Influence of depression on racial and ethnic disparities in diabetes control
Authors' conclusion
The influence of depression on disparities in diabetes control was small. High rates of depression among people with diabetes, especially among those from racial and ethnic minoritized groups, highlight a need to ensure equitable and coordinated care for both conditions, as the effects of mental health treatment may extend to the control of physical health conditions.
Study context
- Population
- Veterans Health Administration (VHA) patients with diabetes
- Participants
- 815,067 participants
- Exposure
- Racial and ethnic minoritized groups vs White patients; depression as mediator, mental health treatment as moderator
- Outcome
- Poor diabetes control (HbA1c >9%); indirect effect of depression on racial and ethnic disparities
Methodological detailsnational cohort, administrative data, linear mixed effects regression
- National cohort
- Administrative data
- Linear mixed effects regression
Main finding
As reported in the abstract
Absolute proportion of disparities accounted for by depression, Hispanic patients (lowest)
0.2%
Absolute proportion of disparities accounted for by depression, Asian patients (highest)
2.0%
Observational data: associations, not effects.
Further findings
| Outcome | Percentage point difference (95% CI) | |
|---|---|---|
| Probability of poor diabetes control, minoritized groupsvs White patients | 5.2% (4.3%–6.0%) | |
| −50510Difference (linear scale) |
- Probability of poor diabetes control, minoritized groups vs White patients: largest difference; higher with American Indian or Alaska Native
Poor diabetes control and depression, overall cohort
- Poor diabetes control
- 20%
- Depression
- 22%
- Depression more common among racial and ethnic minoritized groups
Probability of poor diabetes control, minoritized groups vs White patients
- Probability higher for most minoritized groups vs White patients
Poor diabetes control by mental health visits in patients with depression
- 5+ mental health visits: lower probability of poor diabetes control vs fewer visits, regardless of antidepressant prescription status
Original publication
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