Black Children More Likely to Die From Diabetes

Diana Phillips

May 22, 2017

Death rates for black children with diabetes are more than twice as high as those for their white peers and more than three times higher than those for Hispanic children, researchers report in the May 19 issue of the Morbidity and Mortality Weekly Report.

The higher mortality rate may reflect differences in healthcare access and disease management resources, the authors suggest.

Previous studies have identified disparities in diabetes-related deaths between white and black children, but this is the first to include children of Hispanic ethnicity in the analysis. For the current investigation, Sharon Saydah, PhD, from the National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, and colleagues analyzed 2000 to 2014 data from the National Vital Statistics System for diabetes-related deaths in children overall and by race/ethnicity.

The total number of diabetes-related deaths among 1- to 19-year-old children and adolescents showed a nonsignificant decrease from 265 in 2000 to 2002 (1.15 per 1 million children) to 228 (0.97 per 1 million children) in 2012 to 2014.

"It is encouraging that, despite increases in diabetes prevalence and incidence among children and adolescents during the 14 years from 2000 to 2014, there was no significant increase in diabetes mortality," the authors write. As reported by Medscape Medical News, a recent study showed significant increases in both type 1 and type 2 diabetes among children and adolescents, with a particularly dramatic increase in type 1 diabetes among racial and ethnic minority children.

In the current analysis, Dr Saydah and colleagues found significant racial and ethnic disparities persisted in diabetes-related mortality across nearly all time points. From 2000 to 2002, the mortality rate ratio for blacks vs whites was 2.36, and for blacks vs Hispanics it was 3.69. In the later period, 2012 to 2014, the respective rate ratios were 2.22 and 3.36.

"Hispanics had the lowest diabetes death rates during all periods," the authors report. They note that the diabetes death rate ratios for whites vs Hispanics for the earlier and later periods, respectively, were 1.57 and 1.51.

Because diabetes deaths in children and adolescents are likely attributable to acute diabetes complications, "it would be expected that the highest diabetes-associated mortality would occur among racial/ethnic groups with the highest diabetes incidence and prevalence," the authors write. However, previous research has shown that the incidence and prevalence of type 1 diabetes in children and adolescents is higher among whites than among blacks, they note.

Possible explanations for the mortality rate disparities "could include differences in access to health care, health services, diabetes self- and parent-management education, and diabetes care," the authors hypothesize. The persistent disparities should be investigated further, "so that targeted interventions for prevention of diabetes deaths among children and adolescents can be developed and implemented," they conclude.

The authors have disclosed no relevant financial relationships.

Morb Mortal Wkly Rep. 2017;66:502-505. Full text

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