Abstract
National examination surveys provide trend information on diabetes prevalence, diagnoses, and control. Few localities have access to such information. Using a similar design as the National Health and Nutrition Examination Survey (NHANES), two NYC Health and Nutrition Examination Surveys (NYC HANES) were conducted over a decade, recruiting adults ≥ 20 years using household probability samples (n = 1808 in 2004; n = 1246 in 2013–2014) and physical exam survey methods benchmarked against NHANES. Participants had diagnosed diabetes if told by a health provider they had diabetes, and undiagnosed diabetes if they had no diagnosis but a fasting plasma glucose ≥ 126 mg/dl or A1C ≥ 6.5%. We found that between 2004 and 2014, total diabetes prevalence (diagnosed and undiagnosed) in NYC increased from 13.4 to 16.0% (P = 0.089). In 2013–2014, racial/ethnic disparities in diabetes burden had widened; diabetes was highest among Asians (24.6%), and prevalence was significantly lower among non-Hispanic white adults (7.7%) compared to that among other racial/ethnic groups (P < 0.001). Among adults with diabetes, the proportion of cases diagnosed increased from 68.3 to 77.3% (P = 0.234), and diagnosed cases with very poor control (A1C > 9%), decreased from 26.9 to 18.0% (P = 0.269), though both were non-significant. While local racial/ethnic disparities in diabetes prevalence persist, findings suggest modest improvements in diabetes diagnosis and management.
Similar content being viewed by others
References
Ali MK, Bullard KM, Saaddine JB, Cowie CC, Imperatore G, Gregg EW. Achievement of goals in U.S. diabetes care, 1999–2010. N Engl J Med. 2013;368(17):1613–24.
McWilliams J, Meara E, Zaslavsky AM, Ayanian JZ. Differences in control of cardiovascular disease and diabetes by race, ethnicity, and education: U.S. trends from 1999 to 2006 and effects of Medicare coverage. Ann Intern Med. 2009;150(8):505–15.
Stark Casagrande S, Fradkin JE, Saydah SH, Rust KF, Cowie CC. The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988–2010. Diabetes Care. 2013;36(8):2271–9.
Dresser MG, Short L, Wedemeyer L, Bredow VL, Sacks R, Larson K, et al. Public health detailing of primary care providers: New York City’s experience, 2003–2010. Am J Public Health. 2012;102(S3):S342–52.
Chamany S, Silver LD, Bassett MT, et al. Tracking diabetes: New York City’s A1C registry. Milbank Q. 2009;87(3):547–70.
Yi SS, Chamany S, Thorpe L. Academic and government partnerships to address diabetes in the USA: a narrative review. Current Diabetes Reports. 2017;17(9):75.
McCullough CM, Wang JJ, Parsons AS, Shih SC. Quality measure performance in small practices before and after electronic health record adoption. eGEMs. 2015;3(1):1131.
Boas SJ, Bishop TF, Ryan AM, Shih SC, Casalino LP. Electronic health records and technical assistance to improve quality of primary care: lessons for regional extension centers. Healthcare. 2014;2(2):103–6.
Frieden TR, Bassett MT, Thorpe LE, Farley TA. Public health in new York City, 2002–2007: confronting epidemics of the modern era. Int J Epidemiol. 2008;37(5):966–77.
Thorpe LE, Greene C, Freeman A, Snell E, Rodriguez-Lopez JS, Frankel M, et al. Rationale, design and respondent characteristics of the 2013–2014 New York City Health and Nutrition Examination Survey (NYC HANES 2013–2014). Prev Med Rep. 2015;2:580–5.
Thorpe LE, Gwynn RC, Mandel-Ricci J, Roberts S, Tsoi B, Berman L, et al. Study design and participation rates of the New York City Health and Nutrition Examination Survey, 2004. Prev Chronic Dis. 2006;3(3):A94.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013;36(Supplement 1):S67–74.
Rizzo L, Moser RP, Waldron W, Wang Z, Davis WW. Analytic methods to examine changes across years using HINTS 2003 & 2005 data. Washington DC: US Department of Health and Human Services, National Cancer Institute. 2008.
McNeely MJ, Boyko EJ. Type 2 diabetes prevalence in Asian Americans. Diabetes Care. 2004;27(1):66–9.
Chamany S, Jiang Q, Wu W. Trends in blood sugar control among adults with diabetes in New York City, 2006–2012. New York City Department of Health and Mental Hygiene: Epi Data Brief (53). 2015.
Acknowledgments
Support for NYCHANES 2013–2014 was primarily provided by the de Beaumont Foundation with additional support from the Robert Wood Johnson Foundation, Robin Hood, the New York State Health Foundation, Quest Diagnostics, and the Doris Duke Charitable Foundation, NYC Department of Health and Mental Hygiene, Hunter College Office of the Provost, the City University of New York (CUNY) Vice Chancellors Office of Research, and the CUNY School of Public Health Dean’s Office. Additional support was provided by the Centers for Disease Control and Prevention-funded NYU-CUNY Prevention Research Center (U48DP005008). The contents of this paper are solely the responsibility of the authors and do not represent the official views of the funders.
The authors thank the many people at CUNY and the New York City Health Department who provided support to the survey, including our dedicated field staff team, as well as study participants who made the study possible. We are also grateful to Charon Gwynn, James Hadler, Sonia Angell, Katherine Sutkowi, Winfred Wu, and Sandra Echeverria for their valuable suggestions for this manuscript.
Author information
Authors and Affiliations
Contributions
All authors have contributed to the conception, analysis, interpretation, writing, and final approval of the manuscript and will take public responsibility for its content. LT, SP, and AF designed the study being described; RK, LT, CC, and JRL cleaned, analyzed, and verified the data; LT and RK drafted most sections of this manuscript; and SC and SP led the editing and refinement process. All authors reviewed and commented on the manuscript.
Corresponding author
Rights and permissions
About this article
Cite this article
Thorpe, L.E., Kanchi, R., Chamany, S. et al. Change in Diabetes Prevalence and Control among New York City Adults: NYC Health and Nutrition Examination Surveys 2004–2014. J Urban Health 95, 826–831 (2018). https://doi.org/10.1007/s11524-018-0285-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11524-018-0285-z