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Journal of Public Health Advance Access originally published online on September 24, 2007
Journal of Public Health 2007 29(4):413-419; doi:10.1093/pubmed/fdm058
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© The Author 2007, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Socio-economic status, ethnicity and diabetes management: an analysis of time trends using the health survey for England



Christopher Millett, Consultant in Public Health1,

Sonia Saxena, Senior Lecturer in Primary Care1

Anthea Ng, Research Assistant1

Arch Mainous, III, Professor and Director of Research2

Azeem Majeed, Professor of Primary Care1
1 Department of Primary Care and Social Medicine, Imperial College, London W6 8RP, UK
2 Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA

Address correspondence to Christopher Millett, E-mail: c.millett{at}imperial.ac.uk


  Abstract

Background The National Health Service (NHS) has invested substantially in recent years to reduce variations in health care for chronic conditions such as diabetes. We examined trends in the management of diabetes in England between socio-economic and ethnic groups from 1998 to 2004.

Methods Secondary analyses of Health Survey for England data comparing achievement of national treatment target for blood glucose, blood pressure and cholesterol and use of medications in survey respondents with diabetes.

Results The proportion of respondents with diabetes achieving national treatment targets increased significantly between 1998 and 2004. There was a significantly lower increase in blood pressure control in the black group [13.9% (95% confidence interval (CI) 13.0–14.8%)] but higher increase in south Asian and white Irish groups when compared to the white British group [15.7% (95% CI 15.4–16.0%)]. Manual workers experienced lower improvements in blood pressure control [15.3% (95% CI 14.9–15.7%) versus 16.7% (95% CI 16.2–17.2%)] but higher improvements in cholesterol control [10.3% (95% CI 9.7–10.9%) versus 7.4% (95% CI 6.8–8.0%)] when compared to non-manual workers.

Conclusion There were considerable improvements in the management of diabetes in England during a period of sustained investment in health care quality but these were not distributed uniformly across ethnic and socio-economic groups.

Keywords: diabetes management, ethnicity, Health Survey for England, socio-economic status, time trends


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