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Diabetes Care Among Somali Immigrants and Refugees

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Abstract

The risk for development of diabetes and associated complications among immigrants increases in the years after arrival to the United States. Somali immigrants and refugees represent the largest subset of African immigrants to the United States, yet little is known about the quality of their diabetes care. Therefore, adherence with diabetes quality indicators (Hemoglobin A1C <7%, LDL cholesterol <100 mg/dl, blood pressure <130/80 mm Hg) were compared between Somali and non-Somali patients with diabetes at a large academic primary care practice in the United States in 2008. Demographic and health-seeking behavior variables were assessed for association with adherence among the Somali population. A total of 5,843 non-Somali and 81 Somali patients with diabetes were identified. Somali patients with diabetes were less likely to meet the criteria for optimal glycemic control than non-Somali patients (40.6% vs. 53.9%; P = 0.02). There was a similar, though statistically non-significant, trend towards lower rates of lipid control among Somali patients. There was no difference in achievement of optimal blood pressure between the two groups. There was a strong association between number of primary care visits during the study interval and achievement of all three diabetes care quality goals. This study demonstrates disparities in achievement of diabetes management quality goals among Somali patients compared with non-Somali patients, highlighting the need for additional system and practice changes to target this particularly vulnerable population.

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References

  1. Lanting, L. C., Joung, I. M., Mackenbach, J. P., Lamberts, S. W., & Bootsma, A. H. (2005). Ethnic differences in mortality, end-stage complications, and quality of care among diabetic patients: A review. Diabetes Care, 28(9), 2280–2288.

    Article  PubMed  Google Scholar 

  2. Dallo, F. J., Wilson, F. A., & Stimpson, J. P. (2009). Quality of diabetes care for immigrants in the US. Diabetes Care, 32(8), 1459–1463.

    Article  PubMed  Google Scholar 

  3. Mainous, A. G., 3rd, Diaz, V. A., Saxena, S., & Geesey, M. E. (2007). Heterogeneity in management of diabetes mellitus among Latino ethnic subgroups in the United States. Journal of the American Board of Family Medicine, 20(6), 598–605.

    Article  PubMed  Google Scholar 

  4. Singh, G. K., & Siahpush, M. (2001). All-cause and cause-specific mortality of immigrants and native born in the United States. American Journal of Public Health, 91(3), 392–399.

    Article  PubMed  CAS  Google Scholar 

  5. Goel, M. S., McCarthy, E. P., Phillips, R. S., & Wee, C. C. (2004). Obesity among US immigrant subgroups by duration of residence. JAMA, 292(23), 2860–2867.

    Article  PubMed  CAS  Google Scholar 

  6. Kaplan, M. S., Huguet, N., Newsom, J. T., & McFarland, B. H. (2004). The association between length of residence and obesity among Hispanic immigrants. American Journal of Preventive Medicine, 27(4), 323–326.

    Article  PubMed  Google Scholar 

  7. Creatore, M. I., Moineddin, R., Booth, G., Manuel, D. H., DesMeules, M., McDermott, S., et al. (2010). Age- and sex-related prevalence of diabetes mellitus among immigrants to Ontario, Canada. CMAJ, 182(8), 781–789.

    Article  PubMed  Google Scholar 

  8. Bursztyn, M., & Raz, I. (1995). Blood pressure and insulin in Ethiopian immigrants: longitudinal study. Journal of Human Hypertension, 9(4), 245–248.

    PubMed  CAS  Google Scholar 

  9. Medalie, J. H., Papier, C. M., Goldbourt, U., & Herman, J. B. (1975). Major factors in the development of diabetes mellitus in 10,000 men. Archives of Internal Medicine, 135(6), 811–817.

    Article  PubMed  CAS  Google Scholar 

  10. Uitewaal, P. J., Manna, D. R., Bruijnzeels, M. A., Hoes, A. W., & Thomas, S. (2004). Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: A systematic review. Preventive Medicine, 39(6), 1068–1076.

    Article  PubMed  CAS  Google Scholar 

  11. Kinzie, J. D., Riley, C., McFarland, B., Hayes, M., Boehnlein, J., Leung, P., et al. (2008). High prevalence rates of diabetes and hypertension among refugee psychiatric patients. The Journal of Nervous and Mental Disease, 196(2), 108–112.

    Article  PubMed  Google Scholar 

  12. Desai, J. (2004). State-based diabetes surveillance among minority populations. Preventing Chronic Disease, 1(2), A03.

    PubMed  Google Scholar 

  13. American Diabetes Association. (2008). Standards of medical care in diabetes 2008. Diabetes Care, 31(Suppl 1), S12e54.

    Google Scholar 

  14. Nelson, K. M., Chapko, M. K., Reiber, G., & Boyko, E. J. (2005). The association between health insurance coverage and diabetes care; data from the 2000 behavioral risk factor surveillance system. Health Services Research, 40(2), 361–372.

    Article  PubMed  Google Scholar 

  15. Schillinger, D., Grumbach, K., Piette, J., Wang, F., Osmond, D., Daher, C., et al. (2002). Association of health literacy with diabetes outcomes. JAMA, 288(4), 475–482.

    Article  PubMed  Google Scholar 

  16. Fernandez, A., Schillinger, D., Warton, E. M., Adler, N., Moffet, H. H., Schenker, Y., et al. (2011). Language barriers, physician-patient language concordance, and glycemic control among insured Latinos with diabetes: The diabetes study of Northern California (DISTANCE). Journal of General Internal Medicine, 26(2), 170–176.

    Article  PubMed  Google Scholar 

  17. Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. Journal of Immigrant and Minor Health, 11(6), 460–467.

    Article  Google Scholar 

  18. Derose, K. P., Bahney, B. W., Lurie, N., & Escarce, J. J. (2009). Review: Immigrants and health care access, quality, and cost. Medical Care Research and Review, 66(4), 355–408.

    Article  PubMed  Google Scholar 

  19. McEwen, A., Straus, L., & Croker, H. (2009). Dietary beliefs and behaviour of a UK Somali population. Journal of Human Nutrition Dietetics, 22(2), 116–121.

    Article  CAS  Google Scholar 

  20. McEwen, A., Straus, L., & Ussher, M. (2008). Physical inactivity among a UK Somali population. Journal of Public Health (Oxford), 30(1), 110.

    Article  Google Scholar 

  21. Jain, S., & Chou, C. L. (2000). Use of an orientation clinic to reduce failed new patient appointments in primary care. Journal of General Internal Medicine, 15(12), 878–880.

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

Mark L. Wieland, T. Ben Morrison, Stephen S. Cha and Ahmed S. Rahman have no financial disclosures or conflicts of interest. Rajeev Chaudhry is an employee of Mayo Clinic and the inventor of the GDMS software referenced in this publication. Mayo Clinic has licensed this technology to a commercial entity (VitalHealth Software) but to date has received no royalties. Dr. Chaudhry receives no royalties from the licensing of this technology.

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Authors and Affiliations

  1. Division of Primary Care Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55904, USA

    Mark L. Wieland & Rajeev Chaudhry

  2. Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    T. Ben Morrison

  3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    Stephen S. Cha

  4. Division of Health Care Policy and Research, Mayo Clinic College of Medicine, Rochester, MN, USA

    Ahmed S. Rahman

Authors
  1. Mark L. Wieland
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  2. T. Ben Morrison
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  3. Stephen S. Cha
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  4. Ahmed S. Rahman
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  5. Rajeev Chaudhry
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Correspondence to Mark L. Wieland.

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Wieland, M.L., Morrison, T.B., Cha, S.S. et al. Diabetes Care Among Somali Immigrants and Refugees. J Community Health 37, 680–684 (2012). https://doi.org/10.1007/s10900-011-9499-7

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  • DOI: https://doi.org/10.1007/s10900-011-9499-7

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