Sociodemographic Characteristics of Persons with Diabetes

This chapter examines the sociodemographic characteristics of persons with and without diagnosed diabetes. The primary data source is the 1989 National Health Interview Survey (NHIS), a household interview survey of a representative sample of the U.S. civilian, noninstitutionalized population age ≥18 years. The age distribution of persons with diagnosed diabetes is much older than that of the total population, with 57.9% of diabetic persons being age ≥60 years, compared with only 21.9% of nondiabetic persons. In adults age ≥18 years, median age is 32 years in insulin-dependent diabetes mellitus (IDDM), 64 years in non-insulin-dependent diabetes mellitus (NIDDM), and 40 years in nondiabetic populations. About 58.4% of those with NIDDM are women; this is similar to the percent in nondiabetic persons (52.4%). In persons with IDDM, ~47% are female. Among U.S. adults age ≥18 years with NIDDM, 69.6% are non-Hispanic white, 20.2% are non-Hispanic black, 4.7% are Mexican American, and 5.4% are of other race/ethnicity. This contrasts with the proportion of whites (79.3%), blacks (10.7%), and Mexican Americans (4.0%) in the nondiabetic population and illustrates the disproportionate rate of NIDDM in blacks and Mexican Americans. Duration of diabetes is longest in adults with IDDM, with 60.7% having duration ≥15 years, compared with 27.4% in NIDDM. Onset of diabetes is most frequently at age 10-14 years in IDDM cases diagnosed at age <20 years. Among U.S. adults age ≥18 years, mean age at diagnosis of diabetes is 16.2 years in IDDM and 51.1 years in NIDDM. In persons with NIDDM, mean age at diagnosis is oldest in whites (52.2 years) and youngest in Mexican Americans (45.3 years). Among persons with NIDDM, the highest proportion live in the southeastern United States (39.2%), particularly blacks (60.1%), whereas IDDM and nondiabetic persons are more evenly distributed throughout four regions (i.e., the Northeast, Southeast, Midwest, and West) of the country. Persons with NIDDM most frequently live in or just outside a central city (particularly blacks and Mexican Americans), compared with IDDM and nondiabetic persons, who are more likely to live just outside city bounds. Of those living in urban areas, most diabetic and nondiabetic persons (87.4%-90.5%) live in areas with a population of at least 250,000. Most diabetic and nondiabetic persons (59.1%64.7%) are married. However, there are more widowed persons in NIDDM (22.1%), compared with nondiabetic groups (6.7%), explained at least in part by their older age. Consistent with the older age of persons with NIDDM, family size is smaller in NIDDM than IDDM and nondiabetic persons. The proportion who have completed at least some college education is 50.6% among IDDM, 21.0% among NIDDM, and 40.3% among nondiabetic groups. The proportion with family income ≥$40,000 is 37.7% in IDDM, 15.6% in NIDDM, and 32.8% in nondiabetic persons; the proportion with family income <$10,000 is 11.6% in IDDM, fully 27.9% in NIDDM, and 12.6% in nondiabetic persons. Even after accounting for age, persons with NIDDM have less education and lower income levels. Likewise, at every age, persons with NIDDM are less likely to be employed. Most IDDM (73.9%) and nondiabetic (66.2%) persons were employed in 1989, whereas most persons with NIDDM were not in the labor force (67.3%). Of all diabetic and nondiabetic persons who were working, most (68.4%77.2%) worked for private companies as opposed to working for a government or being self-employed. Compared with IDDM and nondiabetic persons, particularly at age 18-44 years, there are more persons with NIDDM who are military veterans.