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<meta name="robots" content="NOINDEX,NOFOLLOW,NOARCHIVE,NOIMAGEINDEX" /><meta name="citation_inbook_title" content="Diabetes in America. 3rd edition" /><meta name="citation_title" content="Sociodemographic Characteristics of Persons With Diabetes" /><meta name="citation_publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases (US)" /><meta name="citation_date" content="2018/08" /><meta name="citation_author" content="Mark S. Eberhardt" /><meta name="citation_author" content="Sarah Stark Casagrande" /><meta name="citation_author" content="Catherine C. Cowie" /><meta name="citation_pmid" content="33651553" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK567995/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Sociodemographic Characteristics of Persons With Diabetes" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases (US)" /><meta name="DC.Contributor" content="Mark S. Eberhardt" /><meta name="DC.Contributor" content="Sarah Stark Casagrande" /><meta name="DC.Contributor" content="Catherine C. Cowie" /><meta name="DC.Date" content="2018/08" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK567995/" /><meta name="description" content="This chapter presents the demographic and socioeconomic characteristics of people with and without diabetes. The main data source is the National Health Interview Survey (NHIS), with supplemental information from the National Health and Nutrition Examination Survey (NHANES). Estimates from these surveys are nationally representative of the U.S. civilian noninstitutionalized population and are presented for adults age ≥20 years with diabetes diagnosed at either age <20 years or age ≥20 years, adults without diabetes, and when available, youth age <20 years with diabetes and people with undiagnosed diabetes or prediabetes." /><meta name="og:title" content="Sociodemographic Characteristics of Persons With Diabetes" /><meta name="og:type" content="book" /><meta name="og:description" content="This chapter presents the demographic and socioeconomic characteristics of people with and without diabetes. The main data source is the National Health Interview Survey (NHIS), with supplemental information from the National Health and Nutrition Examination Survey (NHANES). Estimates from these surveys are nationally representative of the U.S. civilian noninstitutionalized population and are presented for adults age ≥20 years with diabetes diagnosed at either age <20 years or age ≥20 years, adults without diabetes, and when available, youth age <20 years with diabetes and people with undiagnosed diabetes or prediabetes." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK567995/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-dia3ed-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/dia3ed/ch8/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK567995/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>Cowie CC, Casagrande SS, Menke A, et al., editors. Diabetes in America. 3rd edition. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018 Aug. </p></div><div class="bk_msg_box bk_bttm_mrgn clearfix bk_noprnt"><div class="iconblock clearfix"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/diaonline/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-diaonline-lrg.png" alt="Cover" height="100px" width="80px" /></a><div class="icnblk_cntnt"><ul class="messages"><li class="info icon"><span class="icon"><a href="/books/n/diaonline/">Diabetes in America</a></span></li></ul></div></div></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/dia3ed/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-dia3ed-lrg.png" alt="Cover of Diabetes in America" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>Diabetes in America. 3rd edition.</h2><a data-jig="ncbitoggler" href="#__NBK567995_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK567995_dtls__"><div>Cowie CC, Casagrande SS, Menke A, et al., editors.</div><div>Bethesda (MD): <a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases (US)</a>; 2018 Aug.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/dia3ed/">Contents</a></li><li style="margin-left:1em"><a href="https://www.niddk.nih.gov/about-niddk/strategic-plans-reports/diabetes-in-america-3rd-edition" ref="pagearea=body&targetsite=external&targetcat=link&targettype=publisher">Original Version at NIDDK</a></li></ul></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/dia3ed/ch7/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/dia3ed/ch9/" title="Next page in this title">Next ></a></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK567995_"><span class="label">CHAPTER 8</span><span class="title" itemprop="name">Sociodemographic Characteristics of Persons With Diabetes</span></h1><p class="contrib-group"><span itemprop="author">Mark S. Eberhardt</span>, PhD, <span itemprop="author">Sarah Stark Casagrande</span>, PhD, and <span itemprop="author">Catherine C. Cowie</span>, PhD, MPH.</p><a data-jig="ncbitoggler" href="#__NBK567995_ai__" style="border:0;text-decoration:none">Author Information and Affiliations</a><div style="display:none" class="ui-widget" id="__NBK567995_ai__"><p class="contrib-group"><h4>Authors</h4><span itemprop="author">Mark S. Eberhardt</span>, PhD,<sup>1</sup> <span itemprop="author">Sarah Stark Casagrande</span>, PhD,<sup>2</sup> and <span itemprop="author">Catherine C. Cowie</span>, PhD, MPH<sup>3</sup>.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> Dr. Mark S. Eberhardt is Epidemiologist in the Division of National Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD</div><div class="affiliation"><sup>2</sup> Dr. Sarah Stark Casagrande is Senior Research Analyst at Social & Scientific Systems, Inc., Silver Spring, MD</div><div class="affiliation"><sup>3</sup> Dr. Catherine C. Cowie is Senior Advisor and Director for Diabetes Epidemiology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD</div></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="ch8.sum"><h2 id="_ch8_sum_">Summary</h2><p>This chapter presents the demographic and socioeconomic characteristics of people with and without diabetes. The main data source is the National Health Interview Survey (NHIS), with supplemental information from the National Health and Nutrition Examination Survey (NHANES). Estimates from these surveys are nationally representative of the U.S. civilian noninstitutionalized population and are presented for adults age ≥20 years with diabetes diagnosed at either age <20 years or age ≥20 years, adults without diabetes, and when available, youth age <20 years with diabetes and people with undiagnosed diabetes or prediabetes.</p><p>Overall, people with diabetes were older (76.3% were age ≥50 years compared to 28.2% of people without diagnosed diabetes). In 2009–2010, the current mean age was 46.3 years in people with diabetes diagnosed age <20 years, 60.5 years in people with diabetes diagnosed age ≥20 years, and 45.9 years in people without diabetes. More people with diabetes were male (51.2%) compared to people without diabetes (48.8%). The percentage of male adults among those diagnosed before and after age 20 years was similar (48.9% and 51.4%), and no significant sex differences existed among youth or adults with diabetes diagnosed age <20 years. Adults with diabetes were more frequently non-Hispanic black compared to adults without diabetes. Among those with diabetes diagnosed age ≥20 years, 64.4% were non-Hispanic white, 15.8% non-Hispanic black, 14.8% Hispanic, 4.1% non-Hispanic Asian/Pacific Islander, and 0.9% non-Hispanic American Indian and Alaska Native, similar to adults age ≥20 years with diabetes diagnosed age <20 years. In adults without diabetes, the percentages were 69.6%, 11.4%, 13.6%, 4.8%, and 0.6%, respectively. Among adults with diabetes diagnosed age ≥20 years, the mean age at diagnosis was 52.3 years in non-Hispanic white, 49.4 years in non-Hispanic Asian/Pacific Islander, 47.4 years in non-Hispanic black, 47.3 years in Hispanic, and 46.1 in non-Hispanic American Indian and Alaska Native adults. The mean duration of diabetes was longest for adults with diabetes diagnosed age <20 years. In 2006–2010, 77.2% of adults with diabetes diagnosed age <20 years had diabetes for ≥20 years compared to 14.6% of adults in 2009–2010 with diabetes diagnosed age ≥20 years.</p><p>During 2009–2010, 80.4% of adults with diabetes diagnosed age ≥20 years lived in metropolitan counties compared to 84.3% of adults without diabetes. A similar percentage of people with diagnosed diabetes (53%) and without diabetes (52%) lived in the top 10 most populous states; the rank order of states for the largest percentage of the U.S. population with diabetes was California, Texas, Florida, New York, Ohio, Illinois, Pennsylvania, Michigan, North Carolina, and Georgia. Regionally, a slightly higher percentage lived in the Southern United States (46.1% of adults diagnosed age <20 years, 38.7% of adults diagnosed age ≥20 years, and 35.3% of adults without diagnosed diabetes). In 2009–2010, 83.2% of adults diagnosed age ≥20 years and 83.0% of adults without diabetes were U.S. born, which was similar to the 2006–2010 estimate of 85.9% for adults diagnosed age <20 years. A higher percentage of persons who were age <20 years and had diabetes were U.S. born (96.8%). English was spoken in at least 93% of homes where people with diabetes lived. Over 9% of adults with diabetes in the United States were born in Mexico, Central American, or the Caribbean Islands. Among immigrants, adults with diabetes lived in the United States longer than adults without diagnosed diabetes. For example, 72.3% and 84.2% of adults with diabetes diagnosed before or after age 20 years, respectively, had lived in the United States at least 15 years compared to 58.5% of adults without diagnosed diabetes.</p><p>Marriage was more common among adults with diabetes diagnosed age ≥20 years compared to adults without diabetes or adults diagnosed age <20 years (59.2%, 56.0%, and 48.9%), but a higher percentage of adults with diabetes diagnosed age ≥20 years lived alone compared to adults without diabetes (21.1% vs. 17.1%).</p><p>The level of attained education was lower in adults with diabetes compared to those without diabetes (e.g., 17.6% of adults with diabetes diagnosed age ≥20 years, 18.6% of adults with diabetes diagnosed age <20 years, and 31.4% of adults without diabetes graduated with a bachelor’s degree or higher). Among adults with diabetes diagnosed age ≥20 years, fewer women (13.8%) graduated from college than men (21.2%) compared to women (30.4%) and men (32.5%) without diabetes. College graduation was reported by 40.3% of non-Hispanic Asian/Pacific Islander, 20.1% of non-Hispanic white, 13.3% of non-Hispanic black, and 6.1% of Hispanic adults with diabetes diagnosed age ≥20 years, which was lower than their respective groups without diabetes. Adults with diabetes had lower family income (54.3% diagnosed age <20 years, 43.8% diagnosed age ≥20 years, and 32.4% without diagnosed diabetes made <$35,000 annually between 2007 and 2010). Likewise, more adults with diabetes had a Poverty Income Ratio (PIR) <2.00 (49.1%, 38.4%, and 30.7%, respectively). Nearly 25% of non-Hispanic black, Hispanic, and non-Hispanic American Indian and Alaska Native adults lived below poverty (PIR <1.00) regardless of diabetes diagnosis. After considering family income within age and race/ethnicity groups, only adults age 45–64 years with diabetes diagnosed age ≥20 years had lower incomes than similar age adults without diabetes.</p><p>In 2009–2010, a lower percentage of adults with diabetes diagnosed age ≥20 years reported working in the previous 12 months (43.3%) compared to adults without diabetes (71.8%) or adults in 2006–2010 with diabetes diagnosed age <20 years (53.7%). Over 70% of each group were employed in the private sector, and adults with diabetes diagnosed age ≥20 years had the largest percentage working for the government (21.5%). Being retired was the main reason for not working among adults with diabetes diagnosed age ≥20 years, adults without diabetes, and adults with diabetes diagnosed age <20 years (56.9%, 43.5%, and 38.7%, respectively); and being disabled was more frequently reported by adults in the diabetes groups (28.5%, 15.5%, and 37.2%, respectively). Men with diabetes diagnosed age ≥20 years were more often military veterans than men without diabetes (34.7% vs. 17.2%). Among adults with diabetes diagnosed age ≥20 years, 46.6% received Social Security or Railroad retirement benefits compared to 17.4% of adults without diabetes, and >7% of adults with diabetes received Supplemental Security Income usually due to a disability compared to 2.2% of adults without diabetes.</p></div><div id="ch8.s1"><h2 id="_ch8_s1_">Introduction</h2><p>Understanding sociodemographic characteristics of people with diabetes in the United States is important for health care planning, research, and other public health efforts. Examples of how these data are useful include: (1) knowing the income levels, educational attainment, and race characteristics could lead to designing culturally relevant nutrition and physical activity strategies at appropriate educational levels that are accessible at various income levels; (2) identifying employment patterns of population subgroups with diabetes may provide guidance to improve educational assistance or vocational training; or (3) estimating the future number of persons who may apply for Social Security disability benefits requires knowing the age distribution of people with diabetes, their current use of this benefit, the prevalence of diabetes (see <a href="/books/n/dia3ed/ch2/">Chapter 2</a>
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<i>Prevalence and Incidence of Type 1 Diabetes Among Children and Adults in the United States and Comparison With Non-U.S. Countries</i> and <a href="/books/n/dia3ed/ch3/">Chapter 3</a>
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<i>Prevalence and Incidence of Type 2 Diabetes and Prediabetes</i>), and diabetes mortality (see <a href="/books/n/dia3ed/ch35/">Chapter 35</a>
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<i>Mortality in Type 1 Diabetes</i> and <a href="/books/n/dia3ed/ch36/">Chapter 36</a>
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<i>Mortality Trends in Type 2 Diabetes</i>).</p><p>In <i>Diabetes in America</i>, <i>2nd edition</i>, the chapter on sociodemographic characteristics of people with diabetes presented estimates for people classified with either insulin-dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes mellitus (NIDDM). An increased understanding of the etiology and progression of diabetes has made these terms obsolete (<a class="bk_pop" href="#ch8.ref1">1</a>). Diabetes is now categorized largely as either type 1 diabetes or type 2 diabetes (<a class="bk_pop" href="#ch8.ref2">2</a>); however, information needed to adequately classify the type of diabetes was unavailable for this chapter, which is largely based on self-reported information. In the current chapter, people with diagnosed diabetes were classified by their reported age at diabetes diagnosis (i.e., age <20 years or age ≥20 years). While those diagnosed age <20 years are more likely have type 1 diabetes, and those diagnosed age ≥20 years are more likely to have type 2 diabetes, some overlap of the types of diabetes and age at diagnosis remains.</p></div><div id="ch8.s2"><h2 id="_ch8_s2_">Data Sources and Limitations</h2><p>The data in this chapter of <i>Diabetes in America, 3rd edition</i>, originate from new analyses of two continuous national health surveys conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC). Data from the National Health Interview Surveys (NHIS) 2006–2010 provide most of the chapter’s information for people with diagnosed diabetes, and data from the National Health and Nutrition Examination Surveys (NHANES) 2005–2010 provide supplemental information for people with undiagnosed diabetes and people at high risk for diabetes (commonly called prediabetes). NHIS and NHANES are cross-sectional general health surveys with independent known probability samples that produce nationally representative estimates for the civilian noninstitutionalized U.S. population. Detailed descriptions of the survey methods and quality control procedures are available elsewhere (<a class="bk_pop" href="#ch8.ref3">3</a>,<a class="bk_pop" href="#ch8.ref4">4</a>).</p><p>The demographic characteristics examined among the people with diagnosed diabetes in the NHIS and NHANES were similar. For example, the current age distribution (i.e., at the time of interview) for adults age ≥20 years who had diabetes diagnosed age ≥20 years was similar in the NHIS 2006–2010 compared to the NHANES 2005–2010 (13%–14% in both surveys were age 20–44 years; 46%–48% were age 45–64 years; and 39% in both surveys were age ≥65 years). It is reassuring that the age distributions are similar in the two surveys for people with diagnosed diabetes, since age is strongly related to the age at onset of both major types of diabetes and the risk of diabetic complications, which are related to economic status (see <a href="/books/n/dia3ed/section2/">Section II</a>
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<i>Complications of Diabetes and Related Conditions</i>).</p><p>The two surveys do not include people living in institutions or on active military duty; however, this excludes a very small percentage of adults with diagnosed diabetes. The National Nursing Home Survey 2004 found that approximately 340,000 nursing home residents age ≥65 years had diabetes (<a class="bk_pop" href="#ch8.ref5">5</a>), which represents approximately 2% of people with diagnosed diabetes in the United States according to the CDC’s reported prevalence of diabetes. In 2010, <14% of the approximately 1.4 million persons on active military duty were receiving care for diabetes in the military medical care system (<a class="bk_pop" href="#ch8.ref6">6</a>).</p><p>In this chapter, the following statistical methods and definitions were used. Since NHIS and NHANES use complex survey designs with oversampling of some population subgroups to improve survey reliability, all estimates were weighted, except sample sizes. Standard errors were estimated using SUDAAN (Release 11.0.0) (<a class="bk_pop" href="#ch8.ref7">7</a>). Mean differences were tested with t-tests, and p<0.05 was considered statistically significant. Percent estimates were considered significantly different if 95% confidence intervals prepared with weighted standard errors did not overlap. This method was used due to the large number of comparisons and to allow readers to make their own comparisons of estimates. Only statistically significant differences are mentioned in the text (that is based on non-overlapping 95% confidence intervals or t-tests), unless otherwise noted. No age-standardization or other adjustments were made to the data. Unless noted otherwise, age in the figures and appendices refers to age at interview. All diabetes estimates from the NHIS refer to people with diagnosed diabetes and from here forward will simply be specified as diabetes. Unless stated otherwise, adults refer to persons age ≥20 years and youth refers to persons age <20 years at the time of the survey. Relative standard errors are noted in the figures and appendices if estimates had limited statistical reliability due to small sample sizes. Estimates with relative standard errors >30%–50% should be considered with caution, and those with a relative standard error >50% are not presented. The number of persons with diabetes in the United States by age was based on the NHIS age distribution for persons with diabetes and the number of persons with diagnosed diabetes based on NHIS 2010 estimates.</p><div id="ch8.s2.1"><h3>National Health Interview Survey (NHIS)</h3><p>The NHIS is a household-based interview survey that collects responses in all 50 states and the District of Columbia. For this analysis, multiple years of data were combined to obtain more statistically reliable estimates for the various diabetes categories (see the next paragraph for further details). Between 2006 and 2010, NHIS provided data for approximately 74,000–90,000 interviewed persons annually (<a class="bk_pop" href="#ch8.ref3">3</a>). The final annual NHIS response rates among adults during 2005–2010 were ≥60.8% for adults and ≥70.7% for youth. Since the NHIS is an interview survey, it is only able to distinguish people with diagnosed diabetes from people without diagnosed diabetes. To identify people with diabetes, NHIS asked respondents (or rarely a family proxy), “(Other than during pregnancy for females), Have you EVER been told by a doctor or other health professional that you have diabetes or sugar diabetes?” If the response was “Yes,” the person was classified to have diagnosed diabetes. Persons responding “No” or “Borderline” were classified not to have diagnosed diabetes. People who reported a diabetes diagnosis were then asked “How old were you when a doctor or other health professional first told you that you had diabetes or sugar diabetes?” This was used to identify the age at diagnosis. Since diabetes was only based on interview information, some persons were classified not to have diabetes but, in fact, did have undiagnosed diabetes. Other research has found that approximately 28% of persons with diabetes have undiagnosed diabetes (<a class="bk_pop" href="#ch8.ref8">8</a>).</p><p>The main focus of this chapter is on adults with diabetes diagnosed at age ≥20 years. To produce stable estimates for people with diagnosed diabetes, multiple years of data were combined. For adults with diabetes diagnosed at age ≥20 years, 2009 and 2010 data were combined. For people with diabetes diagnosed at age <20 years, more years of data were combined (generally 2006–2010) to increase the analytic sample size. Where possible, results were presented for youth (age <20 years) with diabetes. In 2009–2010, only 35 adults age ≥20 years (0.05%) and, in 2006–2010, only 30 youth age <20 years (0.05%) had missing data and could not be classified for diagnosed diabetes. Additional information on the NHIS is available (<a class="bk_pop" href="#ch8.ref3">3</a>,<a class="bk_pop" href="#ch8.ref9">9</a>,<a class="bk_pop" href="#ch8.ref10">10</a>,<a class="bk_pop" href="#ch8.ref11">11</a>,<a class="bk_pop" href="#ch8.ref12">12</a>). The final person sample weight was used for the NHIS estimates.</p></div><div id="ch8.s2.2"><h3>National Health and Nutrition Examination Survey (NHANES)</h3><p>The NHANES is an interview and examination survey of approximately 5,000 people in 15 locations per year in the United States. In-home interviews are followed by physical examinations and laboratory tests in Mobile Examination Centers. Persons are selected in households based on a complex survey design. The response rates were ≥70% for all years of NHANES data used in this analysis (<a class="bk_pop" href="#ch8.ref13">13</a>). Data were released in 2-year cycles. For the new analyses in this chapter, data collected from 2005 to 2010 were combined.</p><p>With the combined interview and examination components of the NHANES, it was possible to classify people as having diagnosed diabetes, undiagnosed diabetes, prediabetes, and no diabetes.</p><p>The interview data were used to identify people with diagnosed diabetes. If a person answered “Yes” to the question “(Other than during pregnancy, if female)…Have you ever been told by a doctor or other health professional that you have diabetes or sugar diabetes?,” then they were considered to have diagnosed diabetes. All others were classified not to have diagnosed diabetes. To identify undiagnosed diabetes, two definitions were used. Participants who did not have diagnosed diabetes and (<a class="bk_pop" href="#ch8.ref1">1</a>) had glycosylated hemoglobin (A1c) ≥6.5% (≥48 mmol/mol) or (<a class="bk_pop" href="#ch8.ref2">2</a>) were randomly assigned to the morning sample, fasted 8–<24 hours, and had fasting plasma glucose (FPG) ≥126 mg/dL (≥6.99 mmol/L) were classified to have undiagnosed diabetes; this is considered the clinical definition because these measures are more likely to be used in the medical community due to ease of use for physicians and patients and potentially lower cost. In addition, those who satisfied the clinical definition for diabetes or who had 2-hour plasma glucose ≥200 mg/dL (≥11.10 mmol/L) after a 75 gram oral glucose challenge (i.e., an oral glucose tolerance test [OGTT]) were classified to have undiagnosed diabetes; this is referred to as the research definition because the added 2-hour OGTT is less likely to be used in the medical community. People were considered to have prediabetes among those without diagnosed or clinically defined undiagnosed diabetes if their FPG was 100–125 mg/dL (5.55–6.94 mmol/L) or their A1c was 5.7%–6.4% (39–46 mmol/mol). Those with A1c <5.7% and FPG <100 mg/dL were classified as having no diabetes. In 2005–2010, 6.1% could not be classified using the clinical definition, and 13.7% could not be classified using the research definition. NHANES-recommended glucose corrections were used (<a class="bk_pop" href="#ch8.ref14">14</a>). Sample weighted estimates included home interview weights for diagnosed diabetes; Mobile Examination Center examination weights for undiagnosed diabetes or prediabetes identified by A1c; and fasting or OGTT weights for no diabetes, undiagnosed diabetes, or prediabetes identified by FPG or OGTT, respectively, which maximizes the use of survey information and sample sizes.</p></div></div><div id="ch8.s3"><h2 id="_ch8_s3_">Demographic Characteristics</h2><div id="ch8.s3.1"><h3>Age Distribution</h3><p>The age distribution of people with diagnosed diabetes (mean age 59.3 years) was older than people without diagnosed diabetes (mean age 35.3 years) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig1/?report=objectonly" target="object" rid-figpopup="figch8fig1" rid-ob="figobch8fig1">Figure 8.1</a>). The range of ages for people with diabetes was 2–85 years, and the mode of the age distribution was 85 years (which was the top age released for all persons age ≥85 years for confidentiality reasons). The highest percentage of people with diabetes was in the 50–69 years age group (approximately 50%). In contrast, the highest percentage of people without diabetes was in the <30 years age group (approximately 45%). Among adults age ≥20 years in 2009–2010, the mean ages were 46.3 years for those with diabetes diagnosed age <20 years and 60.5 years for those diagnosed age ≥20 years, which were older than the mean age of 45.9 years for adults without diabetes.</p></div><div id="ch8.s3.2"><h3>Sex Distribution</h3><p>In 2009–2010, among all ages, a significantly higher percentage of people with diabetes were male (51.2%) compared to people without diabetes (48.8%) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab1/?report=objectonly" target="object" rid-figpopup="figch8app1tab1" rid-ob="figobch8app1tab1">Appendix 8.1</a>). In 2009–2010, among adults with diabetes diagnosed age ≥20 years, percentages were not significantly different for males (51.4%) compared with females (48.6%) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig2/?report=objectonly" target="object" rid-figpopup="figch8fig2" rid-ob="figobch8fig2">Figure 8.2</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab2/?report=objectonly" target="object" rid-figpopup="figch8app1tab2" rid-ob="figobch8app1tab2">Appendix 8.2</a>). In 2006–2010, no significant sex difference existed among adults with diabetes diagnosed age <20 years (48.9% male and 51.1% female) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig2/?report=objectonly" target="object" rid-figpopup="figch8fig2" rid-ob="figobch8fig2">Figure 8.2</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab2/?report=objectonly" target="object" rid-figpopup="figch8app1tab2" rid-ob="figobch8app1tab2">Appendix 8.2</a>), nor among youth with diabetes diagnosed age <20 years (52.6% male and 47.4% female) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig2/?report=objectonly" target="object" rid-figpopup="figch8fig2" rid-ob="figobch8fig2">Figure 8.2</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab3/?report=objectonly" target="object" rid-figpopup="figch8app1tab3" rid-ob="figobch8app1tab3">Appendix 8.3</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig1" co-legend-rid="figlgndch8fig1"><a href="/books/NBK567995/figure/ch8.fig1/?report=objectonly" target="object" title="FIGURE 8.1" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig1" rid-ob="figobch8fig1"><img class="small-thumb" src="/books/NBK567995/bin/ch8f1.gif" src-large="/books/NBK567995/bin/ch8f1.jpg" alt="Line graph showing that the age distribution of people with diagnosed diabetes was older compared to people without diagnosed diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig1"><h4 id="ch8.fig1"><a href="/books/NBK567995/figure/ch8.fig1/?report=objectonly" target="object" rid-ob="figobch8fig1">FIGURE 8.1</a></h4><p class="float-caption no_bottom_margin">Age Distribution of Persons, by Diagnosed Diabetes Status, U.S., 2009–2010. Data are self-reported. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig2" co-legend-rid="figlgndch8fig2"><a href="/books/NBK567995/figure/ch8.fig2/?report=objectonly" target="object" title="FIGURE 8.2" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig2" rid-ob="figobch8fig2"><img class="small-thumb" src="/books/NBK567995/bin/ch8f2.gif" src-large="/books/NBK567995/bin/ch8f2.jpg" alt="Bar graphs showing that among adults with diabetes diagnosed equal to or greater than 20 years of age, the distribution of sex was similar by race and ethnicity." /></a><div class="icnblk_cntnt" id="figlgndch8fig2"><h4 id="ch8.fig2"><a href="/books/NBK567995/figure/ch8.fig2/?report=objectonly" target="object" rid-ob="figobch8fig2">FIGURE 8.2</a></h4><p class="float-caption no_bottom_margin">Sex Distribution by Diabetes Status, Age at Diabetes Diagnosis, and Race/Ethnicity, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * Current age: adults ≥20 years, youth <20 years</p></div></div></div><div id="ch8.s3.3"><h3>Race/Ethnicity Distribution</h3><p>People with diabetes in the United States had diverse race and ethnicity backgrounds (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig3/?report=objectonly" target="object" rid-figpopup="figch8fig3" rid-ob="figobch8fig3">Figure 8.3</a>). In 2009–2010, among all persons with diagnosed diabetes, non-Hispanic white persons comprised the largest subgroup (64.9%) followed by non-Hispanic black (15.7%), Hispanic (14.6%), non-Hispanic Asian/Pacific Islander (3.9%), and non-Hispanic American Indian and Alaska Native (0.9%). The race and ethnicity distribution of people without diabetes was 65.9%, 12.6%, 16.2%, 4.7%, and 0.6%, respectively (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab1/?report=objectonly" target="object" rid-figpopup="figch8app1tab1" rid-ob="figobch8app1tab1">Appendix 8.1</a>). Among all ages in 2009–2010, the only race/ethnicity group that had a significantly higher percentage in those with diabetes compared to those without diabetes was non-Hispanic black persons (15.7% and 12.6%, respectively). The largest population subgroup among Hispanics was Mexican American, which comprised a similar percentage among persons with or without diabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab1/?report=objectonly" target="object" rid-figpopup="figch8app1tab1" rid-ob="figobch8app1tab1">Appendix 8.1</a>). About 1% of people with diabetes were in each of the non-Hispanic Asian/Pacific Islander subgroups surveyed, which was similar to the estimates for most of the Asian/Pacific Islander subgroups without diabetes. When non-Hispanic and Hispanic American Indian and Alaska Native categories were combined, the total included 1.2% of all adults with diabetes in the United States (data not shown).</p><p>In 2009–2010, among adults with diabetes diagnosed age ≥20 years, 64.4% were non-Hispanic white, 15.8% non-Hispanic black, 14.8% Hispanic, 4.1% non-Hispanic Asian/Pacific Islander, and 0.9% American Indian and Alaska Native (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig4/?report=objectonly" target="object" rid-figpopup="figch8fig4" rid-ob="figobch8fig4">Figure 8.4</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab2/?report=objectonly" target="object" rid-figpopup="figch8app1tab2" rid-ob="figobch8app1tab2">Appendix 8.2</a>). The race/ethnicity distribution among adults without diabetes in 2009–2010 was 69.6% non-Hispanic white, 11.4% non-Hispanic black, 13.6% Hispanic, 4.8% non-Hispanic Asian/Pacific Islander, and 0.6% American Indian and Alaska Native. In 2006–2010, the percentages among adults with diabetes diagnosed age <20 years were 65.7% non-Hispanic white, 16.4% non-Hispanic black, 13.9% Hispanic, 2.8% non-Hispanic Asian/Pacific Islander, and 1.2% American Indian and Alaska Native.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig3" co-legend-rid="figlgndch8fig3"><a href="/books/NBK567995/figure/ch8.fig3/?report=objectonly" target="object" title="FIGURE 8.3" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig3" rid-ob="figobch8fig3"><img class="small-thumb" src="/books/NBK567995/bin/ch8f3.gif" src-large="/books/NBK567995/bin/ch8f3.jpg" alt="Pie chart showing that people with diabetes in the United States have diverse ethnic backgrounds with non-Hispanic white persons comprising the largest subgroup at 65 percent." /></a><div class="icnblk_cntnt" id="figlgndch8fig3"><h4 id="ch8.fig3"><a href="/books/NBK567995/figure/ch8.fig3/?report=objectonly" target="object" rid-ob="figobch8fig3">FIGURE 8.3</a></h4><p class="float-caption no_bottom_margin">Distribution of Race/Ethnicity Among Persons With Diagnosed Diabetes, U.S., 2009–2010. Data are self-reported. * Hispanic includes Hispanic American Indian/Alaska Native; Other Hispanic includes: multiple Hispanic, Dominican Republic, Other Latin <a href="/books/NBK567995/figure/ch8.fig3/?report=objectonly" target="object" rid-ob="figobch8fig3">(more...)</a></p></div></div><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig4" co-legend-rid="figlgndch8fig4"><a href="/books/NBK567995/figure/ch8.fig4/?report=objectonly" target="object" title="FIGURE 8.4" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig4" rid-ob="figobch8fig4"><img class="small-thumb" src="/books/NBK567995/bin/ch8f4.gif" src-large="/books/NBK567995/bin/ch8f4.jpg" alt="Bar graph showing that non-Hispanic whites comprised the largest race and ethnicity subgroup of persons with diabetes in the United States, regardless of age of diagnosis." /></a><div class="icnblk_cntnt" id="figlgndch8fig4"><h4 id="ch8.fig4"><a href="/books/NBK567995/figure/ch8.fig4/?report=objectonly" target="object" rid-ob="figobch8fig4">FIGURE 8.4</a></h4><p class="float-caption no_bottom_margin">Distribution of Race/Ethnicity, by Diabetes
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Status and Age at Diabetes Diagnosis, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * Current age: adults ≥20 years, youth <20 years</p></div></div><p>Except for non-Hispanic Asian/Pacific Islanders and non-Hispanic American Indian and Alaska Native persons in whom the estimate was unreliable, the percentages were 58.1%, 23.9%, and 16.9%, respectively, for youth age <20 years with diabetes (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig4/?report=objectonly" target="object" rid-figpopup="figch8fig4" rid-ob="figobch8fig4">Figure 8.4</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab3/?report=objectonly" target="object" rid-figpopup="figch8app1tab3" rid-ob="figobch8app1tab3">Appendix 8.3</a>).</p></div><div id="ch8.s3.4"><h3>Age Distribution by Sex</h3><p>Among adults, 87.2% of men and women with diabetes diagnosed age ≥20 years were age ≥45 years compared to 50.3% of adults without diabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab4/?report=objectonly" target="object" rid-figpopup="figch8app1tab4" rid-ob="figobch8app1tab4">Appendix 8.4</a>). Fewer men and women diagnosed age ≥20 years were age 20–44 years (13.5% and 12.1%, respectively) compared to men and women without diabetes (51.4% and 48.1%, respectively) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab4/?report=objectonly" target="object" rid-figpopup="figch8app1tab4" rid-ob="figobch8app1tab4">Appendix 8.4</a>). In 2006–2010, among adults with diabetes diagnosed age <20 years, 43.0% of men and 42.8% of women with diabetes were age 20–44 years; 36.7% of men and 31.2% of women were age 45–64 years; and 20.3% of men and 26.0% of women were age ≥65 years (data not shown).</p></div><div id="ch8.s3.5"><h3>Age Distribution by Race/Ethnicity</h3><p>Adults with diabetes were older than adults without diabetes in every race/ethnicity group examined (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig5/?report=objectonly" target="object" rid-figpopup="figch8fig5" rid-ob="figobch8fig5">Figure 8.5</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab4/?report=objectonly" target="object" rid-figpopup="figch8app1tab4" rid-ob="figobch8app1tab4">Appendix 8.4</a>). Considering groups having statistically reliable estimates, 79.7%–90.2% of non-Hispanic white, non-Hispanic black, Hispanic, or non-Hispanic Asian/Pacific Islander adults with diabetes diagnosed age ≥20 years were age ≥45 years in 2009–2010 compared to 32.3%–55.7% of adults without diabetes. A larger percentage of non-Hispanic white adults with or without diabetes were age ≥65 years and a smaller percentage were age 20–44 years compared to non-Hispanic black or Hispanic adults. The percentage of adults age ≥65 years with diabetes was 42.9% of non-Hispanic white, 31.6% of non-Hispanic black, 29.6% of Hispanic, and 39.3% of non-Hispanic Asian/Pacific Islander adults (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab4/?report=objectonly" target="object" rid-figpopup="figch8app1tab4" rid-ob="figobch8app1tab4">Appendix 8.4</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig5" co-legend-rid="figlgndch8fig5"><a href="/books/NBK567995/figure/ch8.fig5/?report=objectonly" target="object" title="FIGURE 8.5" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig5" rid-ob="figobch8fig5"><img class="small-thumb" src="/books/NBK567995/bin/ch8f5.gif" src-large="/books/NBK567995/bin/ch8f5.jpg" alt="Bar graphs showing that adults with diabetes were older than adults without diabetes in every race and ethnicity group examined." /></a><div class="icnblk_cntnt" id="figlgndch8fig5"><h4 id="ch8.fig5"><a href="/books/NBK567995/figure/ch8.fig5/?report=objectonly" target="object" rid-ob="figobch8fig5">FIGURE 8.5</a></h4><p class="float-caption no_bottom_margin">Distribution of Age Among Adults Age ≥20 Years, by Diabetes Status and Race/Ethnicity, U.S., 2009–2010. Data are self-reported. Error bars represent 95% confidence intervals. </p></div></div></div></div><div id="ch8.s4"><h2 id="_ch8_s4_">Diabetes Characteristics</h2><div id="ch8.s4.1"><h3>Age at Diagnosis of Diabetes</h3><p>In 2009–2010, the mean and median ages at diagnosis were 48.3 and 49.3 years for all adults with diabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab5/?report=objectonly" target="object" rid-figpopup="figch8app1tab5" rid-ob="figobch8app1tab5">Appendix 8.5</a>). For adults with diabetes diagnosed age ≥20 years, the mean age at diagnosis for adults age ≥20 years was 50.6 years; it was similar for men and women, and it varied by race/ethnicity group (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig6/?report=objectonly" target="object" rid-figpopup="figch8fig6" rid-ob="figobch8fig6">Figure 8.6</a>). Non-Hispanic white adults had a significantly older mean age at diagnosis (52.3 years) compared to non-Hispanic black (47.4 years), all Hispanic (47.3 years), Mexican American (46.2 years), non-Hispanic Asian/Pacific Islander adults (49.4 years), and non-Hispanic American Indian and Alaska Native adults (46.1 years) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab5/?report=objectonly" target="object" rid-figpopup="figch8app1tab5" rid-ob="figobch8app1tab5">Appendix 8.5</a>). In 2006–2010, the mean age at diagnosis was 9.6 years among adults diagnosed age <20 years, and no significant difference existed by sex. The only significant difference by race/ethnicity in this younger onset group was between the Hispanic and non-Hispanic American Indian and Alaska Native groups. Their mean ages at diagnosis were 7.5 years and 14.0 years, respectively (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig6/?report=objectonly" target="object" rid-figpopup="figch8fig6" rid-ob="figobch8fig6">Figure 8.6</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab5/?report=objectonly" target="object" rid-figpopup="figch8app1tab5" rid-ob="figobch8app1tab5">Appendix 8.5</a>). Median ages are presented in <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab5/?report=objectonly" target="object" rid-figpopup="figch8app1tab5" rid-ob="figobch8app1tab5">Appendix 8.5</a>.</p></div><div id="ch8.s4.2"><h3>Duration of Diabetes</h3><p>In 2009–2010, among all adults (age ≥20 years) with diabetes, the mean duration of diabetes was 11.6 years and the median duration was 7.6 years (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab6/?report=objectonly" target="object" rid-figpopup="figch8app1tab6" rid-ob="figobch8app1tab6">Appendix 8.6</a>). The range for diabetes duration among adults with diabetes was 1–84 years, and the mode for the diabetes duration was 2 years (noting that the top age was assigned as 85 years for those age ≥85 years). Men had a lower mean and median duration than women, but no significant race or ethnicity difference existed.</p><p>Among adults with diabetes diagnosed age ≥20 years, the overall mean duration was 9.9 years and was higher in women (10.7 years) compared to men (9.1 years) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab6/?report=objectonly" target="object" rid-figpopup="figch8app1tab6" rid-ob="figobch8app1tab6">Appendix 8.6</a>). The respective median durations were 6.8, 7.5, and 6.3 years. Adults with diabetes diagnosed age ≥20 years had a shorter duration of diabetes than adults diagnosed age <20 years. In 2006–2010, the mean duration of diabetes was 39.7 years and the median was 38.6 years in adults diagnosed age <20 years, and there was no significant sex difference for mean duration (40.1 years for women vs. 39.2 years for men). In 2009–2010, among adults with diabetes diagnosed age ≥20 years, 58.6% had a duration of diabetes <10 years, and the percentages decreased as the length of diabetes duration increased (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig7/?report=objectonly" target="object" rid-figpopup="figch8fig7" rid-ob="figobch8fig7">Figure 8.7</a>). In contrast, during 2006–2010 among adults with diabetes diagnosed age <20 years, the percentage was highest for those with diabetes duration ≥25 years; 77.2% had a duration ≥20 years and more than one-third reported a diabetes duration ≥50 years (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig7/?report=objectonly" target="object" rid-figpopup="figch8fig7" rid-ob="figobch8fig7">Figure 8.7</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab7/?report=objectonly" target="object" rid-figpopup="figch8app1tab7" rid-ob="figobch8app1tab7">Appendix 8.7</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig6" co-legend-rid="figlgndch8fig6"><a href="/books/NBK567995/figure/ch8.fig6/?report=objectonly" target="object" title="FIGURE 8.6" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig6" rid-ob="figobch8fig6"><img class="small-thumb" src="/books/NBK567995/bin/ch8f6.gif" src-large="/books/NBK567995/bin/ch8f6.jpg" alt="Bar graph showing that for adults with diabetes diagnosed equal to or greater than 20 years of age, mean age at diagnosis for adults was 50.6 years and similar by sex but differed by ethnicity." /></a><div class="icnblk_cntnt" id="figlgndch8fig6"><h4 id="ch8.fig6"><a href="/books/NBK567995/figure/ch8.fig6/?report=objectonly" target="object" rid-ob="figobch8fig6">FIGURE 8.6</a></h4><p class="float-caption no_bottom_margin">Mean Age at Diabetes Diagnosis Among Adults Age ≥20 Years, by Age at Diabetes Diagnosis, Sex, and Race/Ethnicity, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * 2009–2010</p></div></div><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig7" co-legend-rid="figlgndch8fig7"><a href="/books/NBK567995/figure/ch8.fig7/?report=objectonly" target="object" title="FIGURE 8.7" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig7" rid-ob="figobch8fig7"><img class="small-thumb" src="/books/NBK567995/bin/ch8f7.gif" src-large="/books/NBK567995/bin/ch8f7.jpg" alt="Bar graph showing that for adults with diabetes diagnosed equal to or greater than 20 years of age, 58.6 percent had a duration of diabetes less than 10 years." /></a><div class="icnblk_cntnt" id="figlgndch8fig7"><h4 id="ch8.fig7"><a href="/books/NBK567995/figure/ch8.fig7/?report=objectonly" target="object" rid-ob="figobch8fig7">FIGURE 8.7</a></h4><p class="float-caption no_bottom_margin">Duration of Diabetes Among Adults Age ≥20 Years, by Age at Diagnosis, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * 2009–2010</p></div></div><p>The only significant difference between race/ethnicity groups for mean diabetes duration was between Hispanic and non-Hispanic American Indian and Alaska Native groups (45.1 years and 24.7 years, respectively) whose diabetes was diagnosed age <20 years (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab6/?report=objectonly" target="object" rid-figpopup="figch8app1tab6" rid-ob="figobch8app1tab6">Appendix 8.6</a>). Among those with diabetes diagnosed age ≥20 years, the estimated mean duration range was from 9.1 years for other Hispanic adults to 10.4 years for non-Hispanic black adults, and among those with diabetes diagnosed age <20 years the estimated mean duration range was from 24.7 years for non-Hispanic American Indian and Alaska Native adults to 45.2 years for Mexican American adults.</p></div></div><div id="ch8.s5"><h2 id="_ch8_s5_">Place of Residence</h2><div id="ch8.s5.1"><h3>State of Residence in the United States</h3><p>In general, the rank order of top 10 states with the largest percentages of the total diabetes population in the United States is similar to the rank order of states with the largest percentages of the total U.S. population without diabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab8/?report=objectonly" target="object" rid-figpopup="figch8app1tab8" rid-ob="figobch8app1tab8">Appendix 8.8</a>). Approximately 53% of people with diabetes compared to 52% of people without diabetes lived in these 10 states. The top 10 states with diabetes in descending order were California, Texas, Florida, New York, Ohio, Illinois, Pennsylvania, Michigan, North Carolina, and Georgia. The rank order of states with the largest percentages of U.S. persons without diabetes in descending order was nearly identical, except for rank placement of Ohio, which ranked fifth for the percentage of the U.S. people with diabetes (4.5%) but ranked seventh for the percentage of U.S. people without diabetes (4.0%). With the exception of California and Texas, all other top 10 states are east of the Mississippi River.</p></div><div id="ch8.s5.2"><h3>Metropolitan/Nonmetropolitan County of Residence</h3><p>The majority of adults with and without diabetes lived in more urban counties. In 2009–2010, 80.4% of adults with diabetes diagnosed age ≥20 years lived in metropolitan counties (that is, large, medium, or small) compared to 84.3% of adults without diabetes (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig8/?report=objectonly" target="object" rid-figpopup="figch8fig8" rid-ob="figobch8fig8">Figure 8.8</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab9/?report=objectonly" target="object" rid-figpopup="figch8app1tab9" rid-ob="figobch8app1tab9">Appendix 8.9</a>). The percentage living in nonmetropolitan counties, which include micropolitan counties in micropolitan statistical areas and nonmetropolitan counties not in micropolitan statistical areas (i.e., non-core counties), was 19.7% among those diagnosed age ≥20 years compared with 15.8% of adults without diabetes. No significant percentage differences were observed between adults with diabetes diagnosed age ≥20 years and those without diabetes in the detailed metropolitan/nonmetropolitan categories. During 2006–2010, adults with diabetes diagnosed age <20 years had a similar metropolitan/nonmetropolitan pattern as adults diagnosed age ≥20 years (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig8/?report=objectonly" target="object" rid-figpopup="figch8fig8" rid-ob="figobch8fig8">Figure 8.8</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab9/?report=objectonly" target="object" rid-figpopup="figch8app1tab9" rid-ob="figobch8app1tab9">Appendix 8.9</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig8" co-legend-rid="figlgndch8fig8"><a href="/books/NBK567995/figure/ch8.fig8/?report=objectonly" target="object" title="FIGURE 8.8" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig8" rid-ob="figobch8fig8"><img class="small-thumb" src="/books/NBK567995/bin/ch8f8.gif" src-large="/books/NBK567995/bin/ch8f8.jpg" alt="Bar graph showing that the majority of adults with and without diabetes lived in more urban counties with the largest percentage living in large center metro areas." /></a><div class="icnblk_cntnt" id="figlgndch8fig8"><h4 id="ch8.fig8"><a href="/books/NBK567995/figure/ch8.fig8/?report=objectonly" target="object" rid-ob="figobch8fig8">FIGURE 8.8</a></h4><p class="float-caption no_bottom_margin">Metropolitan/Nonmetropolitan County of Residence of Adults Age ≥20 Years, by Diabetes Status and Age at Diabetes Diagnosis, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * Reference 15</p></div></div></div><div id="ch8.s5.3"><h3>Region of the United States</h3><p>Overall, the regional distribution of all adults with diabetes diagnosed age ≥20 years was generally similar to the distribution of adults without diagnosed diabetes (16.0% in the Northeast, 24.8% in the Midwest, and 20.5% in the West compared to 17.9%, 23.5%, and 23.3%, respectively, for adults without diabetes) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig9/?report=objectonly" target="object" rid-figpopup="figch8fig9" rid-ob="figobch8fig9">Figure 8.9</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab10/?report=objectonly" target="object" rid-figpopup="figch8app1tab10" rid-ob="figobch8app1tab10">Appendix 8.10</a>). A higher percentage of adults with diabetes diagnosed age <20 years lived in the South (46.1%) and a lower percentage in the West (16.4%) compared to adults without diabetes (35.3% and 23.3%, respectively) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab10/?report=objectonly" target="object" rid-figpopup="figch8app1tab10" rid-ob="figobch8app1tab10">Appendix 8.10</a>).</p><p>The regions of the United States where most diabetic individuals lived varied by race and ethnicity, and the distributions were similar to those among adults without diabetes; however, one significant difference existed (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab10/?report=objectonly" target="object" rid-figpopup="figch8app1tab10" rid-ob="figobch8app1tab10">Appendix 8.10</a>). Other Hispanic adults (i.e., Hispanic, but not Mexican American) with diabetes diagnosed age ≥20 years less often lived in the West (19.1%) compared to other Hispanic adults without diabetes (31.1%). The regions with the largest race/ethnicity percentages of total U.S. adults with diabetes diagnosed age ≥20 years were: 66.3% of non-Hispanic white adults resided in the Midwest and South; 79.1% of non-Hispanic black adults resided in the Midwest and South; 77.4% of Hispanic adults resided in the South and West; 90.2% of Mexican American adults (the largest Hispanic subgroup) also resided in the South and West; 51.9% of non-Hispanic Asian/Pacific Islander adults resided in the West; and 53.4% of non-Hispanic American Indian and Alaska Native adults resided in the West.</p><p>In 2006–2010, higher percentages of non-Hispanic white and non-Hispanic black adults with diabetes diagnosed age <20 years resided in the South (40.9% and 71.4%, respectively) compared to non-Hispanic white and non-Hispanic black adults without diabetes in the South in 2009–2010 (33.1% and 56.1%, respectively) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab10/?report=objectonly" target="object" rid-figpopup="figch8app1tab10" rid-ob="figobch8app1tab10">Appendix 8.10</a>).</p></div><div id="ch8.s5.4"><h3>Regions of the World</h3><p>In general, people with or without diabetes in the United States were born in similar regions of the world. In 2009–2010, 83.2% of U.S. adults with diabetes diagnosed age ≥20 years and 83.0% of adults without diabetes were born in the United States (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab11/?report=objectonly" target="object" rid-figpopup="figch8app1tab11" rid-ob="figobch8app1tab11">Appendix 8.11</a>). However, there were a few small, but significant, exceptions. Lower percentages of U.S. adults with diabetes were born in Asia and South America. No sex difference existed. Among adults with diabetes, the percentages of U.S.-born were 95.5% of non-Hispanic white, 90.0% of non-Hispanic black, 39.2% of Hispanic (47.9% of Mexican American and 24.2% of other Hispanic), 19.9% of non-Hispanic Asian/Pacific Islander, and 93.7% of non-Hispanic American Indian and Alaska Native adults. Among non-Hispanic Asian/Pacific Islander adults with diabetes diagnosed age ≥20 years, 33% were born in Southeast Asia, 25.8% in the Indian subcontinent, and 17.7% in other Asian/Pacific Islander areas. Among Hispanic adults with diabetes diagnosed age ≥20 years, the percentage born in the United States was similar among those without diabetes, except for the other Hispanic group. In 2006–2010, among those diagnosed with diabetes age <20 years, 96.8% of youth currently age <20 years and 85.9% of adults currently age ≥20 years with diabetes were born in the United States, which are significantly different.</p></div><div id="ch8.s5.5"><h3>Years Living in the United States, Among Immigrants</h3><p>In 2009–2010, immigrant adults with diabetes lived in the United States longer than immigrant adults without diabetes. A higher percentage of immigrant adults with diabetes (72.3% diagnosed age <20 years and 84.2% diagnosed age ≥20 years) lived in the United States for more than 15 years than immigrant adults without diabetes (58.5%) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig10/?report=objectonly" target="object" rid-figpopup="figch8fig10" rid-ob="figobch8fig10">Figure 8.10</a>). The percentage having lived in the United States ≥15 years increased within the age groups 20–44, 45–64, and ≥65 years. The percentages were 66.7%, 86.1%, and 89.7% among adults with diabetes diagnosed age ≥20 years compared to 42.3%, 79.7%, and 89.2% among adults without diabetes (data not shown). Among adults with diabetes, there were no significant sex or race/ethnicity differences for the years living in the United States (data not shown).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig9" co-legend-rid="figlgndch8fig9"><a href="/books/NBK567995/figure/ch8.fig9/?report=objectonly" target="object" title="FIGURE 8.9" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig9" rid-ob="figobch8fig9"><img class="small-thumb" src="/books/NBK567995/bin/ch8f9.gif" src-large="/books/NBK567995/bin/ch8f9.jpg" alt="Bar graph showing that the regional distribution of all adults with diabetes diagnosed greater than or equal to 20 years was similar to the distribution of adults without diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig9"><h4 id="ch8.fig9"><a href="/books/NBK567995/figure/ch8.fig9/?report=objectonly" target="object" rid-ob="figobch8fig9">FIGURE 8.9</a></h4><p class="float-caption no_bottom_margin">Region of Residence Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2009–2010. Data not available for U.S. Territories. Data are self-reported. Error bars represent 95% confidence intervals. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig10" co-legend-rid="figlgndch8fig10"><a href="/books/NBK567995/figure/ch8.fig10/?report=objectonly" target="object" title="FIGURE 8.10" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig10" rid-ob="figobch8fig10"><img class="small-thumb" src="/books/NBK567995/bin/ch8f10.gif" src-large="/books/NBK567995/bin/ch8f10.jpg" alt="Bar graph showing that a higher percentage of immigrant adults with diabetes, regardless of age of diagnosis, lived in the United States for more than 15 years than those without diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig10"><h4 id="ch8.fig10"><a href="/books/NBK567995/figure/ch8.fig10/?report=objectonly" target="object" rid-ob="figobch8fig10">FIGURE 8.10</a></h4><p class="float-caption no_bottom_margin">Years in the United States Among Adults Age ≥20 Years Who Were Immigrants, by Diabetes Status and Age at Diabetes Diagnosis, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * 2009–2010</p></div></div></div></div><div id="ch8.s6"><h2 id="_ch8_s6_">Socioeconomic Characteristics</h2><div id="ch8.s6.1"><h3>Marital Status</h3><p>A higher percentage of adults who had diabetes diagnosed age ≥20 years were ever married (currently married, divorced/separated, or widowed) and a lower percentage never married or currently lived with a partner compared to adults without diabetes (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig11/?report=objectonly" target="object" rid-figpopup="figch8fig11" rid-ob="figobch8fig11">Figure 8.11</a>). A larger percentage of adults with diabetes age 20–44 years were divorced or separated than adults without diabetes (12.8% vs. 7.6%) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab12/?report=objectonly" target="object" rid-figpopup="figch8app1tab12" rid-ob="figobch8app1tab12">Appendix 8.12</a>). A larger percentage of men with diabetes diagnosed age ≥20 years were married than women with diabetes diagnosed age ≥20 years or men without diabetes (68.9%, 48.9%, 57.6%, respectively), and a larger percentage of women with diabetes diagnosed age ≥20 years were widowed (20.5%) or divorced/separated (18.1%) compared to men with diabetes diagnosed age ≥20 years (5.8% and 12.0%) or women without diabetes (8.4% and 12.8%). The marital status differences between adults with or without diabetes were diminished with increasing age groups. Regardless of diabetes status, men age ≥65 years were more often married (>70%) than women (<45%) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab12/?report=objectonly" target="object" rid-figpopup="figch8app1tab12" rid-ob="figobch8app1tab12">Appendix 8.12</a>). The percentage married ranged from 71.5% among non-Hispanic Asian/Pacific Islander to 42.0% among non-Hispanic black adults with diabetes diagnosed age ≥20 years and from 66.1% to 35.8% among adults without diabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab13/?report=objectonly" target="object" rid-figpopup="figch8app1tab13" rid-ob="figobch8app1tab13">Appendix 8.13</a>). In 2006–2010, adults with diabetes diagnosed age <20 years had similar marital status compared to adults in 2009–2010 with diabetes diagnosed age ≥20 years; however, the younger diagnosis group was also more likely to never have married (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab12/?report=objectonly" target="object" rid-figpopup="figch8app1tab12" rid-ob="figobch8app1tab12">Appendix 8.12</a>).</p></div><div id="ch8.s6.2"><h3>Type of Cohabitation</h3><p>In 2009–2010, 78.9% of adults with diabetes diagnosed age ≥20 years lived with others (32.0% with a married spouse but no child, 22.0% with a child with or without another adult, and 24.9% with other adults but no child). Nearly 83% of adults without diabetes lived with someone and were less likely to have lived with a married spouse only (23.0%) and more likely to have lived with a child (37.1%) compared to adults with diabetes diagnosed age ≥20 years (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig12/?report=objectonly" target="object" rid-figpopup="figch8fig12" rid-ob="figobch8fig12">Figure 8.12</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab14/?report=objectonly" target="object" rid-figpopup="figch8app1tab14" rid-ob="figobch8app1tab14">Appendix 8.14</a>). In 2009–2010, within race/ethnicity groups (except non-Hispanic Asian/Pacific Islanders), the percentage who lived alone was higher in adults with diabetes diagnosed age ≥20 years compared to adults without diabetes: 22.0% versus 18.2% in non-Hispanic white; 27.4% versus 21.6% in non-Hispanic black; and 13.5% versus 9.3% in Hispanic adults (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab15/?report=objectonly" target="object" rid-figpopup="figch8app1tab15" rid-ob="figobch8app1tab15">Appendix 8.15</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig11" co-legend-rid="figlgndch8fig11"><a href="/books/NBK567995/figure/ch8.fig11/?report=objectonly" target="object" title="FIGURE 8.11" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig11" rid-ob="figobch8fig11"><img class="small-thumb" src="/books/NBK567995/bin/ch8f11.gif" src-large="/books/NBK567995/bin/ch8f11.jpg" alt="Bar graph showing that a higher percentage of adults who had diabetes diagnosed at age 20 years or greater were ever married compared to adults without diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig11"><h4 id="ch8.fig11"><a href="/books/NBK567995/figure/ch8.fig11/?report=objectonly" target="object" rid-ob="figobch8fig11">FIGURE 8.11</a></h4><p class="float-caption no_bottom_margin">Marital Status Among Adults Age ≥20 Years, by Diabetes Status and Age at Diabetes Diagnosis, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * 2009–2010</p></div></div><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig12" co-legend-rid="figlgndch8fig12"><a href="/books/NBK567995/figure/ch8.fig12/?report=objectonly" target="object" title="FIGURE 8.12" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig12" rid-ob="figobch8fig12"><img class="small-thumb" src="/books/NBK567995/bin/ch8f12.gif" src-large="/books/NBK567995/bin/ch8f12.jpg" alt="Bar graph showing that 78.9 percent of adults with diabetes diagnosed greater than or equal to 20 years lived with others and the majority lived with a married spouse." /></a><div class="icnblk_cntnt" id="figlgndch8fig12"><h4 id="ch8.fig12"><a href="/books/NBK567995/figure/ch8.fig12/?report=objectonly" target="object" rid-ob="figobch8fig12">FIGURE 8.12</a></h4><p class="float-caption no_bottom_margin">Type of Cohabitation Among Adults Age ≥20 Years, by Diabetes Status and Age at Diabetes Diagnosis, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * With children includes a mother or father living <a href="/books/NBK567995/figure/ch8.fig12/?report=objectonly" target="object" rid-ob="figobch8fig12">(more...)</a></p></div></div><p>Most of these differences between adults with or without diabetes by race/ethnicity did not remain significantly different within age-specific categories (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab15/?report=objectonly" target="object" rid-figpopup="figch8app1tab15" rid-ob="figobch8app1tab15">Appendix 8.15</a>). In 2006–2010, compared to those with diabetes diagnosed age ≥20 years, the percentage of adults with diabetes diagnosed age <20 years who were married with a spouse was lower (23.0% vs. 32.0%), and the percentage who lived with a child was higher (30.5% vs. 22.0%) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig12/?report=objectonly" target="object" rid-figpopup="figch8fig12" rid-ob="figobch8fig12">Figure 8.12</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab14/?report=objectonly" target="object" rid-figpopup="figch8app1tab14" rid-ob="figobch8app1tab14">Appendix 8.14</a>).</p></div><div id="ch8.s6.3"><h3>Family Size</h3><p>Adults with diabetes diagnosed age ≥20 years lived in households with smaller family size than adults without diabetes. A higher percentage of adults with diabetes diagnosed age ≥20 years lived in a family of two persons compared to adults without diabetes (39.3% vs. 29.3%) and less often lived in a family of four or more (21.3% vs. 29.6%); this pattern was present for both sexes (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig13/?report=objectonly" target="object" rid-figpopup="figch8fig13" rid-ob="figobch8fig13">Figure 8.13</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab16/?report=objectonly" target="object" rid-figpopup="figch8app1tab16" rid-ob="figobch8app1tab16">Appendix 8.16</a>). Women with diabetes were more often in a family size of one compared to men with diabetes (28.4% vs. 19.9%). Family size varied by race/ethnicity group among adults with and without diabetes. Among those with diabetes diagnosed age ≥20 years, non-Hispanic white adults more often had a family of two (44.8%); Hispanic and non-Hispanic Asian/Pacific Islander adults more likely had a family of four or more (41.0% and 36.9%), and non-Hispanic black adults were equally likely to have a family size of one or two (30.2% and 33.1%) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab17/?report=objectonly" target="object" rid-figpopup="figch8app1tab17" rid-ob="figobch8app1tab17">Appendix 8.17</a>). Over 95% of all youth (age <20 years) with diabetes lived in families with two or more members (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig13/?report=objectonly" target="object" rid-figpopup="figch8fig13" rid-ob="figobch8fig13">Figure 8.13</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab16/?report=objectonly" target="object" rid-figpopup="figch8app1tab16" rid-ob="figobch8app1tab16">Appendix 8.16</a>).</p></div><div id="ch8.s6.4"><h3>Education</h3><p>Adults age ≥25 years with diabetes attained less education than similar age adults without diabetes (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig14/?report=objectonly" target="object" rid-figpopup="figch8fig14" rid-ob="figobch8fig14">Figure 8.14</a>). While the percentage with some college education was similar, a smaller percentage of adults with diabetes diagnosed age ≥20 years graduated from college (17.6%) compared to adults without diabetes (31.4%), and a larger percentage had less than a high school education (23.7% vs. 13.2%) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig14/?report=objectonly" target="object" rid-figpopup="figch8fig14" rid-ob="figobch8fig14">Figure 8.14</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab18/?report=objectonly" target="object" rid-figpopup="figch8app1tab18" rid-ob="figobch8app1tab18">Appendices 8.18</a> and <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab19/?report=objectonly" target="object" rid-figpopup="figch8app1tab19" rid-ob="figobch8app1tab19">8.19</a>). By age, differences existed between adults with and without diabetes within age groups 25–44 and 45–64 years but were less pronounced in adults age ≥65 years. The percentage with <9th grade education was highest in the ≥65 years age group (16.3% with diabetes diagnosed age ≥20 years and 9.0% without diabetes). Among adults with diabetes diagnosed age ≥20 years, women were less likely to be college graduates compared to men (13.8% vs. 21.2%). A similar pattern, but much smaller difference, existed among women (30.4%) and men (32.5%) without diabetes. Non-Hispanic Asian/Pacific Islander adults in both groups had the highest level of education followed by non-Hispanic white, non-Hispanic black, and Hispanic adults. In 2006–2010, adults age ≥25 years with diabetes diagnosed age <20 years had similar levels of attained education as adults in 2009–2010 who had diabetes diagnosed age ≥20 years (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab18/?report=objectonly" target="object" rid-figpopup="figch8app1tab18" rid-ob="figobch8app1tab18">Appendices 8.18</a> and <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab19/?report=objectonly" target="object" rid-figpopup="figch8app1tab19" rid-ob="figobch8app1tab19">8.19</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig13" co-legend-rid="figlgndch8fig13"><a href="/books/NBK567995/figure/ch8.fig13/?report=objectonly" target="object" title="FIGURE 8.13" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig13" rid-ob="figobch8fig13"><img class="small-thumb" src="/books/NBK567995/bin/ch8f13.gif" src-large="/books/NBK567995/bin/ch8f13.jpg" alt="Bar graph showing that adults with diabetes diagnosed at age 20 years or greater lived in households with smaller family size compared to adults without diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig13"><h4 id="ch8.fig13"><a href="/books/NBK567995/figure/ch8.fig13/?report=objectonly" target="object" rid-ob="figobch8fig13">FIGURE 8.13</a></h4><p class="float-caption no_bottom_margin">Family Size Among Persons, by Diabetes Status and Age at Diabetes Diagnosis, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * Current age: adults ≥20 years, youth <20 years</p></div></div></div><div id="ch8.s6.5"><h3>Family Income</h3><p>In 2009–2010, adults with diabetes had a lower family income than those without diabetes (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig15/?report=objectonly" target="object" rid-figpopup="figch8fig15" rid-ob="figobch8fig15">Figure 8.15</a>). Within age groups, adults with diabetes compared to adults of similar age without diabetes had less family income, except for the age group 20–44 years (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab20/?report=objectonly" target="object" rid-figpopup="figch8app1tab20" rid-ob="figobch8app1tab20">Appendix 8.20</a>). Adult men and women with diabetes had less family income compared to their counterparts without diabetes. A larger percentage of women with diabetes had a family income <$35,000 (51.2%) compared to men with diabetes (36.8%) or women (34.6%) or men (30.1%) without diabetes. Adults with diabetes had lower family income within non-Hispanic white and non-Hispanic black groups, but no significant difference existed between adults with or without diabetes who were Hispanic or non-Hispanic Asian/Pacific Islander. After considering both age and race/ethnicity groups, some adults age 45–64 years with diabetes (e.g., non-Hispanic white and non-Hispanic black adults with diabetes diagnosed age ≥20 years) had lower family incomes than similar age adults without diabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab21/?report=objectonly" target="object" rid-figpopup="figch8app1tab21" rid-ob="figobch8app1tab21">Appendix 8.21</a>).</p><p>In 2007–2010, adults with diabetes diagnosed age <20 years had lower family income than adults in 2009–2010 with diabetes diagnosed age ≥20 years (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig15/?report=objectonly" target="object" rid-figpopup="figch8fig15" rid-ob="figobch8fig15">Figure 8.15</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab20/?report=objectonly" target="object" rid-figpopup="figch8app1tab20" rid-ob="figobch8app1tab20">Appendix 8.20</a>). Among persons with diabetes diagnosed age <20 years, adults and youth (age <20 years) had similar family incomes (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig15/?report=objectonly" target="object" rid-figpopup="figch8fig15" rid-ob="figobch8fig15">Figure 8.15</a>).</p></div><div id="ch8.s6.6"><h3>Poverty Income Ratio</h3><p>A higher percentage of adults with diabetes diagnosed age ≥20 years were below or near the poverty level compared to adults without diabetes. Thirty-eight percent (38.4%) had a PIR <2.00 compared to 30.7% of adults without diabetes, and fewer adults with diabetes (31.6%) were in the most economically advantaged PIR category (≥4.00) compared to adults without diabetes (40.8%) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig16/?report=objectonly" target="object" rid-figpopup="figch8fig16" rid-ob="figobch8fig16">Figure 8.16</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab22/?report=objectonly" target="object" rid-figpopup="figch8app1tab22" rid-ob="figobch8app1tab22">Appendix 8.22</a>). A higher percentage of women compared to men were below the poverty level (PIR <1.00): 19.0% of women and 10.9% of men with diabetes diagnosed age ≥20 years compared to 14.7% and 11.7% of women and men without diabetes. Among adults with or without diabetes, the age group 20–44 years had the highest percentage below poverty (PIR <1.00), and the age group 45–64 years had the highest percentage in the PIR ≥4.00 group. Non-Hispanic black and Hispanic adults had a higher percentage below the poverty level compared to non-Hispanic white or Asian/Pacific Islander adults (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab22/?report=objectonly" target="object" rid-figpopup="figch8app1tab22" rid-ob="figobch8app1tab22">Appendices 8.22</a> and <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab23/?report=objectonly" target="object" rid-figpopup="figch8app1tab23" rid-ob="figobch8app1tab23">8.23</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig14" co-legend-rid="figlgndch8fig14"><a href="/books/NBK567995/figure/ch8.fig14/?report=objectonly" target="object" title="FIGURE 8.14" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig14" rid-ob="figobch8fig14"><img class="small-thumb" src="/books/NBK567995/bin/ch8f14.gif" src-large="/books/NBK567995/bin/ch8f14.jpg" alt="Bar graph showing that adults age 25 years or greater with diabetes attained less education than similar age adults without diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig14"><h4 id="ch8.fig14"><a href="/books/NBK567995/figure/ch8.fig14/?report=objectonly" target="object" rid-ob="figobch8fig14">FIGURE 8.14</a></h4><p class="float-caption no_bottom_margin">Education Among Adults Age ≥25 Years, by Diabetes Status, Age at Diabetes Diagnosis, and Race/Ethnicity, U.S., 2006–2010. Education status was assessed above current age 25 years to allow time to graduate from college. Data are self-reported. <a href="/books/NBK567995/figure/ch8.fig14/?report=objectonly" target="object" rid-ob="figobch8fig14">(more...)</a></p></div></div><p>In 2006–2010, 23.8% of adults with diabetes diagnosed age <20 years lived below poverty (PIR <1.00) compared to 14.8% of adults in 2009–2010 who had diabetes diagnosed age ≥20 years (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig16/?report=objectonly" target="object" rid-figpopup="figch8fig16" rid-ob="figobch8fig16">Figure 8.16</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab22/?report=objectonly" target="object" rid-figpopup="figch8app1tab22" rid-ob="figobch8app1tab22">Appendices 8.22</a> and <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab23/?report=objectonly" target="object" rid-figpopup="figch8app1tab23" rid-ob="figobch8app1tab23">8.23</a>). The PIR distribution for youth (data not shown) and adults with diabetes diagnosed age <20 years were not significantly different, and around 50% were below or near the poverty level (PIR <2.00) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig16/?report=objectonly" target="object" rid-figpopup="figch8fig16" rid-ob="figobch8fig16">Figure 8.16</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig15" co-legend-rid="figlgndch8fig15"><a href="/books/NBK567995/figure/ch8.fig15/?report=objectonly" target="object" title="FIGURE 8.15" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig15" rid-ob="figobch8fig15"><img class="small-thumb" src="/books/NBK567995/bin/ch8f15.gif" src-large="/books/NBK567995/bin/ch8f15.jpg" alt="Bar graph showing that adults with diabetes, regardless of age of diagnosis, had a lower family income than those without diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig15"><h4 id="ch8.fig15"><a href="/books/NBK567995/figure/ch8.fig15/?report=objectonly" target="object" rid-ob="figobch8fig15">FIGURE 8.15</a></h4><p class="float-caption no_bottom_margin">Family Income Among Persons, by Diabetes Status and Age at Diabetes Diagnosis, U.S., 2007–2010. Data are self-reported for 70%–90% of respondents in each category and imputed for others. Error bars represent 95% confidence intervals. * <a href="/books/NBK567995/figure/ch8.fig15/?report=objectonly" target="object" rid-ob="figobch8fig15">(more...)</a></p></div></div><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig16" co-legend-rid="figlgndch8fig16"><a href="/books/NBK567995/figure/ch8.fig16/?report=objectonly" target="object" title="FIGURE 8.16" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig16" rid-ob="figobch8fig16"><img class="small-thumb" src="/books/NBK567995/bin/ch8f16.gif" src-large="/books/NBK567995/bin/ch8f16.jpg" alt="Bar graph showing that 23.8 percent of adults with diabetes diagnosed age less than 20 years lived below poverty compared to 14.8 percent who had diabetes diagnosed age greater than 20 years." /></a><div class="icnblk_cntnt" id="figlgndch8fig16"><h4 id="ch8.fig16"><a href="/books/NBK567995/figure/ch8.fig16/?report=objectonly" target="object" rid-ob="figobch8fig16">FIGURE 8.16</a></h4><p class="float-caption no_bottom_margin">Family Poverty Income Ratio Among Persons, by Diabetes Diagnosis and Sex, U.S., 2007–2010. Subgroup analysis by sex was not possible for youth <20 years because of insufficient sample size. Poverty Income Ratio (PIR) is based on family <a href="/books/NBK567995/figure/ch8.fig16/?report=objectonly" target="object" rid-ob="figobch8fig16">(more...)</a></p></div></div></div></div><div id="ch8.s7"><h2 id="_ch8_s7_">Communication Characteristics</h2><div id="ch8.s7.1"><h3>Main Language of Interview</h3><p>English was spoken by the vast majority of people with and without diabetes in the United States, and Spanish was the next most common spoken language. In 2009–2010, English only was used during 93.9% of NHIS interviews of people with diabetes diagnosed at age ≥20 years and during 94.4% of interviews with those without diabetes (data not shown). Spanish only or Spanish and English were used for about 5% of interviews of adults with or without diabetes. Language use was similar by age and sex, with the range for English only being 92.9% (for age 20–44 years) to 94.5% (for males). Regardless of diabetes status, 99% of non-Hispanic white and non-Hispanic black adults spoke English, and among Hispanic adults, about 22% spoke Spanish only and 14% spoke English and Spanish for their interview. These percentages were similar in Hispanic subgroups. Among all non-Hispanic Asian/Pacific Islander adults, regardless of diabetes status, approximately 93% used English only for their interview. In 2006–2010, among persons with diabetes diagnosed at age <20 years, 93.4% of adults and 95.7% of youth used English only for the NHIS interview (data not shown).</p></div><div id="ch8.s7.2"><h3>Household Telephone Access</h3><p>In 2006–2010, nearly all adults with diabetes had access to a telephone in their home (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig17/?report=objectonly" target="object" rid-figpopup="figch8fig17" rid-ob="figobch8fig17">Figure 8.17</a>), but the type of telephone (i.e., landline or cellular) varied. Regardless of the age at diagnosis, about 20% of adults with diabetes had only a landline telephone compared to 11.1% of adults without diabetes. Phone type was similar for men and women with diabetes, except 82.1% of men with diabetes diagnosed at age ≥20 years had a cell phone in the family compared to 75.8% of women with diabetes diagnosed at age ≥20 years (data not shown). For the age group 20–44 years, 27.8% of adults with diabetes diagnosed at age ≥20 years and 39.5% of adults without diabetes only had cell phone access, but there were no differences by diabetes status in the 45–64 years (15.0% vs. 16.2%) or ≥65 years age groups (7.2% vs. 5.7%). The percentage of cell phone-only households among adults with diabetes diagnosed age ≥20 years varied by race/ethnicity (8.8% of non-Hispanic Asian/Pacific Islander, 11.3% of non-Hispanic white, 15.2% of non-Hispanic black, 22.7% of Hispanic adults). Adults with diabetes diagnosed age ≥20 years compared to adults without diabetes less frequently had a working cell phone in their family (79.0% vs. 87.1%), and lower access was observed in most age, sex, and race/ethnicity categories examined.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig17" co-legend-rid="figlgndch8fig17"><a href="/books/NBK567995/figure/ch8.fig17/?report=objectonly" target="object" title="FIGURE 8.17" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig17" rid-ob="figobch8fig17"><img class="small-thumb" src="/books/NBK567995/bin/ch8f17.gif" src-large="/books/NBK567995/bin/ch8f17.jpg" alt="Pie charts showing that nearly all adults with diabetes had access to a telephone in their home but 20 percent with diabetes had only a landline compared to 11 percent without diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig17"><h4 id="ch8.fig17"><a href="/books/NBK567995/figure/ch8.fig17/?report=objectonly" target="object" rid-ob="figobch8fig17">FIGURE 8.17</a></h4><p class="float-caption no_bottom_margin">Household Telephone Access Among Adults Age ≥20 Years, by Diabetes Status and Age at Diabetes Diagnosis, U.S., 2006–2010. Data are self-reported. * 2009–2010</p></div></div></div></div><div id="ch8.s8"><h2 id="_ch8_s8_">Employment Characteristics</h2><div id="ch8.s8.1"><h3>Employment Status in the Past 12 Months</h3><p>In 2009–2010, adults with diabetes diagnosed age ≥20 years were less likely to be working (43.3%) in the previous 12 months or never worked (6.2%) compared to adults without diabetes (71.8% and 4.4%) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig18/?report=objectonly" target="object" rid-figpopup="figch8fig18" rid-ob="figobch8fig18">Figure 8.18</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab24/?report=objectonly" target="object" rid-figpopup="figch8app1tab24" rid-ob="figobch8app1tab24">Appendix 8.24</a>). Among adults with diabetes diagnosed at age ≥20 years, men were more likely to be working than women (49.0% vs. 37.2%). No significant race/ethnicity differences were noted for working in the last year, except in Hispanic groups who had a higher percentage never working (14.4%) compared to non-Hispanic white (4.0%) and non-Hispanic black (5.3%) groups. Adults in 2009–2010 with diabetes diagnosed at age ≥20 years were less likely to have never worked (6.2%) or be working in the last year (43.3%) than adults in 2006–2010 with diabetes diagnosed at age <20 years (9.8% and 53.7%, respectively).</p></div><div id="ch8.s8.2"><h3>Employment Status in Prior Week</h3><p>When queried in 2009–2010, 35.0% of adults with diabetes diagnosed age ≥20 years and 60.3% of adults without diabetes reported working at a paying job in the prior week. The response “not working and not looking for work” was reported by 59.0% and 29.5% of these groups, respectively.</p><p>During 2006–2010, the estimates for adults with diabetes diagnosed at age <20 years were 42.3% (working) and 48.7% (not working and not looking) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab25/?report=objectonly" target="object" rid-figpopup="figch8app1tab25" rid-ob="figobch8app1tab25">Appendix 8.25</a>).</p></div><div id="ch8.s8.3"><h3>Main Reason for Not Working in Prior Week</h3><p>Among adults with diabetes diagnosed at age ≥20 years, retirement and disability were the main reasons for not working in the prior week (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig19/?report=objectonly" target="object" rid-figpopup="figch8fig19" rid-ob="figobch8fig19">Figure 8.19</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab26/?report=objectonly" target="object" rid-figpopup="figch8app1tab26" rid-ob="figobch8app1tab26">Appendix 8.26</a>). In adults without diabetes, the main reasons were retirement or other reasons, especially caring for the family or home. Women, regardless of a diabetes diagnosis, were more likely to report caring for the family or home as the main reason for not working compared to men.</p><p>The main reason reported for not working varied by race/ethnicity group. Sixty percent (60.8%) of non-Hispanic white adults with diabetes diagnosed age ≥20 years and 50.0% without diabetes reported being retired compared to 46.8% and 30.1% of non-Hispanic blacks and 47.6% and 20.3% of Hispanics, respectively. Over 18% of Hispanic adults with diabetes and 40% without diabetes reported “taking care of the house or family” as the main reason for not working, which was higher than all the other race/ethnicity groups. Going to school as a reason for not working was reported by <1% of adults with diabetes but varied by race and ethnicity group among those without diabetes, (i.e., 17.6% of non-Hispanic Asian/Pacific Islander without diabetes, 9.0% of non-Hispanic black, 6.8% of Hispanic, 5.3% of non-Hispanic white adults). Being disabled was the main reason reported for not working by 27.4% of non-Hispanic white, 42.2% of non-Hispanic black, 22.0% of Hispanic, and 14.9% of non-Hispanic Asian/Pacific Islander adults with diabetes. A similar pattern but less frequent rate of disability as a reason for not working was reported by adults without diabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab26/?report=objectonly" target="object" rid-figpopup="figch8app1tab26" rid-ob="figobch8app1tab26">Appendix 8.26</a>).</p><p>A higher percentage of adults in 2006–2010 with diabetes diagnosed age <20 years reported disability as a reason for not working compared to adults in 2009–2010 with diabetes diagnosed age ≥20 years (37.2% vs. 28.5%) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab26/?report=objectonly" target="object" rid-figpopup="figch8app1tab26" rid-ob="figobch8app1tab26">Appendix 8.26</a>).</p></div><div id="ch8.s8.4"><h3>Type of Employer</h3><p>Among those who ever worked or currently work, a slightly larger percentage of adults with diabetes diagnosed age ≥20 years worked for government employers and a lower percentage worked for private employers than adults without diabetes (21.5% and 70.4% vs. 16.8% and 74.0%) (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig20/?report=objectonly" target="object" rid-figpopup="figch8fig20" rid-ob="figobch8fig20">Figure 8.20</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab27/?report=objectonly" target="object" rid-figpopup="figch8app1tab27" rid-ob="figobch8app1tab27">Appendix 8.27</a>). A higher percentage of women with diabetes diagnosed age ≥20 years worked in State and local government than men with diabetes diagnosed age ≥20 years, similar to the pattern for men and women without diabetes. Men, regardless of diabetes status, were more often self-employed. Within race/ethnicity groups, the employer type was similar for adults with diabetes diagnosed age ≥20 years and adults without diabetes. In 2006–2010, adults with diabetes diagnosed age <20 years were more likely to be working for private employers and less likely to be working for the government, compared to people in 2009–2010 with diabetes diagnosed age ≥20 years.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig18" co-legend-rid="figlgndch8fig18"><a href="/books/NBK567995/figure/ch8.fig18/?report=objectonly" target="object" title="FIGURE 8.18" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig18" rid-ob="figobch8fig18"><img class="small-thumb" src="/books/NBK567995/bin/ch8f18.gif" src-large="/books/NBK567995/bin/ch8f18.jpg" alt="Bar chart showing that adults with diabetes diagnosed greater than or equal to 20 years were less likely to be working in the last year or never worked compared to adults without diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig18"><h4 id="ch8.fig18"><a href="/books/NBK567995/figure/ch8.fig18/?report=objectonly" target="object" rid-ob="figobch8fig18">FIGURE 8.18</a></h4><p class="float-caption no_bottom_margin">Employment in Prior 12 Months Among Adults Age ≥20 Years, by Diabetes Diagnosis and Race/Ethnicity, U.S., 2006–2010. Subgroup analysis by race/ethnicity was not possible for adults diagnosed <20 years because of insufficient sample <a href="/books/NBK567995/figure/ch8.fig18/?report=objectonly" target="object" rid-ob="figobch8fig18">(more...)</a></p></div></div><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig19" co-legend-rid="figlgndch8fig19"><a href="/books/NBK567995/figure/ch8.fig19/?report=objectonly" target="object" title="FIGURE 8.19" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig19" rid-ob="figobch8fig19"><img class="small-thumb" src="/books/NBK567995/bin/ch8f19.gif" src-large="/books/NBK567995/bin/ch8f19.jpg" alt="Bar graphs showing that among adults with diabetes diagnosed greater than or equal to 20 years, retirement and disability were the main reasons for not working the prior week." /></a><div class="icnblk_cntnt" id="figlgndch8fig19"><h4 id="ch8.fig19"><a href="/books/NBK567995/figure/ch8.fig19/?report=objectonly" target="object" rid-ob="figobch8fig19">FIGURE 8.19</a></h4><p class="float-caption no_bottom_margin">Main Reason for Not Working in Prior Week Among Adults Age ≥20 Years, by Diabetes Status, Age at Diabetes Diagnosis, and Sex, U.S., 2006–2010. Data are self-reported. Error bars represent 95% confidence intervals. * 2009–2010</p></div></div><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig20" co-legend-rid="figlgndch8fig20"><a href="/books/NBK567995/figure/ch8.fig20/?report=objectonly" target="object" title="FIGURE 8.20" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig20" rid-ob="figobch8fig20"><img class="small-thumb" src="/books/NBK567995/bin/ch8f20.gif" src-large="/books/NBK567995/bin/ch8f20.jpg" alt="Pie charts showing that a slightly larger percentage of adults with diabetes diagnosed greater than or equal to 20 years worked for government employers compared to those without diabetes." /></a><div class="icnblk_cntnt" id="figlgndch8fig20"><h4 id="ch8.fig20"><a href="/books/NBK567995/figure/ch8.fig20/?report=objectonly" target="object" rid-ob="figobch8fig20">FIGURE 8.20</a></h4><p class="float-caption no_bottom_margin">Type of Employer Among Adults Age ≥20 Years, by Diabetes Status and Age at Diabetes Diagnosis, U.S., 2006–2010. Data are self-reported. * 2009–2010</p></div></div></div><div id="ch8.s8.5"><h3>Hours Worked when Employed</h3><p>Among employed adults, the number of hours worked in the prior week was similar for adults with or without diabetes, with approximately 70% reporting working at least 40 hours (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig21/?report=objectonly" target="object" rid-figpopup="figch8fig21" rid-ob="figobch8fig21">Figure 8.21</a>, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab28/?report=objectonly" target="object" rid-figpopup="figch8app1tab28" rid-ob="figobch8app1tab28">Appendix 8.28</a>). Among adults with diabetes diagnosed age ≥20 years, 76.4% of men and 63.1% of women worked at least 40 hours in the prior week, which was similar to men and women without diabetes (78.5% and 61.4%). The hours worked were similar by race/ethnicity groups and age groups, except for adults age ≥65 years who worked fewer hours; in this age group, only 42.9% of adults with diabetes and 45.2% of adults without diabetes worked at least 40 hours in the prior week. Approximately 25% of adults with or without diabetes who worked <35 hours in the prior week also reported that they usually worked ≥35 hours per week (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab28/?report=objectonly" target="object" rid-figpopup="figch8app1tab28" rid-ob="figobch8app1tab28">Appendix 8.28</a>).</p></div><div id="ch8.s8.6"><h3>Current Occupations of Workers</h3><p>Some difference existed in the type of occupations that were reported by adults with diabetes compared to those without diabetes. The percentage of adults with diabetes diagnosed age ≥20 years was higher for health care support, protective service, maintenance, production, transportation, and military occupations compared to adults without diabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab29/?report=objectonly" target="object" rid-figpopup="figch8app1tab29" rid-ob="figobch8app1tab29">Appendix 8.29</a>). Office and administrative support jobs (14.6%) and production jobs (11.6%) were the most common occupations among adults with diabetes diagnosed age ≥20 years. Among people without diabetes, the most common occupations reported were sales and related jobs (10.4%) and office and administrative support jobs (14.2%). No significant differences for occupation were observed between adults in 2009–2010 with diabetes diagnosed age ≥20 years and adults in 2006–2010 with diabetes diagnosed age <20 years.</p></div><div id="ch8.s8.7"><h3>Veteran Status</h3><p>Diabetes was more frequent among military veterans than among non-veteran adults. Overall, about 35% of men and 1.1% of women with diabetes diagnosed age ≥20 years were military veterans compared with 17.2% of men and 1.3% of women without diabetes (data not shown). Higher percentages of veterans in men with diabetes compared to men without diabetes were observed in the younger age groups, but no significant difference existed in the age group ≥65 years (<a class="figpopup" href="/books/NBK567995/figure/ch8.fig22/?report=objectonly" target="object" rid-figpopup="figch8fig22" rid-ob="figobch8fig22">Figure 8.22</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig21" co-legend-rid="figlgndch8fig21"><a href="/books/NBK567995/figure/ch8.fig21/?report=objectonly" target="object" title="FIGURE 8.21" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig21" rid-ob="figobch8fig21"><img class="small-thumb" src="/books/NBK567995/bin/ch8f21.gif" src-large="/books/NBK567995/bin/ch8f21.jpg" alt="Bar graph showing that among employed adults, the number of hours worked in the prior week was similar for adults with or without diabetes and about 70 percent worked at least 40 hours." /></a><div class="icnblk_cntnt" id="figlgndch8fig21"><h4 id="ch8.fig21"><a href="/books/NBK567995/figure/ch8.fig21/?report=objectonly" target="object" rid-ob="figobch8fig21">FIGURE 8.21</a></h4><p class="float-caption no_bottom_margin">Hours Worked in Prior Week Among Employed Adults Age ≥20 Years, by Diabetes Status and Age at Diabetes Diagnosis, U.S., 2006–2010. Hours worked prior week among persons reporting working for pay prior week; working, but not for pay, at <a href="/books/NBK567995/figure/ch8.fig21/?report=objectonly" target="object" rid-ob="figobch8fig21">(more...)</a></p></div></div><div class="iconblock whole_rhythm clearfix ten_col fig" id="figch8fig22" co-legend-rid="figlgndch8fig22"><a href="/books/NBK567995/figure/ch8.fig22/?report=objectonly" target="object" title="FIGURE 8.22" class="img_link icnblk_img figpopup" rid-figpopup="figch8fig22" rid-ob="figobch8fig22"><img class="small-thumb" src="/books/NBK567995/bin/ch8f22.gif" src-large="/books/NBK567995/bin/ch8f22.jpg" alt="Bar graph showing that, among men, a higher percentage of veterans with diabetes compared to men without diabetes were observed in younger age groups with no difference among those age 65 or older." /></a><div class="icnblk_cntnt" id="figlgndch8fig22"><h4 id="ch8.fig22"><a href="/books/NBK567995/figure/ch8.fig22/?report=objectonly" target="object" rid-ob="figobch8fig22">FIGURE 8.22</a></h4><p class="float-caption no_bottom_margin">Veteran Status Among Men Age ≥20 Years, by Diabetes Status, Age at Diabetes Diagnosis, and Age at Interview, U.S., 2006–2010. Veterans were honorably discharged from active duty in the U.S. Army, Navy, Air Force, Marine Corps, or Coast <a href="/books/NBK567995/figure/ch8.fig22/?report=objectonly" target="object" rid-ob="figobch8fig22">(more...)</a></p></div></div><p>The percentage of men who were veterans varied by race/ethnicity group both in those with diabetes diagnosed age ≥20 years and those without diabetes; the percentage who were veterans remained higher for men with diabetes in each race/ethnicity group compared to those without diabetes (41.0% of non-Hispanic white, 27.8% of non-Hispanic black, 15.8% of Hispanic, 14.1% of Mexican American, 18.6% of other Hispanic, 17.8% of non-Hispanic Asian/Pacific Islander, and 38.7% of non-Hispanic American Indian and Alaska Native groups compared to 20.7%, 15.0%, 5.8%, 5.1%, 7.1%, 6.5%, and 17.6% in men without diabetes within those race/ethnicity groups, respectively) (data not shown). A lower percentage of men in 2006–2010 with diabetes diagnosed age <20 years were veterans compared to men in 2009–2010 with diabetes diagnosed age ≥20 years, and this difference was most pronounced in the 20–44 years age group. In 2006–2010, among adults with diabetes diagnosed age <20 years, nearly 22% of men and <1% of women were military veterans (data not shown).</p></div></div><div id="ch8.s9"><h2 id="_ch8_s9_">Social and Health Benefits</h2><div id="ch8.s9.1"><h3>Reported Health Insurance</h3><p>In 2009–2010, the percentage reporting health insurance coverage was higher in adults with diabetes diagnosed age ≥20 years than among adults without diabetes (90.4% vs. 81.4%) (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab30/?report=objectonly" target="object" rid-figpopup="figch8app1tab30" rid-ob="figobch8app1tab30">Appendix 8.30</a>). The percentage having health insurance was similar for men and women with diabetes; however, among adults without diabetes, a higher percentage of women compared to men had health insurance. Race/ethnicity differences existed among all adults, regardless of diabetes status, and the differences were more pronounced in adults without diabetes. Among adults with diabetes diagnosed age ≥20 years, 80.8% of Hispanic adults with diabetes reported having health insurance coverage which was lower than the 90.0% or higher reported by other race/ethnicity groups. In 2006–2010, 86.1% of adults with diabetes diagnosed age <20 years had health insurance. More detailed health insurance information can be found in <a href="/books/n/dia3ed/ch42/">Chapter 42</a>
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<i>Health Insurance and Diabetes</i>.</p></div><div id="ch8.s9.2"><h3>Federal Benefits Programs</h3><p>Federal benefits were commonly received by people with diabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab31/?report=objectonly" target="object" rid-figpopup="figch8app1tab31" rid-ob="figobch8app1tab31">Appendix 8.31</a>). These include Social Security or Railroad Retirement benefits, Supplemental Security Income (SSI), Supplemental Nutrition Assistance Program (SNAP), formerly called Food Stamps, and Supplemental Nutrition Program for Women, Infants, and Children (WIC) (detailed data not presented for WIC due to small sample size).</p><p>Receipt of Social Security or Railroad Retirement benefits was more common among adults with diabetes diagnosed age ≥20 years than among adults without diabetes (46.6% vs. 17.4%). Among adults age <65 years, a higher percentage of adults with diabetes received these benefits for disability compared to similar age adults without diabetes. A larger percentage of non-Hispanic white adults with diabetes diagnosed age ≥20 years received Social Security or Railroad Retirement benefits compared with adults with diabetes in the other race/Hispanic groups. In 2006–2010, nearly 30% of adults with diabetes diagnosed age <20 years received these benefits.</p><p>Receipt of SSI was higher among adults with diabetes (7.1%–8.7%) than among adults without diabetes (2.2%). Over 85% of all SSI recipients received benefits for disability regardless of diabetes category. The percentage receiving SSI benefits varied by racial/ethnic origin and ranged from 5.7% of non-Hispanic white to 11.9% of non-Hispanic black adults with diabetes diagnosed age ≥20 years.</p><p>A larger percentage of adults with diabetes diagnosed age ≥20 years received SNAP benefits compared to those without diabetes, including 14.7% versus 8.8% in the 20–44 years age group; 10.3% versus 5.0% in the 45–64 years age group; and 6.4% versus 4.2% in the ≥65 years age group, respectively. Similar patterns for receiving Federal public assistance existed for men and women, except that SNAP benefits were more commonly received by women. Receiving SNAP benefits varied by race/ethnicity groups among adults with diabetes. They were received by 7.0% of non-Hispanic white, 18.4% of non-Hispanic black, 11.1% of Hispanic, and 4.6% of non-Hispanic Asian/Pacific Islander adults with diabetes diagnosed age ≥20 years.</p><p>The percentage of adults receiving WIC benefits was significantly lower among adults with diabetes diagnosed at age ≥20 years than among adults without diabetes (0.7% vs. 2.2%) (data not shown). Among women, the estimates were 1.1% and 3.7%. The lower percentage of WIC recipients among adults with diabetes diagnosed age ≥20 years compared to adults without diabetes was observed for non-Hispanic white adults and Hispanic adults, which were the only groups with statistically reliable estimates. Within the age categories (20–44, 45–64, and ≥65 years), there were no differences between adults with diabetes diagnosed age ≥20 years and adults without diabetes (data not shown).</p></div></div><div id="ch8.s10"><h2 id="_ch8_s10_">Demographic Characteristics of People With Undiagnosed Diabetes and Prediabetes</h2><p>The demographic characteristics of people with diagnosed diabetes, undiagnosed diabetes, and prediabetes from the NHANES 2005–2010 are presented in <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab32/?report=objectonly" target="object" rid-figpopup="figch8app1tab32" rid-ob="figobch8app1tab32">Appendices 8.32</a>–<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab34/?report=objectonly" target="object" rid-figpopup="figch8app1tab34" rid-ob="figobch8app1tab34">8.34</a>. Although the estimates for diagnosed diabetes could vary from the NHIS estimates reported in this chapter because they were obtained from a different sample of persons and were collected for a different time period, there were no significant differences between the NHANES and NHIS estimates of diagnosed diabetes for the current ages. <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab32/?report=objectonly" target="object" rid-figpopup="figch8app1tab32" rid-ob="figobch8app1tab32">Appendix 8.32</a> summarizes the demographic profile for adults age ≥20 years with diagnosed and undiagnosed diabetes, prediabetes, and no diabetes. <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab33/?report=objectonly" target="object" rid-figpopup="figch8app1tab33" rid-ob="figobch8app1tab33">Appendix 8.33</a> compares the demographic profiles for adults age ≥20 years with diabetes diagnosed age <20 years or age ≥20 years. <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab34/?report=objectonly" target="object" rid-figpopup="figch8app1tab34" rid-ob="figobch8app1tab34">Appendix 8.34</a> summarizes the demographic profile for youth age 12–19 years with diagnosed and undiagnosed diabetes, prediabetes, and no diabetes.</p><p>Adults age ≥20 years with diagnosed diabetes were similar in age to those with clinical (A1c or FPG) or research (A1c, FPG, or OGTT) defined undiagnosed diabetes. Those classified with a clinical definition for undiagnosed diabetes were predominantly male compared to adults with diagnosed diabetes and those with research defined undiagnosed diabetes. The race/ethnicity percentages for adults with diagnosed diabetes or clinically defined undiagnosed diabetes were similar. However, a larger percentage of those with the research defined undiagnosed diabetes were non-Hispanic white (73.4%) and a smaller percentage were non-Hispanic black (9.5%) compared to adults with diagnosed diabetes (61.4% and 18.2%, respectively, <a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab32/?report=objectonly" target="object" rid-figpopup="figch8app1tab32" rid-ob="figobch8app1tab32">Appendix 8.32</a>). Family income and PIR were similar for all diabetes groups. The only significant difference found between adults in the NHANES with diabetes diagnosed age <20 years and those diagnosed age ≥20 years was that current age was younger for those diagnosed age <20 years (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab33/?report=objectonly" target="object" rid-figpopup="figch8app1tab33" rid-ob="figobch8app1tab33">Appendix 8.33</a>). Compared to diagnosed diabetes, adults with prediabetes were younger, had slightly higher family income and PIRs, and were less likely to be non-Hispanic black (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab32/?report=objectonly" target="object" rid-figpopup="figch8app1tab32" rid-ob="figobch8app1tab32">Appendix 8.32</a>). Youth age 12–19 years with clinically defined prediabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab34/?report=objectonly" target="object" rid-figpopup="figch8app1tab34" rid-ob="figobch8app1tab34">Appendix 8.34</a>) compared to adults with prediabetes (<a class="figpopup" href="/books/NBK567995/table/ch8.app1.tab32/?report=objectonly" target="object" rid-figpopup="figch8app1tab32" rid-ob="figobch8app1tab32">Appendix 8.32</a>) were more often male (68.1% vs. 54.0%), Hispanic (23.7% vs. 13.1%), and living below the poverty level (i.e., PIR <1.00) (25.4% vs. 13.2%).</p></div><div id="ch8.s11"><h2 id="_ch8_s11_">List of Abbreviations</h2><dl><dt id="ch8_abb_DL1_DI1">A1c</dt><dd><p>glycosylated hemoglobin</p></dd><dt id="ch8_abb_DL1_DI2">CDC</dt><dd><p>Centers for Disease Control and Prevention</p></dd><dt id="ch8_abb_DL1_DI3">FPG</dt><dd><p>fasting plasma glucose</p></dd><dt id="ch8_abb_DL1_DI4">NHANES</dt><dd><p>National Health and Nutrition Examination Survey</p></dd><dt id="ch8_abb_DL1_DI5">NHIS</dt><dd><p>National Health Interview Survey</p></dd><dt id="ch8_abb_DL1_DI6">OGTT</dt><dd><p>oral glucose tolerance test</p></dd><dt id="ch8_abb_DL1_DI7">PIR</dt><dd><p>Poverty Income Ratio</p></dd><dt id="ch8_abb_DL1_DI8">SNAP</dt><dd><p>Supplemental Nutrition Assistance Program</p></dd><dt id="ch8_abb_DL1_DI9">SSI</dt><dd><p>Supplemental Security Income</p></dd><dt id="ch8_abb_DL1_DI10">WIC</dt><dd><p>Supplemental Nutrition Program for Women, Infants, and Children</p></dd></dl></div><div id="ch8.rl.r1"><h2 id="_ch8_rl_r1_">References</h2><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="ch8.ref1">Dabelea
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D, Pihoker
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C, Talton
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JW, D’Agostino
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RB, Jr., Fujimoto
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W, Klingensmith
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GJ, Lawrence
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JM, Linder
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B, Marcovina
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SM, Mayer-Davis
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EJ, Imperatore
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JW: Summary health statistics for U.S. adults: National Health Interview Survey, 2009. <em>Vital Health Stat</em>
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JA: Summary health statistics for U.S. adults: National Health Interview Survey, 2010. <em>Vital Health Stat</em>
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10:1–207, 2012 [<a href="https://pubmed.ncbi.nlm.nih.gov/22834228" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22834228</span></a>]</div></dd><dt>13.</dt><dd><div class="bk_ref" id="ch8.ref13">National Center for Health Statistics: National Health and Nutrition Examination Survey. NHANES response rates and population totals [article online], 2015. Available from <a href="https://www.cdc.gov/nchs/nhanes/response_rates_CPS.htm" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>.cdc.gov/nchs<wbr style="display:inline-block"></wbr>/nhanes/response_rates_CPS.htm</a>. Accessed 29 November 2016</div></dd><dt>14.</dt><dd><div class="bk_ref" id="ch8.ref14">National Health and Nutrition Examination Survey: 2007–2008 data documentation, codebook, and frequencies. Plasma fasting glucose and insulin [article online], 2010. Available from <a href="http://wwwn.cdc.gov/nchs/nhanes/2007-2008/GLU_E.htm" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://wwwn<wbr style="display:inline-block"></wbr>.cdc.gov/nchs<wbr style="display:inline-block"></wbr>/nhanes/2007-2008/GLU_E.htm</a>. Accessed 8 January 2015</div></dd><dt>15.</dt><dd><div class="bk_ref" id="ch8.ref15">Ingram
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DD, Franco
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SJ: NCHS urban-rural classification scheme for counties. <em>Vital Health Stat</em>
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2:1–65, 2012 [<a href="https://pubmed.ncbi.nlm.nih.gov/22783637" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22783637</span></a>]</div></dd><dt>16.</dt><dd><div class="bk_ref" id="ch8.ref16">United States Census Bureau: Poverty—experimental measures: the development of the Orshansky poverty thresholds and their subsequent history as the official U.S. poverty measure [article online], 1997. Available from <a href="https://www.census.gov/library/working-papers/1997/demo/fisher-02.html" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>.census.gov<wbr style="display:inline-block"></wbr>/library/working-papers<wbr style="display:inline-block"></wbr>/1997/demo/fisher-02.html</a>. Accessed 20 September 2017</div></dd></dl></div><div id="ch8.app1"><h2 id="_ch8_app1_">Appendices</h2><p id="ch8.app1.tab1"><a href="/books/NBK567995/table/ch8.app1.tab1/?report=objectonly" target="object">APPENDIX 8.1. Distribution of Persons, by Diabetes Status, Age, Sex, and Race/Ethnicity, U.S., 2009–2010</a></p><p id="ch8.app1.tab2"><a href="/books/NBK567995/table/ch8.app1.tab2/?report=objectonly" target="object">APPENDIX 8.2. Distribution of Adults Age ≥20 Years, by Diabetes Status, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab3"><a href="/books/NBK567995/table/ch8.app1.tab3/?report=objectonly" target="object">APPENDIX 8.3. Distribution of Youth Age <20 Years With Diagnosed Diabetes, by Sex and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab4"><a href="/books/NBK567995/table/ch8.app1.tab4/?report=objectonly" target="object">APPENDIX 8.4. Distribution of Adults Age ≥20 Years With Diabetes Diagnosed at Age ≥20 Years or Without Diabetes, by Age, Sex, and Race/Ethnicity, U.S., 2009–2010</a></p><p id="ch8.app1.tab5"><a href="/books/NBK567995/table/ch8.app1.tab5/?report=objectonly" target="object">APPENDIX 8.5. Mean and Median Age at Diagnosis of Diabetes Among Adults Age ≥20 Years, by Age of Diagnosis, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab6"><a href="/books/NBK567995/table/ch8.app1.tab6/?report=objectonly" target="object">APPENDIX 8.6. Mean and Median Years of Diabetes Duration Among Adults Age ≥20 Years, by Age of Diagnosis, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab7"><a href="/books/NBK567995/table/ch8.app1.tab7/?report=objectonly" target="object">APPENDIX 8.7. Distribution of Diabetes Duration Among Adults Age ≥20 Years, by Age of Diagnosis, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab8"><a href="/books/NBK567995/table/ch8.app1.tab8/?report=objectonly" target="object">APPENDIX 8.8. Top Ten States of Residence, by Diabetes Status, U.S., 2006–2010</a></p><p id="ch8.app1.tab9"><a href="/books/NBK567995/table/ch8.app1.tab9/?report=objectonly" target="object">APPENDIX 8.9. Distribution of Adults Age ≥20 Years, by Diabetes Diagnosis and Metropolitan or Nonmetropolitan County of Residence, U.S., 2006–2010</a></p><p id="ch8.app1.tab10"><a href="/books/NBK567995/table/ch8.app1.tab10/?report=objectonly" target="object">APPENDIX 8.10. Region of Residence Among Adults Age ≥20 Years, by Diabetes Diagnosis and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab11"><a href="/books/NBK567995/table/ch8.app1.tab11/?report=objectonly" target="object">APPENDIX 8.11. Region of the World Where Born, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab12"><a href="/books/NBK567995/table/ch8.app1.tab12/?report=objectonly" target="object">APPENDIX 8.12. Marital Status Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, and Sex, U.S., 2006–2010</a></p><p id="ch8.app1.tab13"><a href="/books/NBK567995/table/ch8.app1.tab13/?report=objectonly" target="object">APPENDIX 8.13. Marital Status Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab14"><a href="/books/NBK567995/table/ch8.app1.tab14/?report=objectonly" target="object">APPENDIX 8.14. Types of Cohabitation Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, and Sex, U.S., 2006–2010</a></p><p id="ch8.app1.tab15"><a href="/books/NBK567995/table/ch8.app1.tab15/?report=objectonly" target="object">APPENDIX 8.15. Types of Cohabitation Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab16"><a href="/books/NBK567995/table/ch8.app1.tab16/?report=objectonly" target="object">APPENDIX 8.16. Family Size Among Persons, by Diabetes Diagnosis, Age, and Sex, U.S., 2006–2010</a></p><p id="ch8.app1.tab17"><a href="/books/NBK567995/table/ch8.app1.tab17/?report=objectonly" target="object">APPENDIX 8.17. Family Size Among Persons, by Diabetes Diagnosis, Age, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab18"><a href="/books/NBK567995/table/ch8.app1.tab18/?report=objectonly" target="object">APPENDIX 8.18. Level of Attained Education Among Adults Age ≥25 Years, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab19"><a href="/books/NBK567995/table/ch8.app1.tab19/?report=objectonly" target="object">APPENDIX 8.19. Level of Attained Education Among Adults Age ≥25 Years, by Diabetes Diagnosis, Age and Sex, and Age and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab20"><a href="/books/NBK567995/table/ch8.app1.tab20/?report=objectonly" target="object">APPENDIX 8.20. Family Income Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2007–2010</a></p><p id="ch8.app1.tab21"><a href="/books/NBK567995/table/ch8.app1.tab21/?report=objectonly" target="object">APPENDIX 8.21. Family Income Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age and Sex, and Age and Race/Ethnicity, U.S., 2007–2010</a></p><p id="ch8.app1.tab22"><a href="/books/NBK567995/table/ch8.app1.tab22/?report=objectonly" target="object">APPENDIX 8.22. Family Poverty Income Ratio Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab23"><a href="/books/NBK567995/table/ch8.app1.tab23/?report=objectonly" target="object">APPENDIX 8.23. Family Poverty Income Ratio Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age and Sex, and Age and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab24"><a href="/books/NBK567995/table/ch8.app1.tab24/?report=objectonly" target="object">APPENDIX 8.24. Employment Status in the Past 12 Months Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab25"><a href="/books/NBK567995/table/ch8.app1.tab25/?report=objectonly" target="object">APPENDIX 8.25. Employment Status in Prior Week Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab26"><a href="/books/NBK567995/table/ch8.app1.tab26/?report=objectonly" target="object">APPENDIX 8.26. Main Reason for Not Working in Past Week Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab27"><a href="/books/NBK567995/table/ch8.app1.tab27/?report=objectonly" target="object">APPENDIX 8.27. Type of Employer Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab28"><a href="/books/NBK567995/table/ch8.app1.tab28/?report=objectonly" target="object">APPENDIX 8.28. Number of Hours Worked in Prior Week Among Adults Age ≥20 Years, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab29"><a href="/books/NBK567995/table/ch8.app1.tab29/?report=objectonly" target="object">APPENDIX 8.29. Main Occupation Among Adults Age ≥20 Years, by Diabetes Diagnosis, U.S., 2006–2010</a></p><p id="ch8.app1.tab30"><a href="/books/NBK567995/table/ch8.app1.tab30/?report=objectonly" target="object">APPENDIX 8.30. Health Insurance Coverage for Adults Age ≥20 Years, by Diabetes Diagnosis, Age, Sex, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab31"><a href="/books/NBK567995/table/ch8.app1.tab31/?report=objectonly" target="object">APPENDIX 8.31. Federal Benefit Programs Among Adults Age ≥20 Years, by Diabetes Diagnosis, Sex, Age, and Race/Ethnicity, U.S., 2006–2010</a></p><p id="ch8.app1.tab32"><a href="/books/NBK567995/table/ch8.app1.tab32/?report=objectonly" target="object">APPENDIX 8.32. Demographic Characteristics Among Adults Age ≥20 Years With Diabetes (Diagnosed and Undiagnosed), Prediabetes, and No Diabetes, U.S., 2005–2010</a></p><p id="ch8.app1.tab33"><a href="/books/NBK567995/table/ch8.app1.tab33/?report=objectonly" target="object">APPENDIX 8.33. Demographic Characteristics Among Adults Age ≥20 Years With Diagnosed Diabetes, by Age of Diagnosis, U.S., 2005–2010</a></p><p id="ch8.app1.tab34"><a href="/books/NBK567995/table/ch8.app1.tab34/?report=objectonly" target="object">APPENDIX 8.34. Demographic Characteristics Among Youth Age 12–19 Years With Diabetes (Diagnosed and Undiagnosed), Prediabetes, and No Diabetes, U.S., 2005–2010</a></p></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div id="ch8.ack"><p class="no_top_margin"><b>ACKNOWLEDGMENTS</b></p><p>The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors would like to acknowledge the participants of the NHIS and the NHANES, whose survey participation made this research possible. Also, a special recognition goes to Dr. Maria Villarroel and Dr. Brian W. Ward for providing NHIS state and metropolitan/nonmetropolitan residence results and to Dr. Anjel Vahratian for arranging this contribution.</p></div></dd><dt></dt><dd><div id="ch8.fn1"><p class="no_top_margin"><b>CONVERSIONS</b></p><p>Conversions for A1c and glucose values are provided in <i><a href="/books/n/dia3ed/app1/">Diabetes in America Appendix 1 Conversions</a></i>.</p></div></dd><dt></dt><dd><div id="ch8.fn2"><p class="no_top_margin"><b>DUALITY OF INTEREST</b></p><p>Drs. Eberhardt, Casagrande, and Cowie reported no conflicts of interest.</p></div></dd></dl></div><div id="bk_toc_contnr"></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK567995/?report=reader">PubReader</a></li><li><a href="/books/NBK567995/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK567995" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK567995" style="display:none" title="Cite this Page"><div class="bk_tt">Eberhardt MS, Casagrande SS, Cowie CC. Sociodemographic Characteristics of Persons With Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., editors. Diabetes in America. 3rd edition. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018 Aug. CHAPTER 8.<span class="bk_cite_avail"></span></div></div></li><li><a href="/books/NBK567995/pdf/Bookshelf_NBK567995.pdf">PDF version of this page</a> (6.5M)</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#ch8.sum" ref="log$=inpage&link_id=inpage">Summary</a></li><li><a href="#ch8.s1" ref="log$=inpage&link_id=inpage">Introduction</a></li><li><a href="#ch8.s2" ref="log$=inpage&link_id=inpage">Data Sources and Limitations</a></li><li><a href="#ch8.s3" ref="log$=inpage&link_id=inpage">Demographic Characteristics</a></li><li><a href="#ch8.s4" ref="log$=inpage&link_id=inpage">Diabetes Characteristics</a></li><li><a href="#ch8.s5" ref="log$=inpage&link_id=inpage">Place of Residence</a></li><li><a href="#ch8.s6" ref="log$=inpage&link_id=inpage">Socioeconomic Characteristics</a></li><li><a href="#ch8.s7" ref="log$=inpage&link_id=inpage">Communication Characteristics</a></li><li><a href="#ch8.s8" ref="log$=inpage&link_id=inpage">Employment Characteristics</a></li><li><a href="#ch8.s9" ref="log$=inpage&link_id=inpage">Social and Health Benefits</a></li><li><a href="#ch8.s10" ref="log$=inpage&link_id=inpage">Demographic Characteristics of People With Undiagnosed Diabetes and Prediabetes</a></li><li><a href="#ch8.s11" ref="log$=inpage&link_id=inpage">List of Abbreviations</a></li><li><a href="#ch8.rl.r1" ref="log$=inpage&link_id=inpage">References</a></li><li><a href="#ch8.app1" ref="log$=inpage&link_id=inpage">Appendices</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/33651562" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Prevalence and Incidence of Type 2 Diabetes and Prediabetes.</a><span class="source">[Diabetes in America. 2018]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Prevalence and Incidence of Type 2 Diabetes and Prediabetes.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Cowie CC, Casagrande SS, Geiss LS. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Diabetes in America. 2018 Aug</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/21597458" ref="ordinalpos=1&linkpos=2&log$=relatedarticles&logdbfrom=pubmed">Surveillance of health status in minority communities - Racial and Ethnic Approaches to Community Health Across the U.S. (REACH U.S.) Risk Factor Survey, United States, 2009.</a><span class="source">[MMWR Surveill Summ. 2011]</span><div class="brieflinkpop offscreen_noflow">Surveillance of health status in minority communities - Racial and Ethnic Approaches to Community Health Across the U.S. (REACH U.S.) Risk Factor Survey, United States, 2009.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Liao Y, Bang D, Cosgrove S, Dulin R, Harris Z, Taylor A, White S, Yatabe G, Liburd L, Giles W, et al. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">MMWR Surveill Summ. 2011 May 20; 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