Abstract
Purpose of Review
Type 1 diabetes (T1D) incidence is growing faster among Latino than non-Latino White youth, but ethnic disparities in self-management behaviors and HbA1c are unclear. Socioeconomic status (SES) is a key factor in T1D, which may confound or contribute to disparities in Latino pediatric T1D management. A systematic review examined whether ethnic differences in pediatric T1D outcomes occur and are independent of socioeconomic status (SES).
Recent Findings
Latino youth displayed lower self-management and higher HbA1c in approximately half of the identified studies prior to including SES in analyses. Ethnic differences in self-management were found for objective (i.e., frequency of blood glucose checks), but not subjective measures. Ethnic differences were often eliminated when SES was statistically controlled. SES moderated some differences, suggesting complex sociocultural processes. Articles varied widely in SES measures and the analytic methods used to evaluate ethnic disparities.
Summary
Pediatric Latino T1D disparities are inconsistent and at least partially dependent on the SES context. Recommendations for future research to systematically evaluate SES and Latino T1D disparities are made.
Similar content being viewed by others
Notes
For inclusivity, this review used the term Latino, rather than Hispanic [1].
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Flores G, Abreu M, Olivar MA, Kastner B. Access barriers to health care for Latino children. Arch Pediatr Adolesc Med. 1998;152(11):1119–25.
Klobuchar A America’s Hispanic population: an economic snapshot. 2013
Mayer-Davis EJ, Lawrence JM, Dabelea D, Divers J, Isom S, Dolan L, et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002-2012. N Engl J Med. 2017;376(15):1419–29.
Bowen ME, González HM. Childhood socioeconomic position and disability in later life: results of the health and retirement study. Am J Public Health. 2010;100(Suppl):S197–203.
Levine BS, Anderson BJ, Butler DA, Antisdel JE, Brackett J, Laffel LMB. Predictors of glycemic control and short-term adverse outcomes in youth with type 1 diabetes. J Pediatr. 2001;139(2):197–203.
White NH. Long-term outcomes in youth with diabetes mellitus. Pediatr Clin N Am. 2015;62(4):889–909.
Ferrer RL. Social determinants of health. In: Daaleman TP, Helton MR, editors. Chronic illness care: principles and practice. Springer International Publishing AG; 2018.
Borschuk AP, Everhart RS. Health disparities among youth with type 1 diabetes: a systematic review of the current literature. Fam Syst Heal Syst Heal. 2015 Sep;33(3):297–313.
• Ruiz JM, Hamann HA, Mehl MR, O’Connor MF. The Hispanic health paradox: from epidemiological phenomenon to contribution opportunities for psychological science. Gr Process Intergr Relat. 2016;19(4):462–76. Study highlighting the necessity of exploring Latino health in the context of SES in order to discern cultural resiliency factors.
Flores G. Technical report–racial and ethnic disparities in the health and health care of children. Pediatrics. 2010;125(4):e979–1020.
Flores G, Fuentes-afflick E, Carter-pokras O, Claudio L, Lara M, Mclaurin JA, et al. The health of Latino children. Jama. 2002;288(1):82–90.
Redondo MJ, Rodriguez LM, Haymond MW, Hampe CS, Smith EO, Balasubramanyam A, et al. Serum adiposity-induced biomarkers in obese and lean children with recently diagnosed autoimmune type 1 diabetes. Pediatr Diabetes. 2014;15(8):543–9.
Gandhi K, Tosur M, Schaub R, Haymond MW, Redondo MJ. Racial and ethnic differences among children with new-onset autoimmune type 1 diabetes. Diabet Med. 2017;34(10):1435–9.
Davis CL, Delamater AM, Shaw KH, La Greca AM, Eidson MS, Perez-Rodriguez JE, et al. Brief report: parenting styles, regimen adherence, and glycemic control in 4- to 10-year-old children with diabetes. J Pediatr Psychol. 2001;26(2):123–9.
Delamater AM, Shaw KH, Applegate EB, Pratt IA, Eidson MS, Lancelotta GX, et al. Risk for metabolic control problems in minority youth with diabetes. Diabetes Care. 1999;22(5):700–5.
• Nicholl MC, Valenzuela JM, Lit KKK, DeLucia C, Shoulberg AM, Rohan JM, et al. Featured article: comparison of diabetes management trajectories in Hispanic versus White non-Hispanic youth with type 1 diabetes across early adolescence. J Pediatr Psychol. 2019;44(6):631–41. Article showing changes in Latino disparities only in some T1D outcomes after covarying SES.
•• Willi SM, Miller KM, DiMeglio LA, Klingensmith GJ, Simmons JH, Tamborlane WV, et al. Racial-ethnic disparities in management and outcomes among children with type 1 diabetes. Pediatrics. 2015;135(3):424–34. Showed SES moderation of Latino disparities only in some T1D outcomes.
Coll CG, Marks AK. The immigrant paradox in children and adolescents: is becoming American a developmental risk? Coll CG, Marks AK, editors. Washington: American Psychological Association; 2012.
Destin M. Socioeconomic mobility, identity, and health: experiences that influence immunology and implications for intervention. Am Psychol. 2019;74(2):207–17.
Braveman PA, Cubbin C, Egerter S, Chideya S, Marchi K, Metzler M, et al. Socioeconomic status in health research: one size does not fit all. Jama. 2005;294(22):2879–88.
Queen TL, Baucom KJW, Baker A, Mello D, Berg CA, Wiebe DJ. Neighborhood disorder and type 1 diabetes glycemic control in adolescence. Soc Sci Med. 2017;183:126–9.
Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, et al. Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association. Diabetes Care. 2018;41(7):1–19.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1).
Fortin K, Pries E, Kwon S. Missed medical appointments and disease control in children with type 1 diabetes. J Pediatr Health Care. 2016;30(4):381–9.
Gallegos-Macias AR, Macias SR, Kaufman E, Skipper B, Kalishman N. Relationship between glycemic control, ethnicity and socioeconomic status in Hispanic and white non-Hispanic youths with type 1 diabetes mellitus. Pediatr Diabetes. 2003 Jan 1;4(1):19–23.
•• Kahkoska AR, Shay CM, Crandell J, Dabelea DM, Imperatore G, Lawrence JM, et al. Association of race and ethnicity with glycemic control and hemoglobin a1c levels in youth with type 1 diabetes. JAMA Netw Open. 2018;1(5):e181851. Used a large longitudinal dataset to show Latino disparities in trajectories of HbA1c across adolescence even after covarying SES.
• Moore JM, Snell-Bergeon JK. Trajectories of hemoglobin A1c and body mass index z-score over four decades among 2 to 18 year olds with type 1 diabetes. Pediatr Diabetes. 2019;20(5):594–603 Revealed Latino disparities in trajectories of HbA1c across childhood and adolescence.
Newfield RS, Cohen D, Capparelli EV, Shragg P. Rapid weight gain in children soon after diagnosis of type 1 diabetes: is there room for concern? Pediatr Diabetes. 2009;10(5):310–5.
Petitti DB, Klingensmith GJ, Bell RA, Andrews JS, Dabelea D, Imperatore G, et al. Glycemic control in youth with diabetes: The SEARCH for diabetes in youth study. J Pediatr. 2009;155(5):668–72 e3.
Redondo MJ, Connor CG, Ruedy KJ, Beck RW, Kollman C, Wood JR, et al. Pediatric Diabetes Consortium type 1 diabetes new onset (NeOn) study: factors associated with HbA1c levels one year after diagnosis. Pediatr Diabetes. 2014;15(4):294–302.
Schwartz DD, Axelrad ME, Anderson BJ. Neurocognitive functioning in children and adolescents at the time of type 1 diabetes diagnosis: associations with glycemic control 1 year after diagnosis. Diabetes Care. 2014;37(9):2475–82.
Springer D, Dziura J, Tamborlane WV, Steffen AT, Ahern JH, Vincent M, et al. Optimal control of type 1 diabetes mellitus in youth receiving intensive treatment. J Pediatr. 2006;149(2):227–32.
Tucker C, Wiebe DJ, Main A, Lee AG, White PC. Adolescent information management and parental knowledge in non-Latino White and Latino youth managing type 1 diabetes. J Pediatr Psychol. 2018;43(2):207–17.
Wang JT, Wiebe DJ, White PC. Developmental trajectories of metabolic control among White, Black, and Hispanic youth with type 1 diabetes. J Pediatr. 2011;159(4):571–6.
Main A, Wiebe DJ, Croom AR, Sardone K, Godbey E, Tucker C, et al. Associations of parent-adolescent relationship quality with type 1 diabetes management and depressive symptoms in Latino and Caucasian youth. J Pediatr Psychol. 2014;39(10):1104–14.
Mello D, Wiebe DJ, Barranco C, Barba J. The stress and coping context of type 1 diabetes management among Latino and non-Latino White early adolescents and their mothers. J Pediatr Psychol. 2017;42(6):647–56.
Litonjua AA, Carey VJ, Weiss ST, Gold DR. Race, socioeconomic factors, and area of residence are associated with asthma prevalence. Pediatr Pulmonol. 1999;28(6):394–401.
McClelland GH, Judd CM. Statistical difficulties of detecting interactions and moderator effects. Psychol Bull. 1993;144:376–90.
Gandhi K, Baranowski T, Anderson BJ, Bansal N, Redondo MJ. Psychosocial aspects of type 1 diabetes in Latino- and Asian-American youth. Pediatr Res. 2016;80(3):347–55.
Negy C, Woods DJ. A note on the relationship between acculturation and socioeconomic status. Hisp J Behav Sci. 1992;14(2):248–51.
Hsin O, La Greca AM, Valenzuela J, Moine CT, Delamater AM. Adherence and glycemic control among Hispanic youth with type 1 diabetes: role of family involvement and acculturation. J Pediatr Psychol. 2010;35(2):156–66.
Acknowledgments
The authors would like to thank Jose Barba, David Nunez, Gino Acevedo, Ana Belen Anguiano, Jessica Chavez, and Stephanie Noriega for their assistance with screening articles for this study and W. Kyle Hamilton for his assistance with calculating effect sizes.
Author information
Authors and Affiliations
Contributions
DM and DW equally developed the idea for the current study; DM performed the literature search, screening, and analyses, in conjunction with research assistants; DM and DW equally drafted and critically revised the work.
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Psychosocial Aspects
Rights and permissions
About this article
Cite this article
Mello, D., Wiebe, D. The Role of Socioeconomic Status in Latino Health Disparities Among Youth with Type 1 Diabetes: a Systematic Review. Curr Diab Rep 20, 56 (2020). https://doi.org/10.1007/s11892-020-01346-4
Accepted:
Published:
DOI: https://doi.org/10.1007/s11892-020-01346-4