;111(10):1298–304.

    PubMed  Google Scholar 

  131. Nine SL, Lakies CL, Jarrett HK, Davis BA. Community-based chronic disease management program for African Americans. Outcomes Manag. 2003;7(3):106–12.

    PubMed  Google Scholar 

  132. Two Feathers J, Kieffer EC, Palmisano G, Anderson M, Sinco B, Janz N, et al. Racial and ethnic approaches to community health (REACH) Detroit partnership: improving diabetes-related outcomes among African American and Latino adults. Am J Public Health. 2005;95(9):1552–60.

    PubMed  Google Scholar 

  133. Hill-Briggs F, Renosky R, Lazo M, Bone L, Hill M, Levine D, et al. Development and pilot evaluation of literacy-adapted diabetes and CVD education in urban, diabetic African Americans. J Gen Intern Med. 2008;23(9):1491–4.

    PubMed  Google Scholar 

  134. Plescia M, Herrick H, Chavis L. Improving health behaviors in an African American community: the Charlotte Racial and Ethnic Approaches to Community Health project. Am J Public Health. 2008;98(9):1678–84.

    PubMed  Google Scholar 

  135. Lindquist CH, Gower BA, Goran MI. Role of dietary factors in ethnic differences in early risk of cardiovascular disease and type 2 diabetes. Am J Clin Nutr. 2000;71(3):725–32.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James L. Rosenzweig.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ariza, M.A., Vimalananda, V.G. & Rosenzweig, J.L. The economic consequences of diabetes and cardiovascular disease in the United States. Rev Endocr Metab Disord 11, 1–10 (2010). https://doi.org/10.1007/s11154-010-9128-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11154-010-9128-2

Keywords

Navigation