Diabetes mortality across the 30 biggest U.S. cities: Assessing overall trends and racial inequities. (March 2021)

• Record Type: Journal Article
• Authors: Buscemi, Joanna; Saiyed, Nazia; Silva, Abigail; Ghahramani, Fereshteh; Benjamins, Maureen R.
• Is Part Of: Diabetes research and clinical practice. Volume 173(2021)
• Publication Date: 2021-03
• Subjects: Disparity -- Diabetes -- Mortality -- Local Data -- Health Equity; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2021.108652
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Diabetes mortality rates among Blacks are higher than White rates in all 30 cities. Diabetes mortality inequities are 4 times larger in some cities compared to others. Only 3 of the 30 largest cities had low rates of diabetes mortality and inequity. Washington, D.C. diabetes mortality inequities are the highest of all 30 cities. Abstract: Aims: National data suggest that diabetes mortality disproportionately affects Blacks compared to whites. We aimed to (1) calculate diabetes mortality rates (where diabetes was an underlying cause of death) among the general population of the U.S. and the largest 30 cities; (2) calculate Black/white mortality rate ratios and rate differences; and (3) compare changes in mortality rates and inequities across two 5-year periods (2008–2012 (T1) and 2013–2017 (T2)). Methods: We used vital statistics mortality data and American Community Survey population estimates. Results: The U.S. diabetes mortality rate at T1 was 20.91 per 100, 000, and significantly increased to 21.05 at T2. El Paso had the highest diabetes mortality rate at both time points (T1 = 33.06; T2 = 35.98), while San Francisco had the lowest rate (T1 = 11.41; T2 = 13.18). The U.S. Black mortality rate was 2.21 times higher than the white rate at T2 (95%CI [2.19–2.23]). Eleven cities had significantly higher rate ratios than the U.S. at T2. The Black:white rate ratio in Washington, D.C. was approximately three times higher than the national rate ratio. Conclusions: This city-level data is important to inform more targeted local policy interventions and programming to promote health equity, particularly within cities with the greatest inequities.