Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Research article

Socioeconomic status and race/ethnicity independently predict health decline among older diabetics

Emily J Nicklett

Author Affiliations

School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109-1106, USA

BMC Public Health 2011, 11:684  doi:10.1186/1471-2458-11-684

Published: 2 September 2011



There are pervasive racial and socioeconomic differences in health status among older adults with type 2 diabetes. The extent to which racial/ethnic and socioeconomic disparities unfold to differential health outcomes has yet to be investigated among older adults with diabetes. This study examines whether or not race/ethnicity and SES are independent predictors of steeper rates of decline in self-rated health among older adults in the U.S. with type 2 diabetes.


The study population was a subset of diabetic adults aged 65 and older from the Health and Retirement Study. Respondents were followed up to 16 years. Multilevel cumulative logit regression models were used to examine the contributions of socioeconomic indicators, race/ethnicity, and covariates over time. Health decline was measured as a change in self-reported health status over the follow-up period.


Relative to whites, blacks had a significantly lower cumulative odds of better health status over time (OR: 0.61, p < .0001). Hispanics reported significantly lower cumulative odds better health over time relative to whites (OR: 0.59, p < .05). Although these disparities narrowed when socioeconomic characteristics were added to the model, significant differences remained. Including socioeconomic status did not remove the health effects of race/ethnicity among blacks and Hispanics.


The author found that race/ethnicity and some socioeconomic indicators were independent predictors of health decline among older adults with diabetes.