(WITHDRAWN) Health Status, Health Behaviors and Preventive Health Services of Older Adults with Diabetes

Backgrounds

The prevalence of diabetes among older adults has increased substantially, at 25.2% of Americans age 65 and older. Health complications resulting from diabetes have significant adverse effects on health status of older adults. While diabetes cannot be cured, it can be managed successfully with healthy lifestyle choices. The purpose of this study is to (1) identify disparities between older adults with diabetes and without diabetes in health status, health behaviors, and preventive health services, and (2) examine the impact of health behaviors and preventive health services on perceived health status for older adults with diabetes. It is hypothesized that older adults with diabetes who presented health behaviors and received preventive health services will be more likely to report good health compared to those who did not.

Methods

This study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). The sample included older adults 50 and over who have diabetes. The outcome measure is the perceived health status dichotomized into good health versus poor health. Health behaviors included exercise, current cigarette use, and heavy alcohol drinking. Preventive health services included dental visit, flu shot, and colorectal cancer screening. Chi-square analysis was conducted to examine if significant differences in health status, health behaviors and preventive health services existed between older adults with diabetes and without diabetes. Also weighted multivariate logistic regression was performed to investigate the impact of health behaviors and preventive health service use on perceived health status. Covariates included demographic variables such as gender, race, age, education level, and income.

Results

Older adults with diabetes were significantly more likely to be in poor health than those without diabetes (42.45% versus 17.84%). Compared to non-diabetic group, older adults with diabetes were more likely to have had no exercise in the previous month (40.59% versus 25.48%). More older adults with diabetes reported having visited dentist, had flu shot and colonoscopy than those without diabetes. In both groups, older adults who presented health behaviors and received preventive health services were more likely to report good health compared to those who did not. After controlling for demographic, health behavior, and preventive health services variables, older adults with diabetes were less likely to report better health status than those without diabetes (OR=0.35, p<0.050). Being in a minority race group other than White was associated with poor health status while having post-secondary education and above $15,000 annual household income were associated with good health status.

Conclusions

The findings revealed the disparities in health status, health behaviors, and preventive health care for older adults with diabetes. Given the risk of comorbidities and its complications for older adults with diabetes, receipt of preventive health services is imperative. Social workers can be a vital resource for older adults with diabetes by promoting diabetes self-management education which focuses on healthy life style and preventive care. Further research should be directed toward designing better health promotion programs and policies for older adults with diabetes to delay their functional impairment and allow them to live independently in the community.