Graduation Year
2026
Degree Name
Master of Public Health
Department
Egan School of Nursing and Health Studies
Document Type
Capstone
First Advisor
Marybec Griffin
Second Advisor
Kim Doughty
Abstract
Background:
The study of socioeconomic status effects on diabetes care for adult diabetes patients needs evaluation of present national data because SES produces major differences in chronic disease results. The research investigated how socioeconomic status affects HbA1c test results in American adults who claim to have diabetes.
Methods:
The research used data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES) through a cross-sectional study. Adults aged 18 years and older with self-reported diabetes and complete laboratory and demographic information were included (n = 684). The study used descriptive statistics to describe the sample characteristics while bivariate analysis examined the average HbA1c values between different SES groups defined by the poverty-income ratio (PIR). The research used multivariable linear regression models to study how SES affects HbA1c levels while controlling for age and sex and race/ethnicity and body mass index (BMI).
Results:
The participants were 63.4 years old on average with HbA1c levels at 7.40% and PIR values at 2.49. The HbA1c measurements showed substantial variations between different socioeconomic status (SES) groups (F(3, 680) = 3.99, p = .0078). The adjusted models produced results which indicated that people with elevated SES levels maintained lower HbA1c values (β = –0.117, p = .003). Non-Hispanic Black adults showed higher HbA1c values than Non-Hispanic Whites (β = 0.561, p = .031) but BMI and sex did not affect the results.
Conclusions:
Higher SES was independently associated with better glycemic control among U.S. adults with diabetes. Research studies demonstrate that diabetes care and public health programs need to handle social factors which create economic obstacles to achieve complete health equity.