Women

at High Risk 

for Diabetes:

Access and 

Quality

of Health 

Care,

2003-2006

Advancing Excellence in Health Care • www.ahrq.gov

Agency for Healthcare Research and Quality

Women

at High Risk 

for Diabetes:

Access and 

Quality

of Health 

Care,

2003-2006

U.S. Department of 

Health and Human Services

Agency for Healthcare Research and Quality

540 Gaither Road

Rockville, MD 20850

Centers for Disease Control and Prevention

1600 Clifton Road

Atlanta, GA 30333

AHRQ Publication No. 11-0002

January 2011
Acknowledgments

Centers for Disease Control and Prevention (CDC)

Thomas Frieden, M.D., M.P.H., Director

Ursula E. Bauer, Ph.D., M.P.H., Director of the National Center for Chronic Disease Prevention and

Health Promotion

Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health

Promotion (NCCDPHP)

Ann Albright, Ph.D., R.D., Director of the Division of Diabetes Translation

Gloria L.A. Beckles, M.D., M.Sc., Medical Epidemiologist

Michelle D. Owens-Gary, Ph.D., Behavioral Scientist

Sarah R. Lewis, M.P.H., C.H.E.S.` , Oak Ridge Institute for Science and Education Fellow

Agency for Healthcare Research and Quality (AHRQ)

Carolyn Clancy, M.D., Director

William Munier, M.D., Director, Center for Quality Improvement and Patient Safety

Francis Chesley, M.D., Director, Office of Extramural Research, Education, and Priority Populations

Katherine Crosson, M.P.H., Associate Director, Center for Quality Improvement and Patient Safety

Additional AHRQ Staff

Doreen Bonnett, M.S.W.

Mary Rolston

Other Staff

Paul Gorrell, Ph.D., formerly of Social & Scientific Systems, Inc. (SSS)

Shakeh J. Kaftarian, Ph.D., formerly of AHRQ

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE ii
Table of Contents

Highlights .......................................................................................................................................................1

Introduction and Methods...........................................................................................................................3

Introduction................................................................................................................................................3

Methods......................................................................................................................................................3

Data Sources..............................................................................................................................................4

Data Notes and Limitations ......................................................................................................................4

Contact Information ..................................................................................................................................5

Diabetes Risk Factors of U.S. Women.........................................................................................................7

Population Size and Growth......................................................................................................................7

Demographic and Socioeconomic Profile................................................................................................7

General Health and Well-Being...................................................................................................................9

Self-Rated Health ....................................................................................................................................13

Diagnosed Hypertension.........................................................................................................................16

Diagnosed Overweight............................................................................................................................19

Cholesterol...............................................................................................................................................20

Smoking...................................................................................................................................................23

Alcohol Consumption .............................................................................................................................26

Access to Care..............................................................................................................................................29

Health Insurance......................................................................................................................................29

Use of Health Care Services...................................................................................................................41

Diabetes-Related Risk Reduction .............................................................................................................51

Provider-Directed Risk Reduction..........................................................................................................51

Blood Pressure Measurement..........................................................................................................51

Lipid Profile.....................................................................................................................................55

Provider Advice About Weight........................................................................................................59

Physical Activity ..............................................................................................................................66

Weight Loss......................................................................................................................................70

Appendix A: References.............................................................................................................................83

Appendix B: Tables.....................................................................................................................................87

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE iii
WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE iv
Highlights

The Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and

Quality (AHRQ) are pleased to release this report, Women at High Risk for Diabetes: Access and Quality

of Health Care, 2003-2006, on behalf of the U.S. Department of Health and Human Services (HHS). This

collaboration examined the quality of preventive health care received by U.S. women at high risk and not

at high risk for diabetes, using the most scientifically based measures and national data sources available.

The report presents measures of health care quality showing the use of services in several areas: access to

care, general health and well-being, and preventive care and behaviors. It should be noted that the data

used (2003-2006) will not capture any recent changes in access to and quality of care.

This Highlights section offers a concise overview of findings from this report. The findings indicate 

that, among women at high risk and not at high risk for diabetes, disparities exist in access to and quality

of care.

General Health and Well-Being

• Overall, women at high risk for diabetes were more likely than women not at high risk for diabetes to

report fair/poor health. Regardless of diabetes risk status, fair/poor health was more commonly

reported by minority women, women with low levels of education, and women who lived in lowincome families.

• Overall, women at high risk for diabetes were more likely than women not at high risk for diabetes to

be aware of having major risk factors for diabetes (hypertension, overweight). 

• Regardless of diabetes risk status, awareness of hypertensive status was lowest among MexicanAmerican women and highest among African-American women. Awareness of overweight status was

lowest among minority women and decreased as education or family income decreased.

• Overall, women at high risk for diabetes were less likely than women not at high risk for diabetes to

smoke or consume alcohol. However, alcohol consumption was most commonly reported by nonHispanic women and women with high levels of education or family income.

Access to Care

• Among non-Hispanic whites, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to have only public health insurance coverage during the year.

No significant differences were found among non-Hispanic or Mexican-American women.

• Regardless of diabetes risk status, non-Hispanic black women were significantly more likely than

non-Hispanic white women to have only public health insurance coverage during the year.

• Regardless of diabetes risk status, women with a high school education or less were significantly

more likely than women with more than a high school education to have been uninsured all year.

Diabetes-Related Risk Reduction

• Women at high risk for diabetes were significantly less likely than women not at high risk for

diabetes to report that they exercised for at least 150 minutes per week.

• Women at high risk for diabetes who had a high school education or less were significantly less

likely than women at high risk for diabetes who had more than a high school education to have tried

to lose weight in the past year.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 1
WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 2
Introduction and Methods

Introduction

Diabetes is a chronic disease that is very common, serious, and costly. Diabetes can lead to serious

complications, such as heart disease and stroke, high blood pressure, blindness, and kidney disease.

However, people with diabetes can control the disease and reduce their likelihood of developing

complications.1 An estimated 24 million people in the United States, or 8% of those age 20 years and

over, have diabetes; of those, almost half are women.1,2

At least one-fourth of adults in the United States are also known to have prediabetes, a condition in which

people have blood glucose levels higher than normal but not high enough to be diagnosed with diabetes.

People with prediabetes have an increased risk of type 2 diabetes, heart disease, and stroke.1

Women are more likely than men to develop chronic diseases, such as diabetes, and to suffer

disproportionately from disability compared to men.3 It is important to target women at high risk for

diabetes for intervention to reduce their risk of diabetes. Evidence shows that people with prediabetes

who lose 5 to 7% of their body weight and increase their physical activity can prevent or delay diabetes.4

Early interventions and access to preventive care services are important for women to reduce the risk of

developing other diseases, such as cardiovascular disease.3 However, very few studies have examined

preventive care measures for women at high risk for diabetes. 

To address this gap, CDC collaborated with AHRQ to develop this report, which assesses and describes

the quality of care that women at high risk for diabetes receive in the United States. This report can be

used to identify areas in which intervention can help women at high risk for diabetes across the lifespan,

and to focus attention on possible gaps in public health programs, policies, research, and surveillance. 

Methods

Similar to the 2008 report, Women With Diabetes: Quality of Health Care, 2004-2005, this report analyzes

a wide variety of measures selected by experts at CDC and AHRQ as highly relevant to an examination of

the quality of health care for women at high risk for diabetes. Due to data availability and other

constraining factors, the measures discussed in this report are not necessarily comprehensive. Still, they

highlight important areas of health care quality of particular relevance to women at high risk for diabetes.

Throughout the report, the comparison groups are:

• Women at high risk for diabetes

• Women not at high risk for diabetes

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 3
Women are defined as females age 18 years and older. Women at high risk for diabetes were identified by

the following criteria5

:

• Age 45 years and over with a body mass index (BMI) of 25 kg/m2 or greater, or

• Ages 18-44 years with a body mass index (BMI) of 25 kg/m2 or greater, and any of the following:

o Low physical activity (less than 150 minutes per week)

o Family history of diabetes

o Racial or ethnic background in a high-risk group (African American, Hispanic or Latino, 

American Indian or Alaska Native, Asian American, or Native Hawaiian or Pacific Islander)

o History of gestational diabetes or baby with birth weight greater than 9 lb

o Hypertension (blood pressure greater than or equal to 140/90 mm Hg [systolic] or 

90 mm Hg [diastolic])

o Dyslipidemia (low-density lipoprotein [LDL] greater than 130 mg/dL; high-density lipoprotein 

[HDL] less than 50 mg/dL, triglyceride level above 250 mg/dL)

o History of heart attack, stroke, or peripheral arterial disease

Women not at high risk are defined as women who do not have diabetes and do not meet any of the above

criteria for women at high risk for diabetes.

Data Sources

Data from the National Health and Nutrition Examination Survey (NHANES) were analyzed. NHANES

is conducted by the National Center for Health Statistics, part of CDC, with data collection on an annual

basis. Data are currently released in 2-year cycles. For this report, combined data from the 2003-2004 and

2005-2006 NHANES were analyzed. 

The NHANES is a national survey of the U.S. civilian noninstitutionalized population. All ages are

included in the survey population. The survey is designed to be nationally representative. Approximately

5,000 people are examined each year, with oversampling of African Americans, Mexican Americans,

adolescents, older people, and low-income non-Hispanic whites.

In addition to in-person, in-home interviews, NHANES respondents are asked to participate in physical

examinations and laboratory tests conducted in mobile examination centers (MECs). Tests include blood

pressure readings, height and weight measurements (used for BMI calculation), and blood tests for

cholesterol levels.

Data Notes and Limitations

1. Race and ethnicity categories are based on respondent self report.

2. Two components of the definition above for being at high risk for diabetes (history of gestational

diabetes or baby with birth weight greater than 9 lb, and history of peripheral arterial disease) were

not included due to limitations of the source data.

3. Low physical activity was defined as having less than 150 minutes of activity per week. Activities

included walking, bicycling, and working in the home or yard where the activity required at least

moderate physical effort.

4. Family history of diabetes is based on respondent self report.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 4
5. Blood pressure was based on mean values of the second, third, and fourth readings. Hypertension

was defined as a mean systolic reading greater than or equal to 140 mm Hg OR a mean diastolic

reading greater than or equal to 90 mm Hg.

6. Dyslipidemia was defined as having an LDL value greater than 130 mg/dL OR an HDL value less

than 50mg/dL OR a triglyceride value greater than 250 mg/dL.

7. Indicators of socioeconomic position used were education attained and family income, measured as

poverty-income ratio (U.S. Census Bureau, poverty-income ratio). Poverty status was defined by

categories of the poverty-income ratio. Negative/poor refers to household incomes below the Federal

poverty line (FPL); near poor/low, over the poverty line to just below 200% of FPL; middle, 200% to

just below 400% of FPL; and high, 400% of FPL and over. Self-reported education and income may

be subject to recall and social desirability bias.

8. Only differences with a two-tailed p-value <0.05 are considered statistically significant. 

All comparisons between groups are based on estimates age-standardized to the U.S. Census 2000

population. Estimates based on cell size less than 100 or a relative standard error greater than 30%

do not meet the criteria for statistical reliability, data quality, or confidentiality and are not reported. 

Contact Information

Agency home page: http://www.cdc.gov/nchs.

Data system home page: http://www.cdc.gov/nchs/nhanes.htm. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 5
WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 6
Diabetes Risk Factors of U.S. Women

Population Size and Growth

In 2005, 51.4% of the estimated population age 18 years and over were women.6 From 2005-2050,

through the combination of low birth rates, declining death rates, and net international migration, the

population of women age 18 years and older is projected to grow by 59 million.7-9 This growth will

increase the number of women at high risk for developing diabetes. The number of women diagnosed with

diabetes is projected to reach 27.5 million by 2050; of these, more than one-third will be age 75 or older.10

Demographic and Socioeconomic Profile

Age and race/ethnicity are strongly associated with risk of developing or having diabetes.11-13 In 2005,

48.8% of women were in the reproductive years (18-44); 32.6% were in the middle years (45-64); and

18.7% were age 65 and older (numbers do not add to 100 due to funding).6

The female population is racially and ethnically heterogeneous.14 Among U.S. women reporting a single

race in 2005, an estimated 70% were non-Hispanic white; 12.4% were non-Hispanic black, 11.8% were

Hispanic of any race, 4.5% were Asian, 0.9% were American Indian or Alaska Native, and 0.2% were

Pacific Islander. From 2005-2050, the number of nonwhite minority females is projected to increase from

approximately 30% to nearly 60% of the total female population.15 Since minorities can be at greater risk

for diabetes than non-Hispanic whites, the projected growth in the number of minority women suggests

that increasing numbers of minority women will be diagnosed with diabetes.10

Socioeconomic position, as measured by education, income, or occupation, is strongly associated with

prevalence and incidence of diabetes.12,16-21 Among women age 18 years and over in 2005, approximately

15% had not completed high school and only about one-quarter had completed college or higher;

estimates for older women were 25.4% and 14.9%, respectively.22 Regardless of level of education

attained, earnings for women are about three-quarters of that for men even when they work full time and

year round.23 Therefore, poverty is a major concern for women across the lifespan.

In 2005, more than 14 million (13%) women lived below the Federal poverty threshold, accounting for 3

out of every 5 poor adults age 18 years and over.24 About 59% of poor women are in the reproductive

years but nearly 24% of women are in the middle years and 17% of older women live below the poverty

threshold. In 2005, 1 in 4 black women and 1 in 5 Hispanic women lived in poverty; there was very little

variation with age. A substantial proportion of American women of all racial and ethnic origins are

exposed to socioeconomic circumstances that put them at increased risk of developing diabetes. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 7
In addition to nonmodifiable factors such as age and race, a number of potentially modifiable biologic and

behavioral factors are associated with an increased risk of type 2 diabetes. 

These include:

• Obesity, hypertension, physical inactivity, and high-calorie diets 

• Excessive alcohol use and tobacco use 

• Psychosocial factors such as depression and poor mental health status13

Increased physical activity and weight loss can prevent or delay the onset of type 2 diabetes among highrisk adults of both sexes, different ages, and racial and ethnic origins.4,25-27 Furthermore, the effect of such

lifestyle modification on the incidence of type 2 diabetes might be sustainable.28-30 However, the

demographic and socioeconomic profiles of women at greater risk for diabetes are similar to the profile of

those with inadequate access to health care and low levels of evidence-based preventive health care

services, such as advice regarding lifestyle modification.31-33

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 8
General Health and Well-Being

Self-rated health is a global indicator of physical, mental, and social well-being that is measured by asking

individuals to evaluate their health status on a 5-point scale (excellent, very good, good, fair, or poor).34 A

large body of evidence indicates that ratings of fair or poor health are powerful predictors of increased

levels of mortality, morbidity, functional decline, risk factors for chronic diseases, and use of health care

services.34-39 Adults who have high levels of risk factors for diabetes are more likely than those with lower

levels to report fair/poor health and less likely to report excellent/very good/good health. 

The odds of reporting fair/poor health are higher for Hispanics and non-Hispanic blacks than nonHispanic whites,36 are higher among women with histories of gestational diabetes (hGDM) than women

without hGDM,37 and increase with increasing obesity, more so in women than men.36, 38 In addition,

adults without diabetes who engage in physical activity are more likely than those who do not to report

excellent/very good/good health.39

General health and well-being in the past year among women age 18 years and over, by diabetes risk

status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• Women at high risk for diabetes were significantly more likely than women not at high risk for

diabetes to report fair or poor health in the past year.

• No significant differences were found between women at high risk and women not at high risk in

self-reported physical and mental limitations or activity limitation in the past year.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 9

0

4

8

12

16

20

Percent 

At High Risk

Fair/Poor Health

Activity 

Limitation

Physical and Mental 

Health Limitation

Not at High Risk
Women age 18 years and over who were ever told by a doctor or other health professional that they had

hypertension or were overweight,* by diabetes risk status, 2003-2006

* Data for women not at high risk for diabetes who were told they

were overweight did not meet criteria for statistical reliability, data

quality, or confidentiality.

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• Women at high risk for diabetes were significantly more likely than women not at high risk for

diabetes to have been told by a doctor or other health professional that they had hypertension.

• Approximately 2 out of 3 women at high risk for diabetes were told by a health care professional that

they were overweight. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 10

0

8

16

24

32

40

48

56

64

72

80

Percent 

At High Risk

Hypertension

Overweight

Not at High Risk
Women age 18 years and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status,

2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• Women at high risk for diabetes were significantly less likely than women not at high risk for

diabetes to have LDL cholesterol less than 130 mg/dL.

0

8

16

24

32

40

48

56

64

72

80

Percent 

At High Risk

Not at High Risk

LDL cholesterol

<130 mg/dL

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 11
General health and well-being in the past year among women age 18 years and over, by diabetes risk 

status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• Women at high risk for diabetes were significantly less likely than women not at high risk to be

current smokers in the past year.

• Women at high risk for diabetes were significantly less likely than women not at high risk for

diabetes to report consumption of 12 or more alcoholic drinks in the past year.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 12

0

8

16

24

32

40

48

56

64

72

80

Percent 

At High Risk

Current Smoker

12 or More 

Drinks/Year

Not at High Risk
Self-Rated Health

Women age 18 years and over who reported fair or poor health in the past year, by diabetes risk status and

race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• In each racial/ethnic group, no significant differences were found between women at high risk and

women not at high risk for diabetes who reported fair or poor health in the past year.

• Regardless of diabetes risk status, non-Hispanic black and Mexican American women were

significantly more likely than non-Hispanic white women to report fair or poor health in the past

year.

0

5

10

15

20

25

30

35

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 13
Women age 18 years and over who reported fair or poor health in the past year, by diabetes risk status

and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• Women at high risk for diabetes were significantly more likely than women not at high risk for

diabetes to report fair or poor health in the past year if they had more than a high school education.

No differences were found for women with lower levels of education.

• Regardless of diabetes risk status, women with more than a high school education were significantly

less likely to report fair or poor health than women with lower levels of education.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 14

0

10

20

30

40

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
General health and well-being in the past year among women age 18 years and over, by diabetes risk 

status and family income, 2003-2006 

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• Women at high risk for diabetes were significantly more likely than women not at high risk for

diabetes to report fair or poor health in the past year if they were poor or near poor. No significant

differences were found between women at high risk and not at high risk who lived in middle- or

high-income families.

• Regardless of diabetes risk status, women who lived in poor, near-poor, or middle-income families

were significantly more likely than women who lived in high-income families to report fair or poor

health in the past year. 

0

5

10

15

20

25

30

35

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 15
Diagnosed Hypertension

Women age 18 years and over who had ever been told by a doctor or other health professional that they

had hypertension, by diabetes risk status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• Non-Hispanic white and non-Hispanic black women at high risk for diabetes were significantly more

likely than those not at high risk for diabetes to have been told by a doctor or other health

professional that they had hypertension. No significant difference was found between MexicanAmerican women at risk and not at high risk for diabetes.

• Among women at high risk for diabetes, the proportion of non-Hispanic blacks who were told that

they had hypertension was significantly higher than the proportion of non-Hispanic whites. The

proportion of Mexican Americans was significantly lower than the proportion of non-Hispanic

whites.

• Among women not at high risk for diabetes, non-Hispanic blacks were significantly more likely to be

told by a doctor or other health professional that they had hypertension. No significant difference was

found between Mexican Americans and non-Hispanic whites. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 16

0

5

10

15

20

25

30

35

40

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at HighRisk

Mexican 

American
Women age 18 years and over who had ever been told by a doctor or other health professional that they

had hypertension, by diabetes risk status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• At all levels of education, women at high risk for diabetes were significantly more likely than women

not at high risk for diabetes to report ever having been told that they had hypertension.

• Among women at high risk and not at high risk for diabetes, the proportions of women who had been

told that they had hypertension did not significantly vary by level of education. 

0

5

10

15

20

25

30

35

40

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 17
Women age 18 years and over who had ever been told by a doctor or other health care professional that

they had hypertension, by diabetes risk status and family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• At all levels of family income, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to report that they had been told by a doctor or other health

professional that they had hypertension.

• There were no significant differences by income in the percentages of women at high risk or not at

high risk for diabetes who reported having been told that they had hypertension.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 18

0

5

10

15

20

25

30

35

40

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Diagnosed Overweight

Women at high risk for diabetes who were told by a doctor or other health professional that they were

obese, by race/ethnicity, education, and family income, 2003-2006

Source: National Health and Nutrition Examination

Survey, 2003-2006

Appendix Table: Tables 2, 3, and 4 

• Among women at high risk for diabetes, non-Hispanic blacks and Mexican Americans were

significantly less likely than non-Hispanic whites to report having been told that they were

overweight.

• Women at high risk for diabetes with a high school education or less were significantly less likely

than women at high risk for diabetes with a higher level of education to report having been told that

they were overweight.

• Women at high risk for diabetes who lived in poor, near-poor, or middle-income families were

significantly less likely than women at high risk for diabetes who lived in high-income families to

report having been told that they were overweight.

0

10

20

30

40

50

60

70

80

90

Percent 

Non-Hispanic White 

Non-Hispanic Black

Mexican American

Less Than High School

High School

More Than High School

Poor

High Income

Middle Income

Near Poor

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 19
Cholesterol

Managing cholesterol levels has been shown to reduce cardiovascular risk among those at high risk for

diabetes with elevated glucose levels (prediabetes). Individuals with prediabetes usually have significantly

increased levels of total cholesterol, LDL, and triglycerides, while HDL levels are significantly lower.40

According to the American Heart Association, optimal LDL cholesterol is less than 100 mg/dL; optimal

HDL cholesterol for women is greater than 50 mg/dL; and optimal triglyceride level is less than 

150 mg/dL.41

Women age 18 and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status and 

race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• Among non-Hispanic whites, women at high risk for diabetes were significantly less likely than

women not at high risk for diabetes to have LDL cholesterol less than 130 mg/dL.

• Compared with non-Hispanic whites, non-Hispanic blacks and Mexican Americans at high risk for

diabetes were significantly more likely to have LDL cholesterol less than 130 mg/dL.

• There were no significant racial or ethnic differences among women not at high risk for diabetes.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 20

0

10

20

30

40

50

60

70

80

90

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at HighRisk

Mexican 

American
Women age 18 and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status 

and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3

• Among women who have a high school diploma or more, women at high risk for diabetes were

significantly less likely than those not at high risk to have LDL cholesterol less than 130 mg/dL. 

• There were no significant differences by diabetes risk status among women with less than a high

school diploma.

0

10

20

30

40

50

60

70

80

90

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 21
Women age 18 and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status 

and income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4

• Among middle- and high-income groups, women at high risk were significantly less likely than

women not at high risk to have LDL cholesterol less than 130 mg/dL. 

• No significant differences were found by diabetes risk status among other income groups.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 22

0

10

20

30

40

50

60

70

80

90

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Smoking

Women age 18 years and over who reported that they were current smokers, by diabetes risk status and

race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• No significant differences were found in any racial/ethnic group between women at high risk for

diabetes and women not at high risk for diabetes who were current smokers in the past year.

• Regardless of diabetes risk status, non-Hispanic black and Mexican-American women were

significantly less likely than non-Hispanic white women to be current smokers.

0

5

10

15

20

25

30

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 23
Women age 18 years and over who reported that they were current smokers, by diabetes risk status 

and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• Women at high risk for diabetes were significantly less likely than women not at high risk for

diabetes to be current smokers in the past year if they had a high school education or less. 

• No significant difference was found between women at high risk and women not at high risk who

had more than a high school education.

• Regardless of diabetes risk status, women with a high school education or less were significantly

more likely than women with more than a high school education to be current smokers in the 

past year.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 24

0

10

20

30

40

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
Women age 18 years and over who reported that they were current smokers, by diabetes risk status and

family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4

• Women at high risk for diabetes were significantly less likely than women not at high risk for

diabetes to be current smokers in the past year if they lived in near-poor or middle-income families.

No significant differences were found between women at high risk and not at high risk for diabetes

who lived in poor or high-income families.

• Regardless of diabetes risk status, women who lived in poor, near-poor, or middle-income families

were significantly more likely than women who lived in high-income families to be current smokers

in the past year.

0

5

10

15

20

25

30

35

40

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 25
Alcohol Consumption

Women age 18 years and over who had 12 or more alcoholic drinks in the past year, by diabetes

risk status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• Among non-Hispanic white women, women at high risk for diabetes were significantly less likely

than women not at high risk for diabetes to report consumption of 12 or more alcoholic drinks in the

past year. 

• No significant differences were found between women at high risk and not at high risk for diabetes

among non-Hispanic black or Mexican-American women.

• Regardless of diabetes risk status, non-Hispanic black and Mexican-American women were

significantly less likely than non-Hispanic white women to report consumption of 12 or more

alcoholic drinks in the past year.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 26

0

10

20

30

40

50

60

70

80

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American
Women age 18 years and over who had 12 or more alcoholic drinks in the past year, by diabetes 

risk status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• Women at high risk for diabetes were significantly less likely than women not at high risk for

diabetes to report consumption of 12 or more alcoholic drinks if they had more than a high school

education. 

• No significant differences were found between women at high risk and not at high risk who had

lower levels of education.

• Regardless of diabetes risk status, women with less than a high school education were significantly

less likely than women with more than a high school education to report consumption of 12 or more

alcoholic drinks in the past year. 

0

10

20

30

40

50

60

70

80

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 27
Women age 18 years and over who had 12 or more alcoholic drinks in the past year, by diabetes risk status

and family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• Women at high risk for diabetes were significantly less likely than women not at high risk for

diabetes to report consumption of 12 or more alcoholic drinks in the past year if they lived in nearpoor or high-income families.

• Women at high risk for diabetes who lived in poor or near-poor families were significantly less likely

than women at high risk who lived in high-income families to report consumption of 12 or more

alcoholic drinks in the past year. 

• No significant difference was found between women who lived in middle-income and high-income

families.

• Women not at high risk for diabetes who lived in poor, near-poor, or middle-income families were

significantly less likely than women not at high risk who lived in high-income families to consume

12 or more alcoholic drinks in the past year.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 28

0

9

18

27

36

45

54

63

72

81

90

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Access to Care

Lack of access to care can shorten lives and influence an individual’s overall quality of life.42 Women who

are at high risk for diabetes need a consistent source of health care, either a person or a place, to receive

ongoing patient-centered preventive care, which can delay or prevent the complications of diabetes.

Several factors can impede a woman’s ability to obtain access to care. Race and ethnicity, socioeconomic

position, age, and other factors contribute to the lack of ongoing care for women.43

Health Insurance 

Health insurance coverage during the past year among women ages 18-64 years, by diabetes 

risk status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• The types of health insurance coverage reported by women at high risk for diabetes were not

significantly different from the types of coverage reported by women not at high risk for diabetes. 

0

10

20

30

40

50

60

70

80

90

100

Percent 

At High Risk

Any Type

Any Private

Public Only

Not at High Risk

Uninsured Any Period

Uninsured All Year

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 29
30 WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE

Women ages 18-64 years with any type of health insurance coverage during the past year, by diabetes risk

status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• Mexican-American women at high risk for diabetes were significantly less likely than MexicanAmerican women not at high risk for diabetes to have any type of insurance during the past year. 

• Among women at high risk for diabetes, Mexican-American and non-Hispanic black women were

significantly less likely than non-Hispanic white women to have any type of insurance during the 

past year. 

• Among women not at high risk for diabetes, Mexican Americans were significantly less likely than

non-Hispanic whites to have any type of insurance during the past year. 

0

10

20

30

40

50

60

70

80

90

100

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American
WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 31

Women ages 18-64 years with any type of health insurance coverage during the past year, by diabetes risk

status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• At all levels of education, the proportion of women at high risk for diabetes who reported having any

type of health insurance was not significantly different from the proportion of women not at high risk

for diabetes.

• Regardless of diabetes risk status, women who had a high school education or less were significantly

less likely than women who had higher levels of education to have any type of health insurance. 

0

10

20

30

40

50

60

70

80

90

100

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
Women ages 18-64 years with any type of health insurance during the past year, by diabetes risk status and

family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• At all levels of family income, the proportion of women at high risk for diabetes who reported having

any type of health insurance was not significantly different from the proportions of women not at

high risk for diabetes.

• Regardless of diabetes risk status, women who lived in poor, near-poor, or middle-income families

were significantly less likely than women who lived in high-income families to report having any

type of health insurance during the past year. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 32

0

20

40

60

80

100

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Women ages 18-64 years with any private health insurance during the year, by diabetes risk status and

race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• Among Mexican Americans, women at high risk for diabetes were significantly less likely than

women not at high risk for diabetes to have any private health insurance during the year. No

significant differences were found among non-Hispanic black or non-Hispanic white women.

• Regardless of diabetes risk status, Mexican-American and non-Hispanic black women were

significantly less likely than non-Hispanic white women to have any private health insurance during

the year.

0

10

20

30

40

50

60

70

80

90

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 33
Women ages 18-64 years with any private health insurance during the year, by diabetes risk status and 

education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• At all levels of education, the proportions of women at high risk and not at high risk for diabetes who

reported having any private health insurance during the year were not significantly different.

• Regardless of diabetes risk status, women who had a high school education or less were significantly

less likely than women with more than a high school education to have any private health insurance

during the year. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 34

0

10

20

30

40

50

60

70

80

90

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
Women ages 18-64 years with private health insurance during the year, by diabetes risk status and family 

income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• At all levels of family income, the proportions of women at high risk and not at high risk for diabetes

who reported having any private health insurance during the year were not significantly different.

• Regardless of diabetes risk status, women who lived in poor, near-poor, or middle-income families

were significantly less likely than women who lived in high-income families to have private health

insurance during the year.

0

10

20

30

40

50

60

70

80

90

100

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 35
Women ages 18-64 years with only public health insurance during the year, by diabetes risk status and

race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• Among non-Hispanic whites, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to have only public health insurance during the year. No

significant differences were found among non-Hispanic black or Mexican-American women.

• Regardless of diabetes risk status, non-Hispanic black women were significantly more likely than

non-Hispanic white women to have only public health insurance during the year.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 36

0

5

10

15

20

25

30

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American
Women ages 18-64 years with only public health insurance coverage during the year, by diabetes risk status

and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• Among women with a high school education or higher, women at high risk for diabetes were

significantly more likely than those not at high risk for diabetes to have only public health insurance

during the year.

• Regardless of diabetes risk status, women with a high school education or less were significantly

more likely than women with more than a high school education to have only public health insurance

during the year. 

0

10

20

30

40

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 37
Women ages 18-64 years with only public health insurance during the year, by diabetes risk status and 

family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• In near-poor families, women at high risk for diabetes were significantly more likely than women not

at high risk for diabetes to have only public health insurance during the year. No significant

differences were found at other levels of family income. 

• Regardless of diabetes risk status, women who were poor, near poor, or middle income were

significantly more likely than women who were high income to have only public health insurance

during the year. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 38

0

10

20

30

40

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Women ages 18-64 years who were uninsured all year, by diabetes risk status and race/ethnicity, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 2

• In each racial/ethnic group, the proportion of women at high risk for diabetes who were uninsured all

year was not significantly different from the proportion among women not at high risk for diabetes.

• Among women at high risk for diabetes, Mexican-American and non-Hispanic black women were

significantly more likely than non-Hispanic white women to be uninsured all year.

• Among women not at high risk for diabetes, Mexican-American women were significantly more

likely than non-Hispanic white women to be uninsured all year. 

0

5

10

15

20

25

30

35

40

45

50

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 39
Women ages 18-64 years who were uninsured all year, by diabetes risk status and education, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 3 

• At all levels of education, the proportion of women who were uninsured all year was not significantly

different between women at high risk and not at high risk for diabetes.

• Regardless of diabetes risk status, women with a high school education or less were significantly

more likely than women with more than a high school education to be uninsured all year.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 40

0

10

20

30

40

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
Use of Health Care Services

Women age 18 years and over reporting use of health care services, by diabetes risk status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• The percentages of women at high risk for diabetes who reported that they had a specific source of

ongoing care or that the source was a clinic or health center were not significantly different from the

percentages among women not at high risk for diabetes. 

• The percentage of women at high risk for diabetes who reported an office or outpatient visit in the

past 12 months was not significantly different from the percentage among women not at high risk for

diabetes.

0

20

40

60

80

100

Percent 

At High Risk

Specific Source

of Ongoing Care

Office or Outpatient

Visit in Past 12 Months

Clinic or

Health Center

Not at High Risk

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 41
42 WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE

Women age 18 years and over who had a specific source of ongoing care, by diabetes risk status and

race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• In all racial/ethnic groups, no significant difference was found between the percentages of women at

high risk and not at high risk for diabetes who had a specific source of ongoing care.

• Regardless of diabetes risk status, Mexican-American women were significantly less likely than nonHispanic white women to have a specific source of ongoing care. 

• Non-Hispanic black women not at high risk for diabetes were significantly more likely than nonHispanic white women not at high risk for diabetes to have a specific source of ongoing care. 

0

10

20

30

40

50

60

70

80

90

100

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American
WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 43

Women age 18 years and over who had a specific source of ongoing care, by diabetes risk status and 

education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• Among women with a high school education or more, women at high risk for diabetes were

significantly more likely than those not at high risk to have a specific source of ongoing care.

• Women at high risk for diabetes who had less than a high school education or a high school

education were significantly less likely than women at high risk for diabetes who had more than a

high school education to have a specific source of ongoing care. 

• Women not at high risk for diabetes who had a high school education were significantly less likely

than those with more than a high school education to have a specific source of ongoing care. 

0

10

20

30

40

50

60

70

80

90

100

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
Women age 18 years and over who had a specific source of ongoing care, by diabetes risk status and

family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• Women at high risk for diabetes who lived in near-poor families were significantly more likely that

those not at high risk for diabetes to have a specific source of ongoing care. We found no significant

differences by diabetes risk status in the other family income groups. 

• Among women at high risk for diabetes, those who lived in poor or near-poor families were

significantly less likely than those who lived in high-income families to have a specific source of

ongoing care. No significant difference was found for women in middle-income families.

• Women not at high risk for diabetes who were poor, near poor, or middle income were significantly

less likely than those with high income to have a specific source of ongoing care.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 44

0

20

40

60

80

100

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Women age 18 years and over whose source of ongoing care is a clinic or health center, by diabetes risk

status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• Mexican-American women at high risk for diabetes were significantly more likely than those not at

high risk for diabetes to use a clinic or health center as their ongoing source of care. No significant

difference was found in other racial/ethnic groups.

• Regardless of diabetes risk status, Mexican-American women were significantly more likely than

non-Hispanic white women to use a clinic or health center as their ongoing source of care. No

significant difference was found between non-Hispanic black and non-Hispanic white women. 

0

10

20

30

40

50

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 45
Women age 18 years and over whose source of ongoing care is a clinic or health center, by diabetes risk

status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• At all levels of education, no significant difference was found between women at high risk for

diabetes and women not at high risk for diabetes in the percentages reporting a clinic or health center

as their ongoing source of care. 

• Regardless of diabetes risk status, women who had less than a high school education were

significantly more likely than women who had more than a high school education to have a clinic or

health center as their ongoing source of care. No significant difference was found for women with a

high school education.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 46

0

10

20

30

40

50

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
Women age 18 years and over whose source of ongoing care is a clinic or health center, by diabetes risk

status and family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• No significant difference by income was found between the percentages of women at high risk and

not at high risk for diabetes who had a clinic or health center as their ongoing source of care.

• Women at high risk for diabetes who were poor or near poor were significantly more likely than

women at high risk for diabetes with high income to have a clinic or health center as their ongoing

source of care. 

• Women not at high risk for diabetes who were poor, near poor, or middle income were significantly

more likely than women not at high risk for diabetes with high income to have a clinic or health

center as their ongoing source of care. 

0

10

20

30

40

50

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 47
Women age 18 years and over who reported an office or outpatient visit in the past 12 months, by

diabetes risk status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• In each racial/ethnic group, the proportions of women at high risk and not at high risk for diabetes

who reported making an office or outpatient visit in the past 12 months were not significantly

different.

• Regardless of diabetes risk status, Mexican-American women were significantly less likely than nonHispanic white women to have reported an office or outpatient visit in the past 12 months. No

significant differences were found between non-Hispanic black and non-Hispanic white women. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 48

0

10

20

30

40

50

60

70

80

90

100

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American
Women age 18 years and over who reported an office or outpatient visit in the past 12 months, by diabetes

risk status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• At all levels of education, no significant difference was found between the percentages of women at

high risk and not at high risk for diabetes who reported an office or outpatient visit in the past 

12 months.

• Regardless of diabetes risk status, women with less than a high school education were less likely than

women with more than a high school education to report an office or outpatient visit in the past 

12 months. 

0

20

40

60

80

100

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 49
Women age 18 years and over who reported an office or outpatient visit in the past 12 months, by 

diabetes risk status and family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• At any level of family income, the proportions of women at high risk or not at high risk for diabetes

who reported an office visit or outpatient visit were not significantly different. 

• Women at high risk for diabetes who lived in poor or near-poor families were significantly less likely

than women at high risk for diabetes who lived in high-income families to report an office or

outpatient visit in the past 12 months.

• Women not at high risk for diabetes who lived in poor, near poor, or middle-income families were

significantly less likely than women not at high risk for diabetes who lived in high-income families to

report an office or outpatient visit in the past 12 months. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 50

0

20

40

60

80

100

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Diabetes-Related Risk Reduction

Provider-Directed Preventive Care

Individuals at high risk for diabetes have been shown to have an increased risk for cardiovascular disease,

when compared to those not at high risk.44 For instance, at-risk adults are more likely to have

cardiovascular disease risk factors, including higher mean weight, waist circumference, systolic blood

pressure, and triglyceride levels, as well as a higher prevalence of hypertension.45

Blood Pressure Measurement

High blood pressure is more common among individuals at high risk for diabetes, compared to those not

at high risk.46 Hypertension, defined as a systolic blood pressure of 140 mm Hg or higher or a diastolic

blood pressure of 90 mm Hg or higher, is a major risk factor for cardiovascular disease. It is

recommended that adults have their blood pressure checked at least once every 2 years.47

Women age 18 and over whose provider measured their blood pressure within the past 2 years, by diabetes

risk status, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 2

• No significant differences were found between women at high risk and not at high risk for diabetes

who had their blood pressure measured by a provider within the past 2 years. 

0

10

20

30

40

50

60

70

80

90

100

Percent 

At High Risk

Not at High Risk

Blood Pressure Measured

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 51
Women age 18 and over whose provider measured their blood pressure within the past 2 years, by diabetes

risk status and race/ethnicity, 2003/2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 2 

• In each racial/ethnic group, no significant difference was found between women at high risk and not

at high risk for diabetes who reported having their blood pressure measured by a provider within the

past 2 years.

• Among women at high risk for diabetes, Mexican Americans were significantly less likely than nonHispanic whites to report having their provider measure their blood pressure within the past 2 years.

No significant difference was found for non-Hispanic blacks.

• Among women not at risk, no significant differences were found by race/ethnicity.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 52

0

10

20

30

40

50

60

70

80

90

100

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American
Women age 18 and over whose provider measured their blood pressure within the past 2 years, by diabetes

risk status and education, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 3 

• At all levels of education, no significant differences were found between women at high risk and not

at high risk for diabetes who had their blood pressure measured by a provider within the past 2 years. 

• Women at high risk for diabetes who had more than a high school education were significantly more

likely than women with lower levels of education to report having their blood pressure measured by a

health care provider within the past 2 years.

• Women not at high risk for diabetes who had more than a high school education were significantly

more likely than those with only a high school education to report having their blood pressure

measured by a health care provider within the past 2 years.

0

20

40

60

80

100

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 53
Women age 18 and over whose provider measured their blood pressure within the past 2 years, by diabetes

risk status and family income, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 4 

• At all levels of family incomes, no significant differences were found between women at high risk

and not at high risk for diabetes who had their blood pressure measured by a health care provider

within the past 2 years.

• Women at high risk who were poor or near poor were significantly less likely than those who had

high income to report having their provider measure their blood pressure within the past 2 years.

• Women not at high risk for diabetes who had less than high income were also significantly less likely

to have their provider measure their blood pressure within the past 2 years.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 54

0

20

40

60

80

100

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Lipid Profile

Women age 18 and over who had a lipid profile in the past 2 years, by diabetes risk status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• No significant difference was found between women at high risk for diabetes and women not at high

risk for diabetes to report having a lipid profile in the past 2 years.

0

10

20

30

40

50

60

70

80

90

100

Percent 

At High Risk

Not at High Risk

Lipid profile in past 2 years

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 55
Women age 18 and over who had a lipid profile in the past 2 years, by diabetes risk status 

and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• Within each racial/ethnic group, no differences were found between women at high risk and not at

high risk for diabetes who reported having a lipid profile in the past 2 years.

• Regardless of diabetes risk status, Mexican-American and non-Hispanic black women were

significantly less likely than non-Hispanic white women to report having a lipid profile in the past 2

years.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 56

0

20

40

60

80

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American
Women age 18 and over who had a lipid profile in the past 2 years, by diabetes risk status and education,

2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• Women at high risk for diabetes with more than a high school education were significantly more

likely than those not at risk to have had a lipid profile in the past 2 years. No significant differences

were found by diabetes risk status among women with a high school diploma or less.

• Women at high risk for diabetes with a high school diploma or less were significantly less likely than

those who had more than a high school education to have had a lipid profile in the past 2 years. 

• There were no significant differences by education level among women not at high risk.

0

20

40

60

80

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 57
Women age 18 and over who had a lipid profile in the past 2 years, by diabetes risk status and family 

income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• Women at high risk for diabetes who lived in poor families were significantly more likely than

women not at high risk for diabetes to have had a lipid profile in the past 2 years. Within the other

family income groups, there were no significant differences by diabetes risk status.

• Women at high risk for diabetes who lived in high-income families were significantly more likely

than those who lived in families with lower incomes to report having a lipid profile in the past 2

years.

• Women not at high risk for diabetes who lived in high-income families were significantly more likely

than those who lived in poor or near-poor families to report having a lipid profile in the past 2 years.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 58

0

20

40

60

80

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Provider Advice About Weight

Being overweight or obese is an established risk factor for diabetes. The American Diabetes Association

recommends that clinicians counsel overweight or obese patients to lose 5 to 10% of their body weight

and increase their physical activity to at least 150 minutes per week to reduce diabetes risk.48 Although

clinician advice has been associated with adoption of healthy behaviors, only about one-third of adults at

risk reported that they had received such advice in 2006.45

Obese women with high cholesterol who were given advice by provider, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

0

20

40

60

80

100

Percent 

At High Risk

Exercise for

Cholesterol Reduction

Eat Fewer High-Fat or

High-Cholesterol Foods

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 59
Advice about exercising for cholesterol reduction

Obese women with high cholesterol who were given advice that they should exercise for cholesterol 

reduction, by race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• Among obese women with high cholesterol, Mexican Americans were significantly more likely than

non-Hispanic whites to be given advice that they should exercise to lower their cholesterol. No

significant difference was found for non-Hispanic black women.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 60

0

15

30

45

60

75

90

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Mexican 

American
Obese women with high cholesterol who were given advice that they should exercise for cholesterol 

reduction, by education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3

• There were no significant differences by education among obese women with high cholesterol who

were given advice that they should exercise for cholesterol reduction. 

0

10

20

30

40

50

60

70

80

90

Percent 

At High Risk

Less Than 

High School

High School

More Than

High School

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 61
Obese women with high cholesterol who were given advice that they should exercise for cholesterol 

reduction, by family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4

• There were no significant differences by income among obese women with high cholesterol who

were given advice that they should exercise for cholesterol reduction. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 62

0

15

30

45

60

75

90

Percent 

 At High Risk

Poor 

Near Poor

Middle Income

High Income
Advice about eating fewer high-fat or high-cholesterol foods

Obese women with high cholesterol who were given advice about eating fewer high-fat or high-cholesterol

foods, by race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• Among obese women with high cholesterol, Mexican Americans were significantly more likely than

non-Hispanic whites to be given advice that they should eat fewer high-fat or high-cholesterol foods. 

0

20

40

60

80

100

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Mexican 

American

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 63
Obese women with high cholesterol who were given advice about eating fewer high-fat or high-cholesterol

foods, by education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3

• There were no significant differences by education among obese women with high cholesterol who

were given advice about eating fewer high-fat or high-cholesterol foods. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 64

0

20

40

60

80

100

Percent 

At High Risk

Less Than 

High School

High School

More Than

High School
Obese women with high cholesterol who were given advice about eating fewer high-fat or high-cholesterol

foods, by family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4

• Obese women with middle income were significantly less likely than those with high income to be

given advice about eating fewer high-fat or high-cholesterol foods. No significant difference was

found between lower than middle-income groups and the high-income group.

Self-Care Behaviors

Numerous studies with followup periods ranging from 7 to 20 years have indicated that lifestyle

modification through dietary changes and regular physical activity significantly lowers long-term diabetes

risk among those with impaired glucose tolerance or prediabetes.4,25-30 However, according to the 2006

National Health Interview Survey, only 52.2% of adults with self-reported prediabetes reported trying to

control or lose weight; 54.7% reported reducing fat or calories; and 48.5% reported increasing physical

activity. Women were more likely than men to report engaging in each activity, and individuals of normal

weight were less likely to report engaging in each activity than those who were overweight or obese.45

0

20

40

60

80

100

Percent 

 At High Risk

Poor 

Near Poor

Middle Income

High Income

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 65
66 WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE

Physical Activity

Women age 18 and over who exercise 150 minutes/week, by diabetes risk status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• Women at high risk for diabetes were significantly less likely than women not at high risk for

diabetes to report that they exercised 150 minutes per week.

0

10

20

30

40

Percent 

At High Risk

Not at High Risk
WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 67

Women age 18 and over who exercise 150 minutes/week, by diabetes risk status and race/ethnicity, 2003-

2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• Among non-Hispanic whites, women at high risk for diabetes were significantly less likely than

women not at high risk for diabetes to exercise 150 minutes per week. There were no significant

differences by diabetes risk status in the other racial/ethnic groups.

• Among women at high risk for diabetes, the percentage of women who reported at least 150

minutes/week of exercise was not significantly different between the racial/ethnic groups. This

finding was similar for women not at high risk for diabetes.

0

5

10

15

20

25

30

35

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American
68 WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE

Women age 18 and over who exercise 150 minutes/week, by diabetes risk status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• Women at high risk for diabetes who had more than a high school education were significantly less

likely to exercise at least 150 minutes per week than women not at high risk. No significant

differences were found by diabetes risk status among those with a high school diploma or less.

• Among women at high risk for diabetes, no significant differences were found by education. 

• Women not at high risk for diabetes who had not graduated from high school were significantly less

likely than those who had more than a high school education to exercise at least 150 minutes per

week. 

0

10

20

30

40

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 69

Women age 18 and over who exercise 150 minutes/week, by diabetes risk status and family 

income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• Among poor and high-income groups, women at high risk for diabetes were significantly less likely

than women not at high risk for diabetes to exercise for at least 150 minutes per week. There were no

significant differences among near-poor and middle-income groups by diabetes risk status. 

• Among women not at risk, poor women were significantly more likely than women who had high

income to exercise at least 150 minutes per week. No significant differences were found by income

level among women at risk. 

0

10

20

30

40

50

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income
Weight Loss

Women age 18 and over who tried to lose weight in the past 12 months, by diabetes risk status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2

• Women at high risk for diabetes were significantly more likely than women not at high risk for

diabetes to have tried to lose weight in the past 12 months. 

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 70

0

10

20

30

40

50

Percent 

At High Risk

Not at High Risk
Women age 18 and over who tried to lose weight in the past 12 months, by diabetes risk status and

race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• In all racial/ethnic groups, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to have tried to lose weight in the past 12 months. 

• Among women at high risk for diabetes, non-Hispanic blacks and Mexican Americans were

significantly less likely than non-Hispanic whites to have tried to lose weight in the past 12 months. 

• Non-Hispanic black women not at high risk for diabetes were significantly less likely than nonHispanic white women not at high risk for diabetes to have tried to lose weight in the past 12 months.

No significant difference was found between Mexican-American and non-Hispanic white women

who were not at high risk for diabetes. 

0

20

40

60

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 71
Women age 18 and over who tried to lose weight in the past 12 months, by diabetes risk status and 

education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• At all levels of education, women at high risk for diabetes were significantly more likely than women

not at high risk for diabetes to have tried to lose weight in the past 12 months.

• Women at high risk for diabetes who had a high school education or less were significantly less

likely than women at high risk for diabetes who had more than a high school education to have tried

to lose weight in the past year.

• Among women not at high risk, those who had less than a high school education were significantly

less likely than those who had more than a high school education to have tried to lose weight in the

past year.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 72

0

10

20

30

40

50

60

70

80

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
Women age 18 and over who tried to lose weight in the past 12 months, by diabetes risk status and family

income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• At all levels of family income, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to have tried to lose weight in the past 12 months.

• Regardless of diabetes risk status, women who lived in poor or near-poor families were significantly

less likely than those who lived in high-income families to have tried to lose weight in the past 12

months.

0

20

40

60

80

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 73
Weight loss by exercising

Women age 18 and over who tried to lose weight by exercising in the past 12 months, by diabetes 

risk status, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 2

• Women at high risk for diabetes were significantly more likely than women not at high risk for

diabetes to report that they tried to lose weight by exercising in the past 12 months.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 74

0

10

20

30

40

50

Percent 

At High Risk

Not at High Risk
Women age 18 and over who tried to lose weight by exercising in the past 12 months, by diabetes risk 

status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 2 

• In each racial/ethnic group, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to report that they tried to lose weight by exercising in the past 12

months. 

• Among women at high risk for diabetes, Mexican-American women were significantly less likely

than non-Hispanic white women to report they tried to lose weight by exercising in the past year.

• Among women not at high risk for diabetes, non-Hispanic black women were significantly less likely

than non-Hispanic white women to report that they tried to lose weight by exercising in the past year.

No significant difference was found for Mexican-American women.

0

10

20

30

40

50

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 75
Women age 18 and over who tried to lose weight by exercising in the past 12 months, by diabetes risk 

status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 3 

• Regardless of education level, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to report that they tried to lose weight by exercising in the past 12

months.

• Regardless of diabetes risk status, women with a high school education or less were significantly less

likely than those with more than a high school education to report that they tried to lose weight by

exercising in the past 12 months.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 76

0

10

20

30

40

50

Percent 

 At High Risk

High School

Not at High Risk

More Than

High School

Less Than

High School
Women age 18 and over who tried to lose weight by exercising in the past 12 months, by diabetes risk 

status and family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006

Appendix Table: Table 4 

• At all levels of family income, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to report that they tried to lose weight by exercising in the past 12

months.

• Regardless of diabetes risk status, women who lived in poor or near-poor families were significantly

less likely than women who lived in high-income families to report that they tried to lose weight by

exercising in the past 12 months.

0

10

20

30

40

50

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 77
Weight loss by dieting

Women age 18 and over who tried to lose weight by dieting in the past 12 months, by diabetes risk status,

2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 2

• Women at high risk for diabetes were significantly more likely than women not at high risk for

diabetes to report that they tried to lose weight by dieting in the past 12 months.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 78

0

10

20

30

40

50

60

Percent 

At High Risk

Not at High Risk

Dieted in past 12 months
Women age 18 and over who tried to lose weight by dieting in the past 12 months, by diabetes risk status

and race/ethnicity, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 2 

• In each racial/ethnic group, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to report that they tried to lose weight by dieting in the past 12

months. 

• Among women at risk, only Mexican Americans were significantly less likely than non-Hispanic

whites to report that they tried to lose weight by dieting in the past 12 months.

• Among women not at high risk for diabetes, both non-Hispanic blacks and Mexican Americans were

significantly less likely than non-Hispanic whites to report that they tried to lose weight by dieting in

the past 12 months. 

0

10

20

30

40

50

60

Percent 

At High Risk

Non-Hispanic

White

Non-Hispanic 

Black

Not at High Risk

Mexican 

American

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 79
Women age 18 and over who tried to lose weight by dieting in the past 12 months, by diabetes risk status

and education, 2003-2004 

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 3 

• At each level of education, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to report that they tried to lose weight by dieting in the past 12

months.

• Regardless of diabetes risk status, women with a high school education or less were significantly less

likely than women with higher levels of education to report that they tried to lose weight by dieting in

the past 12 months.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 80

0

20

40

60

Percent 

At High Risk

Less Than 

High School

High School

Not at High Risk

More Than

High School
Women age 18 and over who tried to lose weight by dieting in the past 12 months, by diabetes risk status

and family income, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004

Appendix Table: Table 4 

• At all levels of family income, women at high risk for diabetes were significantly more likely than

women not at high risk for diabetes to report that they tried to lose weight by dieting in the past 12

months.

• Regardless of diabetes risk status, women who lived in poor or near poor families were significantly

less likely than women who lived in high income families to report that they tried to lose weight by

dieting in the past 12 months.

0

20

40

60

Percent 

 At High Risk

Poor 

Near Poor

Not at High Risk

Middle Income

High Income

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 81
82 WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE
WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 83

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Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final

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42. Chassin MR, Galvin RW. The urgent need to improve health care quality. Institute of Medicine National Roundtable on

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National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation; 2001. 

44. Ford E, Zhao G, Li C. Prediabetes and the risk for cardiovascular disease: a systematic review of the evidence. J Am

Coll Cardiol 2010 Mar 30;55(13):1310-7. 

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Med 2010 Apr;38(4):403-9. 

46. Lim SC, Tai ES, Tan BY, et al. Cardiovascular risk profile in individuals with borderline glycemia: the effect of the 1997

American Diabetes Association diagnostic criteria and the 1998 World Health Organization Provisional Report. Diabetes

Care 2000 Mar; 23(3):278-82.

47. Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection,

Evaluation and Treatment of High Blood Pressure. Hypertension 2003 Dec;42(6);1206-52.

48. Rolka DR, Burrows NR, Geiss LS. Self-reported prediabetes and risk-reduction activities. MMWR 2008 Nov

7:58(44):1203-5.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 85
WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 86
Appendix B: Tables

Table 

number Title

1a Selected characteristics among women age 18 and over overall and by diabetes risk status, United States, 2003-2006 (crude)

1b Selected characteristics among women age 18 and over overall and by diabetes risk status, United States, 2003-2006 

 (age standardized)

2 Percentage of women at high risk or not at high risk for diabetes who received preventive care, by race/ethnicity, United States, 

 2003-2006 (crude)

2a Age-standardized percentage of women at high risk or not at high risk for diabetes who received preventive care, by race/ethnicity, 

 United States, 2003-2006

3 Percentage of women at high risk or not at high risk for diabetes who received preventive care, by education, United States, 

 2003-2006 (crude)

3a Age-standardized percentage of women at high risk or not at high risk for diabetes who received preventive care, by education, 

 United States, 2003-2006 

4 Percentage of women at high risk or not at high risk for diabetes who received preventive care, by family income, United States, 

 2003-2006 (crude)

4a Age-standardized percentage of women at high risk or not at high risk for diabetes who received preventive care, 

 by family income, United States, 2003-2006

5a Age-standardized percentage of women at high risk for diabetes who received preventive care, by race/ethnicity, 

 United States, 2003-2006 

5b Age-standardized percentage of women at high risk for diabetes who received preventive care, by education, 

 United States, 2003-2006

5c Age-standardized percentage of women at high risk for diabetes who received preventive care, by family income, United States, 

 2003-2006

6a Age-standardized percentage of women not at high risk for diabetes who received preventive care, by race/ethnicity, 

 United States, 2003-2006

6b Age-standardized percentage of women not at high risk for diabetes who received preventive care, by education, 

 United States, 2003-2006

6c Age-standardized percentage of women not at high risk for diabetes who received preventive care, by family income, 

 United States, 2003-2006

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 87
Table 1a. Selected characteristics among women age 18 years and over overall and by diabetes risk status,

United States, 2003-2006 (crude)

At high risk Not at high risk Total

Sample 95% CI 95% CI Sample 95% CI 95% CI Sample 95% CI 95% CI 

Selected characteristics size Percent (low) (high) size Percent (low) (high) size Percent (low) (high)

Total 3,007 100 1,901 100 4,908 100

Age 18-44 1,627 47.9 44.7 51.1 1,171 58.9 55.5 62.2 2,798 52.6 49.7 55.4

45-64 799 35.1 32.3 38.0 352 26.3 23.7 29.1 1,151 31.4 29.1 33.8

65 and over 581 17.0 14.7 19.6 378 14.8 13.1 16.8 959 16.1 14.4 17.9

Race/ Non-Hispanic white 1,318 73.6 67.4 79.0 1,077 86.0 82.6 88.9 2,395 78.7 74.0 82.8

ethnicity Non-Hispanic black 791 16.9 13.2 21.4 308 7.9 5.8 10.8 1,099 13.2 10.2 16.9

Mexican American 707 9.5 6.7 13.2 325 6.1 4.6 7.9 1,032 8.1 6.0 10.8

Education Less than high school 897 19.0 16.4 21.9 453 15.0 12.9 17.5 1,350 17.3 15.6 19.2

High school 778 27.1 25.3 28.9 457 23.0 20.8 25.4 1,235 25.3 23.9 26.8

More than high school 1,331 53.9 51.5 56.3 984 62.0 58.6 65.2 2,315 57.3 55.1 59.5

Family Negative/poor 633 14.1 12.2 16.3 379 13.1 10.6 16.1 1,012 13.7 11.8 15.9

income Near poor 775 22.6 20.6 24.7 437 19.1 16.9 21.5 1,212 21.1 19.6 22.6

Middle income 780 31.8 29.5 34.3 463 29.1 26.2 32.1 1,243 30.7 28.8 32.6

High income 654 31.5 28.6 34.5 525 38.7 34.6 42.9 1,179 34.5 31.7 37.6

Key: CI = confidence interval.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

Note: Percentages may not add to 100 due to rounding. Negative/poor refers to household incomes below the Federal poverty line; near poor/low,

above the poverty line to just below 200 percent of the poverty line; middle income, 200 percent to just below 400 percent of the poverty line; and

high income, 400 percent of the poverty line and over.

Table 1b. Selected characteristics among women age 18 years and over overall and by diabetes risk status,

United States, 2003-2006 (age standardized)

At high risk Not at high risk Total

Sample 95% CI 95% CI Sample 95% CI 95% CI Sample 95% CI 95% CI 

Selected characteristics size Percent (low) (high) size Percent (low) (high) size Percent (low) (high)

Total 3,007 100 1,901 100 4,908 100

Age 18-44 1,627 49.9 46.7 53.2 1,171 60.7 57.4 64.0 2,798 54.5 51.7 57.3

45-64 799 32.5 29.9 35.3 352 24.1 21.7 26.8 1,151 28.9 26.7 31.3

65 and over 581 17.5 15.2 20.2 378 15.1 13.3 17.1 959 16.5 14.8 18.4

Race/ Non-Hispanic white 1,318 73.3 67.1 78.8 1,077 85.8 82.4 88.7 2,395 78.5 73.8 82.7

ethnicity Non-Hispanic black 791 17.0 13.2 21.5 308 8.0 5.8 10.9 1,099 13.3 10.3 16.9

Mexican American 707 9.7 6.9 13.4 325 6.2 4.7 8.0 1,032 8.2 6.1 11.0

Education Less than high school 897 19.2 16.6 22.1 453 15.2 13.0 17.6 1,350 17.5 15.7 19.4

High school 778 27.2 25.4 29.1 457 22.9 20.7 25.3 1,235 25.4 23.9 26.8

More than high school 1,331 53.6 51.2 55.9 984 62.0 58.6 65.2 2,315 57.2 55.0 59.3

Family Negative/poor 633 14.4 12.5 16.6 379 13.4 10.8 16.4 1,012 14.0 12.0 16.1

income Near poor 775 22.8 20.7 24.9 437 19.2 17.0 21.6 1,212 21.2 19.8 22.8

Middle income 780 31.8 29.5 34.3 463 29.2 26.3 32.2 1,243 30.7 28.8 32.6

High income 654 31.0 28.2 33.9 525 38.3 34.3 42.4 1,179 34.1 31.3 37.1

Key: CI = confidence interval.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

Note: Percentages may not add to 100 due to rounding. Estimates are age standardized to the 2000 standard population using three age-groups: 18-44,

45-64, and 65 and over. Negative/poor refers to household incomes below the Federal poverty line; near poor/low, above the poverty line to just below

200 percent of the poverty line; middle income, 200 percent to just below 400 percent of the poverty line; and high income, 400 percent of the poverty

line and over.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 88
Table 2. Percentage of women at high risk or not at high risk for diabetes who received preventive care,a 

by race/ethnicity, United States, 2003-2006 (crude)

Non-Hispanic White Non-Hispanic black Mexican American Totalc

At high Not at At high Not at At high Not at At high Not at

risk high risk risk high risk risk high risk risk high risk

Category Measures Percent Percent Percent Percent Percent Percent Percent Percent

Access to careb Women ages 18-64 with any type 

of insurance during the year 87.9 83.6 78.3 76.6 47.3 57.6 85.9 83.0

Women ages 18-64 with any private 

insurance during the year 76.3 74.5 53.6 53.0 31.6 45.5 71.6 72.6

Women ages 18-64 with only public 

insurance during the year 11.6 9.0 24.5 22.9 15.5 12.1 14.3 10.2

Women ages 18-64 uninsured all year, 

2003-2004 data only 6.5 9.2 11.7 13.0 42.9 41.7 7.5 9.5

Women ages 18-64 with any period of 

public insurance during the year 19.2 13.0 27.2 24.6 17.3 14.9 20.9 14.0

Women ages 18-64 with any period of 

uninsurance during the year 18.7 20.3 29.9 31.1 60.8 50.0 21.0 21.2

General health Women age 18 and over who reported 

and well-being fair or poor health in the past year 13.7 10.1 24.4 19.7 30.5 24.6 15.6 10.8

Women age 18 and over with physical 

and mental health limitations 5.4 3.9 * * 2.4 * 4.7 3.7

Women age 18 and over who are 

current smokers 20.9 27.0 18.1 20.5 11.5 13.5 20.3 26.5

Women age 18 and over who had at

least 12 alcohol drinks/1 yr 65.3 75.5 46.9 50.1 51.3 56.7 62.1 73.6

Women age 18 and over who have 

alcohol at least 1 day per year 66.4 77.5 51.9 52.9 57.1 56.9 63.9 75.6

Women age 18 and over who drink 

alcohol, mean number of alcoholic 

drinks per week in the past 12 months 2.2 3.4 2.5 * 94.3 2.1 2.3 3.5

Specific to Women age 18 and over whose provider 

cardiovascular measured their blood pressure within 

disease the past 2 years-2003-2004 data only 97.2 95.9 97.7 96.9 88.6 91.5 97.3 96.0

Women age 18 and over who had a 

lipid profile in the past 2 years 64.8 56.0 59.4 53.3 35.4 37.8 63.8 55.8

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 59.7 74.8 70.2 79.0 70.7 76.5 61.7 75.1

Women age 18 and over who exercise 

150 minutes/week 26.2 32.4 23.5 29.4 22.9 29.3 25.7 32.1

Obese women who were told that they 

were overweight 70.6 * 59.4 * 56.5 * 68.1 *

Obese women with high cholesterol 

who were given advice that they should 

exercise for cholesterol reduction 77.9 * 82.9 * 87.7 * 78.7 *

Obese women with high cholesterol 

who were given advice about eating 

fewer high-fat or high-cholesterol foods 

for cholesterol reduction 81.8 * 85.7 * 94.6 * 82.5 *

Women age 18 and over with activity 

limitation in the past year 1.7 1.8 1.8 1.8 1.9 1.9 1.7 1.8

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 89
Table 2. Percentage of women at high risk or not at high risk for diabetes who received preventive care,a 

by race/ethnicity, United States, 2003-2006 (crude) (continued) 

Non-Hispanic white Non-Hispanic black Mexican American Total

At high Not at At high Not at At high Not at At high Not at

risk high risk risk high risk risk high risk risk high risk

Category Measures Percent Percent Percent Percent Percent Percent Percent Percent

New measures Women age 18 and over who have ever 

been told by a doctor or other health 

professional that they had hypertension 35.9 17.1 36.6 20.0 17.4 12.9 36.0 17.4

Women age 18 and over who had a 

specific source of ongoing care 93.3 90.1 93.8 92.2 76.2 76.0 93.4 90.3

Women age 18 and over whose source 

of ongoing care is clinic or health center 14.4 13.4 20.3 24.2 44.6 36.9 15.5 14.3

Women age 18 and over whose source 

of ongoing care is doctor's office or 

health maintenance organization 83.3 84.3 72.0 69.5 50.1 57.2 81.1 83.0

Women age 18 and over whose source 

of ongoing care is hospital outpatient 

department 1.4 1.0 7.4 4.7 * * 2.5 1.3

Women age 18 and over who reported 

an office or outpatient visit in the past 

12 months 92.4 91.5 89.7 89.6 76.5 81.4 91.9 91.3

Women age 18 and over who reported 

an inpatient discharge in the past 

12 months 13.0 10.3 14.2 14.4 14.9 10.1 13.2 10.6

Women age 18 and over who tried to 

lose weight in the past 12 months 59.3 33.6 53.6 19.3 55.1 28.2 58.3 32.4

Women age 18 and over who tried to

lose weight by dieting in the past 

12 months 52.3 33.3 50.8 20.2 48.8 24.4 52.0 32.2

Women age 18 and over who tried to 

lose weight by exercising in the past 1

2 months 38.3 27.4 39.7 16.2 34.8 19.7 38.5 26.5

a Estimates are not adjusted. Denominator excluded all missing values.

b The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier. c Total = women at high risk plus women not at high risk for diabetes.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 90
Table 2a. Age-standardized percentage of women at high risk or not at high risk for diabetes who received

preventive care,a by race/ethnicity, United States, 2003-2006

Non-Hispanic white Non-Hispanic black Mexican American Total

At high Not at At high Not at At high Not at At high Not at

risk high risk risk high risk risk high risk risk high risk

Category Measures Percent Percent Percent Percent Percent Percent Percent Percent

Access to careb Women ages 18-64 with any type of

insurance during the year 87.4 83.7 78.3 78.0 48.3 61.0 85.6 83.1

Women ages 18-64 with any private 

insurance during the year 75.1 74.6 53.7 57.0 33.2 47.0 70.5 72.8

Women ages 18-64 with only public 

insurance during the year 12.2 8.9 24.3 20.5 14.9 14.0 14.9 10.1

Women ages 18-64 uninsured all year, 

2003-2004 data only 7.0 9.1 11.9 11.5 41.7 36.7 7.8 9.4

Women ages 18-64 with any period of 

public insurance during the year 19.5 12.9 27.1 21.9 17.0 16.1 21.3 13.9

Women ages 18-64 with any period of 

uninsurance during the year 19.7 20.1 29.8 29.3 59.7 47.6 21.7 20.9

General health Women age 18 and over who reported 

and well-being fair or poor health in the past year 13.2 10.2 25.6 23.8 35.9 27.1 15.3 11.1

Women age 18 and over with physical 

and mental health limitations 5.0 4.3 * * 3.3 * 4.4 4.1

Women age 18 and over who are current 

smokers 23.0 27.0 17.4 20.7 11.2 16.5 21.5 26.4

Women age 18 and over who had at 

least 12 alcohol drinks/1 yr 67.3 75.5 46.3 51.6 49.1 57.5 63.2 73.5

Women age 18 and over who have 

alcohol at least 1 day per year 68.2 77.4 50.0 51.5 52.0 54.3 65.0 75.4

Women age 18 and over who drink 

alcohol, mean number of alcoholic drinks 

per week in the past 12 months 2.2 3.4 2.5 * 1.3 * 2.3 3.5

Specific to Women age 18 and over whose provider 

cardiovascular measured their blood pressure within the 

disease past 2 years-2003-2004 data only 97.1 95.9 97.7 96.9 90.5 91.1 97.3 96.0

Women age 18 and over who had a lipid 

profile in the past 2 years 60.1 56.0 60.4 55.3 42.8 46.0 60.5 56.1

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 61.4 74.7 69.1 76.0 69.7 70.9 63.2 74.8

Women age 18 and over who exercise 

150 minutes/week 25.0 32.4 22.8 26.5 21.2 27.8 25.0 32.1

Obese women who were told that they 

were overweight 69.8 * 59.9 * 55.6 * 67.3 *

Obese women with high cholesterol who 

were given advice that they should 

exercise for cholesterol reduction 78.0 * 83.5 * 90.0 * 79.1 *

Obese women with high cholesterol who 

were given advice about eating fewer 

high-fat or high-cholesterol foods for 

cholesterol reduction 84.1 * 85.3 * 94.4 * 84.2 *

Women age 18 and over with activity 

limitation in the past year 1.7 1.8 1.8 1.8 1.8 1.8 1.7 1.8

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 91
Table 2a. Age-standardized percentage of women at high risk or not at high risk for diabetes who received

preventive care,a by race/ethnicity, United States, 2003-2006 (continued)

Non-Hispanic white Non-Hispanic black Mexican American Total

At high Not at At high Not at At high Not at At high Not at

risk high risk risk high risk risk high risk risk high risk

Category Measures Percent Percent Percent Percent Percent Percent Percent PercentNew measures Women age 18 and over who have ever 

been told by a doctor or other health 

professional that they had hypertension 31.5 17.5 40.5 24.9 25.1 20.0 32.9 18.0

Women age 18 and over who had a 

specific source of ongoing care 92.6 90.2 94.2 92.6 78.8 78.1 92.9 90.5

Women age 18 and over whose source 

of ongoing care is clinic or health center 15.0 13.5 20.5 22.5 43.3 32.8 15.9 14.4

Women age 18 and over whose source 

of ongoing care is doctor's office or 

health maintenance organization 82.4 84.2 71.9 71.9 51.5 60.9 80.4 83.0

Women age 18 and over whose source 

of ongoing care is hospital outpatient 

department 1.5 1.0 7.3 3.8 * * 2.7 1.3

Women age 18 and over who reported 

an office or outpatient visit in the 

past 12 months 91.9 91.5 90.1 88.7 79.0 83.5 91.7 91.4

Women age 18 and over who reported 

an inpatient discharge in the past 

12 months 13.5 10.3 14.7 14.6 14.2 10.1 13.6 10.7

Women age 18 and over who tried to 

lose weight in the past 12 months 60.1 33.8 52.6 18.6 51.6 27.3 58.6 32.5

Women age 18 and over who tried to 

lose weight by dieting in the past 

12 months 52.5 33.4 50.0 20.4 46.5 23.9 51.9 32.3

Women age 18 and over who tried 

to lose weight by exercising in the 

past 12 months 39.9 27.3 37.8 15.3 31.8 19.9 39.6 26.3

a Estimates are adjusted to the age distribution of the 2000 Census population. Denominator excluded all missing values.

b The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 92
Table 3. Percentage of women at high risk or not at high risk for diabetes who received preventive care,a by

education, United States, 2003-2006 (crude)

Category Measures Less than high school High school More than high school

At high risk Not at high risk At high risk Not at high risk At high risk Not at high risk

Percent Percent Percent Percent Percent Percent

Access to careb Women ages 18-64 with any type of 

insurance during the year 59.2 59.2 79.7 72.2 88.3 87.8

Women ages 18-64 with any private 

insurance during the year 37.3 32.6 62.5 61.1 77.0 80.3

Women ages 18-64 with only public

insurance during the year 21.8 26.1 17.2 10.6 11.2 7.2

Women ages 18-64 uninsured all year, 

2003-2004 data only 29.5 33.5 12.6 16.8 6.1 7.5

Women ages 18-64 with any period of 

public insurance during the year 24.3 27.3 22.3 15.4 18.8 11.4

Women ages 18-64 with any period of 

uninsurance during the year 47.4 46.7 29.0 32.4 18.3 16.9

General health Women age 18 and over who reported 

and well-being fair or poor health in the past year 34.9 28.7 17.1 16.9 10.9 6.4

Women age 18 and over with physical 

and mental health limitations * * * * 4.8 3.5

Women age 18 and over who are current 

smokers 23.3 35.3 25.2 36.7 15.2 18.2

Women age 18 and over who had at 

least 12 alcohol drinks/1 yr 49.9 55.5 57.7 64.3 66.4 75.7

Women age 18 and over who have 

alcohol at least 1 day per year 48.2 50.0 60.1 67.0 69.9 79.4

Women age 18 and over who drink 

alcohol, mean number of alcoholic 

drinks per week in the past 12 months 3.6 4.5 2.0 4.2 2.0 2.9

Specific to Women age 18 and over whose provider 

cardiovascular measured their blood pressure within 

disease the past 2 years-2003-2004 data only 94.1 94.4 93.6 92.7 98.0 97.1

Women age 18 and over who had a 

lipid profile in the past 2 years 52.2 55.0 59.1 54.0 65.5 53.6

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 67.8 71.9 59.8 71.9 63.0 78.8

Women age 18 and over who exercise 

150 minutes/week 25.0 25.5 26.6 28.4 25.9 34.0

Obese women who were told that they 

were overweight 58.9 * 60.9 * 74.0 *

Obese women with high cholesterol who

were given advice that they should 

exercise for cholesterol reduction 82.6 * 75.0 * 82.1 *

Obese women with high cholesterol 

who were given advice about eating 

fewer high-fat or high-cholesterol foods 

for cholesterol reduction 87.5 * 85.2 * 81.8 *

Women age 18 and over with activity 

limitation in the past year 1.7 1.6 1.7 1.7 1.8 1.8

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 93
Table 3. Percentage of women at high risk or not at high risk for diabetes who received preventive care,a by

education, United States, 2003-2006 (crude) (continued)

Category Measures Less than high school High school More than high school

At high risk Not at high risk At high risk Not at high risk At high risk Not at high risk

Percent Percent Percent Percent Percent Percent

New measures Women age 18 and over who have ever 

been told by a doctor or other health

professional that they had hypertension 35.7 22.8 34.6 22.4 31.2 13.4

Women age 18 and over who had a 

specific source of ongoing care 87.0 88.6 90.1 82.5 93.9 89.0

Women age 18 and over whose source 

of ongoing care is clinic or health center 32.1 28.4 16.8 18.7 14.9 13.1

Women age 18 and over whose source of 

ongoing care is doctor's office or health 

maintenance organization 62.9 67.6 77.4 78.0 83.1 84.1

Women age 18 and over whose source 

of ongoing care is hospital outpatient 

department 4.6 * 4.8 * 1.0 *

Women age 18 and over who reported 

an office or outpatient visit in the past 

12 months 86.4 85.2 92.0 88.2 91.6 90.7

Women age 18 and over who reported 

an inpatient discharge in the past 

12 months 14.8 14.8 13.6 13.2 11.9 7.8

Women age 18 and over who tried to lose 

weight in the past 12 months 45.5 15.8 56.3 29.2 64.4 36.5

Women age 18 and over who tried to 

lose weight by dieting in the past 

12 months 42.0 17.6 49.5 25.8 56.9 36.3

Women age 18 and over who tried to 

lose weight by exercising in the past 

12 months 24.7 10.1 35.4 20.8 45.3 30.9

a Estimates are not adjusted. Denominator excluded all missing values.

b The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 94
Table 3a. Age-standardized percentage of women at high risk or not at high risk for diabetes who received

preventive care,a by education, United States, 2003-2006

Category Measures Less than high school High school More than high school

At high risk Not at high risk At high risk Not at high risk At high risk Not at high risk

Percent Percent Percent Percent Percent Percent

Access to careb Women ages 18-64 with any type of 

insurance during the year 59.4 59.5 79.2 72.1 87.9 88.0

Women ages 18-64 with any private 

insurance during the year 37.7 35.4 61.7 61.0 76.3 80.6

Women ages 18-64 with only public 

insurance during the year 21.5 23.8 17.5 10.6 11.5 7.2

Women ages 18-64 uninsured all year, 

2003-2004 data only 29.0 32.8 12.9 16.8 6.5 7.5

Women ages 18-64 with any period of 

public insurance during the year 24.0 25.5 22.8 15.5 18.6 11.2

Women ages 18-64 with any period of 

uninsurance during the year 47.2 45.9 29.6 32.5 19.0 16.4

General health Women age 18 and over who reported 

and well-being fair or poor health in the past year 35.0 29.2 17.0 16.0 10.9 7.0

Women age 18 and over with physical and

mental health limitations * * * * 4.5 4.4

Women age 18 and over who are current 

smokers 25.2 38.1 27.3 38.7 14.9 17.5

Women age 18 and over who had at least 

12 alcohol drinks/1 yr 52.6 57.0 58.8 65.6 65.6 74.6

Women age 18 and over who have alcohol 

at least 1 day per year 51.4 51.7 61.2 68.6 69.3 77.7

Women age 18 and over who drink alcohol, 

mean number of alcoholic drinks per week 

in the past 12 months 3.5 * 2.0 4.1 2.0 3.0

Specific to Women age 18 and over whose provider 

cardiovascular measured their blood pressure within the 

disease past 2 years-2003-2004 data only 94.0 93.5 93.2 92.7 98.0 97.3

Women age 18 and over who had a lipid 

profile in the past 2 years 48.6 51.0 55.2 51.5 64.6 57.2

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 69.1 70.8 60.5 73.1 63.8 77.8

Women age 18 and over who exercise 

150 minutes/week 25.6 26.2 26.7 28.8 24.9 33.7

Obese women who were told that they 

were overweight 58.9 * 60.0 * 73.8 *

Obese women with high cholesterol who 

were given advice that they should exercise 

for cholesterol reduction 87.7 * 71.7 * 82.9 *

Obese women with high cholesterol who 

were given advice about eating fewer highfat or high-cholesterol foods for cholesterol 

reduction 91.0 * 84.3 * 83.8 *

Women age 18 and over with activity 

limitation in the past year 1.7 1.7 1.7 1.7 1.8 1.8

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 95
Table 3a. Age-standardized percentage of women at high risk or not at high risk for diabetes who received

preventive care,a by education, United States, 2003-2006 (continued)

Category Measures Less than high school High school More than high school

At high risk Not at high risk At high risk Not at high risk At high risk Not at high risk

Percent Percent Percent Percent Percent Percent

New measures Women age 18 and over who ever been 

told by a doctor or other health 

professional that they had hypertension 33.0 19.8 31.5 21.4 31.2 17.4

Women age 18 and over who had a 

specific source of ongoing care 86.1 87.9 89.1 82.0 93.8 89.8

Women age 18 and over whose source of 

ongoing care is clinic or health center 33.3 33.3 18.0 19.3 15.0 12.8

Women age 18 and over whose source of 

ongoing care is doctor's office or health

maintenance organization 61.5 62.8 76.0 77.3 82.9 84.4

Women age 18 and over whose source 

of ongoing care is hospital outpatient 

department 4.8 * 5.1 * 1.0 *

Women age 18 and over who reported 

an office or outpatient visit in the past 

12 months 85.7 83.2 91.6 87.8 91.9 91.4

Women age 18 and over who reported 

an inpatient discharge in the past 12 

months 14.8 14.6 13.8 13.1 12.6 8.5

Women age 18 and over who tried to 

lose weight in the past 12 months 46.9 17.7 57.5 30.1 63.0 35.5

Women age 18 and over who tried to 

lose weight by dieting in the past 

12 months 43.1 19.3 50.0 26.3 55.5 35.4

Women age 18 and over who tried 

to lose weight by exercising in the 

past 12 months 25.5 11.0 37.0 21.4 44.4 29.4

a Estimates are adjusted to the age distribution of the 2000 Census population. Denominator excluded all missing values.

b The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 96
Table 4. Percentage of women at high risk or not at high risk for diabetes who received preventive care,a by

family income,b United States, 2003-2006 (crude)

Negative/poor Near poor/low Middle income High income

At high Not at At high Not at At high Not at At high Not at

risk high risk risk high risk risk high risk risk high risk

Category Measures Percent Percent Percent Percent Percent Percent Percent Percent

Access to carec Women ages 18-64 with any type of 

insurance during the year 61.5 62.2 65.6 59.3 85.5 82.3 96.6 95.2

Women ages 18-64 with any private 

insurance during the year 23.9 28.9 43.9 44.7 77.0 74.5 90.6 91.8

Women ages 18-64 with only public 

insurance during the year 37.2 31.8 21.6 14.0 8.5 7.9 6.0 3.5

Women ages 18-64 uninsured all year, 

2003-2004 data only 23.9 28.3 25.6 29.6 8.4 ***

Women ages 18-64 with any period of 

public insurance during the year 39.8 33.7 25.0 16.9 14.6 12.1 15.3 8.4

Women ages 18-64 with any period of 

uninsurance during the year 48.9 46.3 43.6 46.3 21.4 22.8 8.3 7.6

General health Women age 18 and over who reported 

and well-being fair or poor health in the past year 32.1 22.1 25.9 18.8 14.7 11.7 6.6 5.0

Women age 18 and over with physical 

and mental health limitations * * *** 4.7 5.6 *

Women age 18 and over who are 

current smokers 35.6 37.5 17.8 31.9 18.9 27.0 13.7 15.6

Women age 18 and over who had at 

least 12 alcohol drinks/1 yr 55.3 59.4 48.8 61.5 63.7 68.2 70.1 81.5

Women age 18 and over who have 

alcohol at least 1 day per year 51.6 57.6 52.6 60.4 65.4 72.9 75.0 84.2

Women age 18 and over who drink 

alcohol, mean number of alcoholic 

drinks per week in the past 12 months 2.2 4.1 2.9 4.2 2.3 3.0 1.7 3.1

Specific to Women age 18 and over whose provider 

cardiovascular measured their blood pressure within 

disease the past 2 years-2003-2004 data only 91.7 88.7 92.7 93.3 97.8 95.5 99.3 100.0

Women age 18 and over who had a 

lipid profile in the past 2 years 42.0 36.4 56.8 48.2 62.5 55.9 71.8 60.2

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 68.9 75.7 68.5 74.9 59.6 77.3 60.9 74.4

Women age 18 and over who exercise 

150 minutes/week 27.5 44.6 24.5 26.6 26.4 28.8 25.2 30.9

Obese women who were told that they 

were overweight 58.8 * 62.3 * 66.8 * 77.1 *

Obese women with high cholesterol who 

were given advice that they should 

exercise for cholesterol reduction 82.5 * 80.8 * 74.3 * 85.8 *

Obese women with high cholesterol who 

were given advice about eating fewer 

high-fat or high-cholesterol foods for 

cholesterol reduction 92.6 * 87.1 * 73.2 * 88.7 *

Women age 18 and over with activity 

limitation in the past year 1.7 1.6 1.6 1.7 1.8 1.8 1.8 1.8

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 97
Table 4. Percentage of women at high risk or not at high risk for diabetes who received preventive care,a by

family income,b United States, 2003-2006 (crude) (continued)

Negative/poor Near poor/low Middle income High income

At high Not at At high Not at At high Not at At high Not at

risk high risk risk high risk risk high risk risk high risk

Category Measures Percent Percent Percent Percent Percent Percent Percent Percent

New measures Women age 18 and over who have ever

been told by a doctor or other health 

professional that they had hypertension 24.4 14.6 36.7 21.1 32.7 16.9 35.1 15.3

Women age 18 and over who had a 

specific source of ongoing care 85.3 82.5 89.3 79.7 92.6 89.2 95.1 93.3

Women age 18 and over whose source 

of ongoing care is clinic or health center 33.4 34.4 24.1 20.3 15.0 16.4 12.0 9.9

Women age 18 and over whose source 

of ongoing care is doctor's office or 

health maintenance organization 59.7 57.1 70.7 75.7 81.0 80.3 87.3 89.0

Women age 18 and over whose source 

of ongoing care is hospital outpatient 

department 5.8 * 4.1 2.6 2.8 * * *

Women age 18 and over who reported 

an office or outpatient visit in the past 

12 months 85.9 84.0 85.8 85.3 93.5 87.3 93.5 94.7

Women age 18 and over who reported 

an inpatient discharge in the past 

12 months 15.9 13.3 14.1 11.6 12.0 11.1 10.7 7.2

Women age 18 and over who tried 

to lose weight in the past 12 months 51.8 23.1 50.5 21.4 59.5 34.5 67.6 38.2

Women age 18 and over who tried to 

lose weight by dieting in the past 

12 months 45.5 25.6 46.3 23.2 53.9 33.8 57.8 36.2

Women age 18 and over who tried 

to lose weight by exercising in the 

past 12 months 31.7 19.0 31.4 15.1 39.1 26.7 47.4 32.6

a Estimates are not adjusted. Denominator excluded all missing values.

b Negative/poor refers to household incomes below the Federal poverty line; near poor/low, above the poverty line to just below 200 percent of the

poverty line; middle income, 200 percent to just below 400 percent of the poverty line; and high income, 400 percent of the poverty line and over.

c The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 98
Table 4a. Age-standardized percentage of women at high risk or not at high risk for diabetes who received

preventive care,a by family income,b United States, 2003-2006

Negative/poor Near poor/low Middle Income High income

At high Not at At high Not at At high Not at At high Not at

risk high risk risk high risk risk high risk risk high risk

Category Measures Percent Percent Percent Percent Percent Percent Percent Percent

Access to carec Women ages 18-64 with any type of 

insurance during the year 60.9 60.6 65.6 58.4 85.2 82.6 96.5 95.3

Women ages 18-64 with any private 

insurance during the year 24.9 25.5 43.9 44.3 76.4 74.7 90.9 91.8

Women ages 18-64 with only public 

insurance during the year 35.7 34.0 21.6 13.6 8.7 7.9 5.6 3.4

Women ages 18-64 uninsured all year, 

2003-2004 data only 23.3 35.2 25.5 32.2 8.6 ***

Women ages 18-64 with any period of 

public insurance during the year 38.3 36.5 25.0 16.2 14.8 12.1 14.5 8.5

Women ages 18-64 with any period of 

uninsurance during the year 48.7 48.8 43.6 46.7 22.0 22.0 8.4 7.8

General health Women age 18 and over who reported 

and well-being fair or poor health in the past year 34.9 24.6 25.6 18.7 14.2 12.8 6.8 5.8

Women age 18 and over with physical 

and mental health limitations * * * ** * 4.7 *

Women age 18 and over who are 

current smokers 34.4 35.9 19.3 33.9 19.8 27.3 13.5 14.7

Women age 18 and over who had at 

least 12 alcohol drinks/1 yr 54.0 60.4 51.0 62.7 65.3 67.6 69.6 80.7

Women age 18 and over who have 

alcohol at least 1 day per year 49.1 55.9 55.3 62.4 66.7 72.0 74.9 82.9

Women age 18 and over who drink 

alcohol, mean number of alcoholic 

drinks per week in the past 12 months 2.0 4.2 2.9 4.4 2.3 3.3 1.7 3.0

Specific to Women age 18 and over whose 

cardiovascular provider measured their blood 

disease pressure within the past 2 years2003-2004 data only 92.1 82.2 92.1 93.2 97.8 95.5 99.0 100.0

Women age 18 and over who had a 

lipid profile in the past 2 years 47.1 38.5 53.0 46.8 60.2 57.1 69.2 61.7

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 65.5 68.6 69.9 73.1 60.2 77.0 64.2 74.6

Women age 18 and over who exercise 

150 minutes/week 26.0 43.6 24.6 27.5 26.2 29.0 21.9 29.9

Obese women who were told that 

they were overweight 58.7 * 62.2 * 66.8 * 76.3 *

Obese women with high cholesterol 

who were given advice that they 

should exercise for cholesterol reduction 83.2 * 82.9 * 76.4 * 81.7 *

Obese women with high cholesterol 

who were given advice about eating 

fewer high-fat or high-cholesterol 

foods for cholesterol reduction 93.2 * 86.8 * 73.7 * 90.8 *

Women age 18 and over with activity

limitation in the past year 1.6 1.6 1.7 1.8 1.8 1.8 1.8 1.8

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 99
Table 4a. Age-standardized percentage of women at high risk or not at high risk for diabetes who received

preventive care,a by family income,b United States, 2003-2006 (continued)

Negative/poor Near poor/low Middle income High income

At high Not at At high Not at At high Not at At high Not at

risk high risk risk high risk risk high risk risk high risk

Category Measures Percent Percent Percent Percent Percent Percent Percent Percent

New measures Women age 18 and over who have 

ever been told by a doctor or other 

health professional that they had 

hypertension 30.2 19.8 32.9 20.1 29.8 17.6 32.6 18.4

Women age 18 and over who had a 

specific source of ongoing care 86.0 81.1 88.2 79.0 92.1 89.6 94.4 93.4

Women age 18 and over whose source 

of ongoing care is clinic or health center 32.9 32.3 25.2 21.3 15.3 16.9 12.2 9.8

Women age 18 and over whose source 

of ongoing care is doctor's office or 

health maintenance organization 61.0 56.8 69.0 74.3 80.9 80.1 87.0 89.2

Women age 18 and over whose source 

of ongoing care is hospital 

outpatient department 5.3 * 4.5 2.9 2.7 ***

Women age 18 and over who 

reported an office or outpatient visit 

in the past 12 months 86.2 82.0 84.5 85.1 93.4 87.3 93.7 95.1

Women age 18 and over who 

reported an inpatient discharge in 

the past 12 months 15.0 12.5 14.2 10.9 11.9 11.2 12.0 8.1

Women age 18 and over who 

tried to lose weight in the past 12 

months 50.3 24.0 52.5 21.7 60.4 34.2 65.0 37.0

Women age 18 and over who 

tried to lose weight by dieting in

the past 12 months 44.6 24.6 47.8 23.5 54.4 33.3 55.5 34.7

Women age 18 and over who 

tried to lose weight by exercising 

in the past 12 months 29.0 18.0 33.2 15.5 40.7 25.7 45.7 31.0

a Estimates are adjusted to the age distribution of the 2000 Census population. Denominator excluded all missing values.

b Negative/poor refers to household incomes below the Federal poverty line; near poor/low, above the poverty line to just below 200 percent of the

poverty line; middle income, 200 percent to just below 400 percent of the poverty line; and high income, 400 percent of the poverty line and over.

c The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed (such as described above). The questions are no longer entirely comparable to the questions provided in 2003-2004

and earlier.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 100
Table 5a. Age-standardized percentage of women at high risk for diabetes who received preventive care,a

by race/ethnicity, United States, 2003-2006

Category Measures Percent Z-score, vs. white

Non-Hispanic Non-Hispanic Mexican Mexican 

white black American Totalc Black American

Access to careb Women ages 18-64 with any type of insurance

during the year 87.4 78.3 48.3 85.6 -3.42 -11.89

Women ages 18-64 with any private insurance 

during the year 75.1 53.7 33.2 70.5 -7.72 -14.35

Women ages 18-64 with only public insurance 

during the year 12.2 24.3 14.9 14.9 5.32 1.08

Women ages 18-64 uninsured all year, 

2003-2004 data only 7.0 11.9 41.7 7.8 2.11 12.77

Women ages 18-64 with any period of public 

insurance during the year 19.5 27.1 17.0 21.3 2.82 -0.85

General health Women ages 18-64 with any period of 

and well-being uninsurance during the year 19.7 29.8 59.7 21.7 3.83 13.61

Women age 18 and over who reported fair or 

poor health in the past year 13.2 25.6 35.9 15.3 4.73 10.56

Women age 18 and over with physical and 

mental health limitations 5.0 * 3.3 4.4 * -1.64

Women age 18 and over who are current 

smokers 23.0 17.4 11.2 21.5 -2.17 -6.53

Women age 18 and over who had at least 

12 alcohol drinks/1 yr 67.3 46.3 49.1 63.2 -5.00 -5.00

Women age 18 and over who have alcohol 

at least 1 day per year 68.2 50.0 52.0 65.0 -5.51 -5.27

Specific to Women age 18 and over who drink alcohol, 

cardiovascular mean number of alcoholic drinks per week in 

disease the past 12 months 2.2 2.5 1.3 2.3 0.46 -3.18

Women age 18 and over whose provider 

measured their blood pressure within the past 

2 years-2003-2004 data only 97.1 97.7 90.5 97.3 0.52 -3.61

Women age 18 and over who had a lipid 

profile in the past 2 years 60.1 60.4 42.8 60.5 0.12 -5.86

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 61.4 69.1 69.7 63.2 2.03 2.78

Women age 18 and over who exercise 

150 minutes/week 25.0 22.8 21.2 25.0 -1.01 -1.50

Obese women who were told that they 

were overweight 69.8 59.9 55.6 67.3 -3.00 -3.97

Obese women with high cholesterol who 

were given advice that they should exercise 

for cholesterol reduction 78.0 83.5 90.0 79.1 0.88 2.20

Obese women with high cholesterol who were 

given advice about eating fewer high-fat or 

high-cholesterol foods for cholesterol reduction 84.1 85.3 94.4 84.2 0.28 2.09

Women age 18 and over with activity

limitation in the past year 1.7 1.8 1.8 1.7 0.76 3.02

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 101
Table 5a. Age-standardized percentage of women at high risk for diabetes who received preventive care,a

by race/ethnicity, United States, 2003-2006 (continued)

Category Measures Percent Z-score, vs. white

Non-Hispanic Non-Hispanic Mexican Mexican 

white black American Totalc Black American

New measures Women age 18 and over who ever been told 

by a doctor or other health professional that 

they had hypertension 31.5 40.5 25.1 32.9 3.56 -2.43

Women age 18 and over who had a specific 

source of ongoing care 92.6 94.2 78.8 92.9 1.39 -5.61

Women age 18 and over whose source of 

ongoing care is clinic or health center 15.0 20.5 43.3 15.9 1.64 8.47

Women age 18 and over whose source of 

ongoing care is doctor's office or health 

maintenance organization 82.4 71.9 51.5 80.4 -3.15 -9.96

Women age 18 and over whose source of 

ongoing care is hospital outpatient 

department 1.5 7.3 * 2.7 5.53 *

Women age 18 and over who reported an 

office or outpatient visit in the past 

12 months 91.9 90.1 79.0 91.7 -1.34 -5.91

Women age 18 and over who reported 

an inpatient discharge in the past 

12 months 13.5 14.7 14.2 13.6 0.70 0.35

Women age 18 and over who tried to lose 

weight in the past 12 months 60.1 52.6 51.6 58.6 -2.17 -2.91

Women age 18 and over who tried to lose 

weight by dieting in the past 12 months 52.5 50.0 46.5 51.9 -0.84 -2.06

Women age 18 and over who tried to lose 

weight by exercising in the past 12 months 39.9 37.8 31.8 39.6 -0.63 -2.45

a Estimates are adjusted to the age distribution of the 2000 Census population. Denominator excluded all missing values.

b The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

c Total = Women at high risk plus women not at high risk.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

The degree of freedom for denominator is 30. Z-scores are formatted to bold blue if the difference between estimates is significant at 0.05 level.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 102
Table 5b. Age-standardized percentage of women at high risk for diabetes who received preventive care,a

by education, United States, 2003-2006

Category Measures Percent Z-score, vs. college

Less than More than Less than 

high school High school high school high school High school

Access to careb Women ages 18-64 with any type of insurance 

during the year 59.4 79.2 87.9 -8.69 -3.18

Women ages 18-64 with any private insurance 

during the year 37.7 61.7 76.3 -10.17 -4.52

Women ages 18-64 with only public insurance 

during the year 21.5 17.5 11.5 3.79 3.27

Women ages 18-64 uninsured all year, 

2003-2004 data only 29.0 12.9 6.5 6.63 2.55

Women ages 18-64 with any period of public 

insurance during the year 24.0 22.8 18.6 1.84 1.56

General health Women ages 18-64 with any period of 

and well-being uninsurance during the year 47.2 29.6 19.0 8.20 3.49

Women age 18 and over who reported fair or 

poor health in the past year 35.0 17.0 10.9 8.81 2.87

Women age 18 and over with physical and 

mental health limitations * * 4.5 * *

Women age 18 and over who are current smokers 25.2 27.3 14.9 4.23 4.24

Women age 18 and over who had at least 12 

alcohol drinks/1 yr 52.6 58.8 65.6 -3.71 -1.56

Women age 18 and over who have alcohol at 

least 1 day per year 51.4 61.2 69.3 -4.85 -1.91

Specific to Women age 18 and over who drink alcohol, 

cardiovascular mean number of alcoholic drinks per week 

disease in the past 12 months 3.5 2.0 2.0 2.06 -0.02

Women age 18 and over whose provider 

measured their blood pressure within the past 

2 years-2003-2004 data only 94.0 93.2 98.0 -2.76 -2.64

Women age 18 and over who had a lipid 

profile in the past 2 years 48.6 55.2 64.6 -5.77 -3.10

Women age 18 and over whose LDL cholesterol 

was less than 130 mg/dL 69.1 60.5 63.8 1.23 -0.94

Women age 18 and over who exercise 150 

minutes/week 25.6 26.7 24.9 0.24 0.74

Obese women who were told that they 

were overweight 58.9 60.0 73.8 -4.07 -3.92

Obese women with high cholesterol who were 

given advice that they should exercise for 

cholesterol reduction 87.7 71.7 82.9 0.96 -1.51

Obese women with high cholesterol who 

`were given advice about eating fewer high-fat 

or high-cholesterol foods for cholesterol reduction 91.0 84.3 83.8 1.73 0.08

Women age 18 and over with activity limitation 

in the past year 1.7 1.7 1.8 -2.86 -1.51

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 103
Table 5b. Age-standardized percentage of women at high risk for diabetes who received preventive care,a

by education, United States, 2003-2006 (continued)

Category Measures Percent Z-score, vs. college

Less than More than Less than 

high school High school high school high school High school

New measures Women age 18 and over who ever been told by 

a doctor or other health professional that 

they had hypertension 33.0 31.5 31.2 0.74 0.11

Women age 18 and over who had a specific 

source of ongoing care 86.1 89.1 93.8 -4.43 -3.41

Women age 18 and over whose source of 

ongoing care is clinic or health center 33.3 18.0 15.0 4.94 1.02

Women age 18 and over whose source of 

ongoing care is doctor's office or health 

maintenance organization 61.5 76.0 82.9 -5.59 -2.31

Women age 18 and over whose source of 

ongoing care is hospital outpatient department 4.8 5.1 1.0 4.05 4.55

Women age 18 and over who reported an 

office or outpatient visit in the past 12 months 85.7 91.6 91.9 -3.52 -0.17

Women age 18 and over who reported an

inpatient discharge in the past 12 months 14.8 13.8 12.6 1.14 0.55

Women age 18 and over who tried to lose

weight in the past 12 months 46.9 57.5 63.0 -5.63 -2.46

Women age 18 and over who tried to lose 

weight by dieting in the past 12 months 43.1 50.0 55.5 -4.73 -2.58

Women age 18 and over who tried to lose 

weight by exercising in the past 12 months 25.5 37.0 44.4 -6.67 -2.65

a Estimates are adjusted to the age distribution of the 2000 Census population. Denominator excluded all missing values.

b The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

The degree of freedom for denominator is 30. Z-scores are formatted to bold blue if the difference between estimates is significant at 0.05 level.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 104
Table 5c. Age-standardized percentage of women at high risk for diabetes who received preventive care,a

by family income,b United States, 2003-2006

Category Measures Percent Z-score, vs. high income

Negative/ Near Middle High Negative/ Near Middle

poor poor/low income income poor poor/low income

Access to carec Women ages 18-64 with any type of insurance 

during the year 60.9 65.6 85.2 96.5 -9.31 -10.58 -5.53

Women ages 18-64 with any private insurance 

during the year 24.9 43.9 76.4 90.9 -20.43 -15.10 -5.74

Women ages 18-64 with only public insurance 

during the year 35.7 21.6 8.7 5.6 9.29 5.45 1.73

Women ages 18-64 uninsured all year, 

2003-2004 data only 23.3 25.5 8.6 * * * *

Women ages 18-64 with any period of public 

insurance during the year 38.3 25.0 14.8 14.5 6.12 2.90 0.09

General health Women ages 18-64 with any period of 

and well-being uninsurance during the year 48.7 43.6 22.0 8.4 8.94 12.42 5.27

Women age 18 and over who reported fair or 

poor health in the past year 34.9 25.6 14.2 6.8 11.61 7.19 3.72

Women age 18 and over with physical and 

mental health limitations * * * 4.7 * **

Women age 18 and over who are current smokers 34.4 19.3 19.8 13.5 6.00 2.01 2.22

Women age 18 and over who had at least 

12 alcohol drinks/1 yr 54.0 51.0 65.3 69.6 -3.65 -4.74 -1.17

Women age 18 and over who have alcohol 

at least 1 day per year 49.1 55.3 66.7 74.9 -6.01 -5.88 -2.52

Specific to Women age 18 and over who drink alcohol, 

cardiovascular mean number of alcoholic drinks per week in 

disease the past 12 months 2.0 2.9 2.3 1.7 0.74 1.75 2.15

Women age 18 and over whose provider 

measured their blood pressure within the past 

2 years-2003-2004 data only 92.1 92.1 97.8 99.0 -2.55 -3.65 -0.92

Women age 18 and over who had a lipid 

profile in the past 2 years 47.1 53.0 60.2 69.2 -6.03 -4.27 -2.35

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 65.5 69.9 60.2 64.2 0.25 1.16 -0.80

Women age 18 and over who exercise 

150 minutes/week 26.0 24.6 26.2 21.9 1.30 0.99 1.45

Obese women who were told that they were 

overweight 58.7 62.2 66.8 76.3 -3.84 -3.01 -2.12

Obese women with high cholesterol who were 

given advice that they should exercise for 

cholesterol reduction 83.2 82.9 76.4 81.7 0.14 0.15 -0.62

Obese women with high cholesterol who 

were given advice about eating fewer high-fat or

high-cholesterol foods for cholesterol reduction 93.2 86.8 73.7 90.8 0.49 -0.82 -3.30

Women age 18 and over with activity limitation 

in the past year 1.6 1.7 1.8 1.8 -8.28 -5.23 -1.86

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 105
Table 5c. Age-standardized percentage of women at high risk for diabetes who received preventive care,a

by family income,b United States, 2003-2006 (continued)

Category Measures Percent Z-score, vs. high income

Negative/ Near Middle High Negative/ Near Middle

poor poor/low income income poor poor/low income

New measures Women age 18 and over who ever been told 

by a doctor or other health professional that 

they had hypertension 30.2 32.9 29.8 32.6 -0.64 0.10 -0.83

Women age 18 and over who had a specific 

source of ongoing care 86.0 88.2 92.1 94.4 -3.57 -3.62 -1.42

Women age 18 and over whose source of 

ongoing care is clinic or health center 32.9 25.2 15.3 12.2 5.00 3.78 1.04

Women age 18 and over whose source of 

ongoing care is doctor's office or health 

maintenance organization 61.0 69.0 80.9 87.0 -6.00 -4.67 -2.19

Women age 18 and over whose source of 

ongoing care is hospital outpatient department 5.3 4.5 2.7 * * * *

Women age 18 and over who reported an 

office or outpatient visit in the past 12 months 86.2 84.5 93.4 93.7 -3.88 -5.12 -0.20

Women age 18 and over who reported 

an inpatient discharge in the past 12 months 15.0 14.2 11.9 12.0 1.27 1.00 -0.05

Women age 18 and over who tried to lose 

weight in the past 12 months 50.3 52.5 60.4 65.0 -4.18 -3.89 -1.50

Women age 18 and over who tried to 

lose weight by dieting in the past 12 months 44.6 47.8 54.4 55.5 -2.95 -2.35 -0.37

Women age 18 and over who tried to 

lose weight by exercising in the past 12 months 29.0 33.2 40.7 45.7 -4.67 -3.66 -1.51

a Estimates are adjusted to the age distribution of the 2000 Census population. Denominator excluded all missing values.

b Negative/poor refers to household incomes below the Federal poverty line; near poor/low, over the poverty line to just below 200 percent of the

poverty line; middle, 200 percent to just below 400 percent of the poverty line; and high, 400 percent of the poverty line and over.

c The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

The degree of freedom for denominator is 30. Z-scores are formatted to bold blue if the difference between estimates is significant at 0.05 level.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 106
Table 6a. Age-standardized percentage of women not at high risk for diabetes who received preventive

care,a by race/ethnicity, United States, 2003-2006

Category Measures Percent Z-score, vs. white

Non-Hispanic Non-Hispanic Mexican Mexican

white black American Totalc Black American

Access to careb Women ages 18-64 with any type of 

insurance during the year 83.7 78.0 61.0 83.1 -1.74 -6.56

Women ages 18-64 with any private 

insurance during the year 74.6 57.0 47.0 72.8 -4.61 -6.51

Women ages 18-64 with only public 

insurance during the year 8.9 20.5 14.0 10.1 3.56 1.56

Women ages 18-64 uninsured all year, 

2003-2004 data only 9.1 11.5 36.7 9.4 0.72 5.84

Women ages 18-64 with any period of

public insurance during the year 12.9 21.9 16.1 13.9 2.75 1.02

General health Women ages 18-64 with any period of 

and well-being uninsurance during the year 20.1 29.3 47.6 20.9 2.68 7.00

Women age 18 and over who reported 

fair or poor health in the past year 10.2 23.8 27.1 11.1 4.14 4.24

Women age 18 and over with physical 

and mental health limitations 4.3 * * 4.1 * *

Women age 18 and over who are 

current smokers 27.0 20.7 16.5 26.4 -2.03 -3.31

Women age 18 and over who had at

least 12 alcohol drinks/1 yr 75.5 51.6 57.5 73.5 -5.93 -3.76

Women age 18 and over who have 

alcohol at least 1 day per year 77.4 51.5 54.3 75.4 -5.99 -4.49

Specific to Women age 18 and over who drink 

cardiovascular alcohol, mean number of alcoholic 

disease drinks per week in the past 12 months 3.4 * * 3.5 * *

Women age 18 and over whose 

provider measured their blood pressure 

within the past 2 years-2003-2004 

data only 95.9 96.9 91.1 96.0 0.48 -1.80

Women age 18 and over who had a 

lipid profile in the past 2 years 56.0 55.3 46.0 56.1 -0.15 -2.70

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 74.7 76.0 70.9 74.8 0.23 -0.62

Women age 18 and over who 

exercise 150 minutes/week 32.4 26.5 27.8 32.1 -1.91 -1.35

Obese women who were told that 

they were overweight * * ** * *

Obese women with high cholesterol

who were given advice that they 

should exercise for cholesterol reduction * * ** * *

Obese women with high cholesterol 

who were given advice about eating 

fewer high-fat or high-cholesterol foods 

for cholesterol reduction * * ** * *

Women age 18 and over with activity 

limitation in the past year 1.8 1.8 1.8 1.8 0.60 1.89

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 107
Table 6a. Age-standardized percentage of women not at high risk for diabetes who received preventive

care,a by race/ethnicity, United States, 2003-2006 (continued)

Category Measures Percent Z-score, vs. white

Non-Hispanic Non-Hispanic Mexican Mexican

white black American Totalc Black American

New measures Women age 18 and over who ever been 

told by a doctor or other health 

professional that they had hypertension 17.5 24.9 20.0 18.0 2.21 0.65

Women age 18 and over who had a 

specific source of ongoing care 90.2 92.6 78.1 90.5 2.29 -8.64

Women age 18 and over whose source 

of ongoing care is clinic or health center 13.5 22.5 32.8 14.4 6.67 13.13

Women age 18 and over whose source 

of ongoing care is doctor's office or 

health maintenance organization 84.2 71.9 60.9 83.0 -3.05 -4.68

Women age 18 and over whose source 

of ongoing care is hospital outpatient 

department 1.0 3.8 * 1.3 2.87 *

Women age 18 and over who reported 

an office or outpatient visit in the past 

12 months 91.5 88.7 83.5 91.4 -0.95 -2.81

Women age 18 and over who reported an 

inpatient discharge in the past 12 months 10.3 14.6 10.1 10.7 1.73 -0.07

Women age 18 and over who tried to 

lose weight in the past 12 months 33.8 18.6 27.3 32.5 -4.47 -1.50

Women age 18 and over who tried to 

lose weight by dieting in the past 

12 months 33.4 20.4 23.9 32.3 -3.57 -2.40

Women age 18 and over who tried 

to lose weight by exercising in the 

past 12 months 27.3 15.3 19.9 26.3 -4.53 -1.71

a Estimates are adjusted to the age distribution of the 2000 Census population. Denominator excluded all missing values.

b The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

c Total = women at high risk plus women not at high risk for diabetes.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

The degree of freedom for denominator is 30. Z-scores are formatted to bold blue if the difference between estimates is significant at 0.05 level.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 108
Table 6b. Age-standardized percentage of women not at high risk for diabetes who received preventive

care,a by education, United States, 2003-2006

Category Measures Percent Z-score, vs. college

Less than More than Less than 

High school High school high school high school High school

Access to careb Women ages 18-64 with any type of insurance 

during the year 59.5 72.1 88.0 -6.29 -5.05

Women ages 18-64 with any private insurance 

during the year 35.4 61.0 80.6 -10.66 -5.15

Women ages 18-64 with only public insurance 

during the year 23.8 10.6 7.2 4.99 1.71

Women ages 18-64 uninsured all year, 

2003-2004 data only 32.8 16.8 7.5 3.89 2.63

Women ages 18-64 with any period of public 

insurance during the year 25.5 15.5 11.2 4.10 1.60

General health Women ages 18-64 with any period of 

and well-being uninsurance during the year 45.9 32.5 16.4 6.69 4.46

Women age 18 and over who reported fair 

or poor health in the past year 29.2 16.0 7.0 6.77 3.58

Women age 18 and over with physical and 

mental health limitations * * 4.4 * *

Women age 18 and over who are current 

smokers 38.1 38.7 17.5 5.75 5.67

Women age 18 and over who had at least 

12 alcohol drinks/1 yr 57.0 65.6 74.6 -4.39 -1.89

Women age 18 and over who have alcohol 

at least 1 day per year 51.7 68.6 77.7 -6.66 -2.01

Specific to Women age 18 and over who drink alcohol, 

cardiovascular mean number of alcoholic drinks per week in

disease the past 12 months * 4.1 3.0 * 1.73

Women age 18 and over whose provider 

measured their blood pressure within the past 

2 years-2003-2004 data only 93.5 92.7 97.3 -1.24 -2.12

Women age 18 and over who had a lipid 

profile in the past 2 years 51.0 51.5 57.2 -1.50 -1.68

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 70.8 73.1 77.8 -1.20 -0.95

Women age 18 and over who exercise 

150 minutes/week 26.2 28.8 33.7 -2.09 -1.41

Obese women who were told that they 

were overweight * * * * *

Obese women with high cholesterol who 

were given advice that they should exercise 

for cholesterol reduction ** * * *

Obese women with high cholesterol who 

were given advice about eating fewer 

high-fat or high-cholesterol foods for 

cholesterol reduction * * * * *

Women age 18 and over with activity 

limitation in the past year 1.7 1.7 1.8 * -1.09

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 109
Table 6b. Age-standardized percentage of women not at high risk for diabetes who received preventive

care,a by education, United States, 2003-2006

Category Measures Percent Z-score, vs. college

Less than More than Less than 

High school High school high school high school High school

New measures Women age 18 and over who ever been 

told by a doctor or other health professional 

that they had hypertension 19.8 21.4 17.4 0.86 1.66

Women age 18 and over who had a specific 

source of ongoing care 87.9 82.0 89.8 -0.79 -2.22

Women age 18 and over whose source of 

ongoing care is clinic or health center 33.3 19.3 12.8 5.99 1.85

Women age 18 and over whose source of 

ongoing care is doctor's office or health 

maintenance organization 62.8 77.3 84.4

Women age 18 and over whose source of 

ongoing care is hospital outpatient 

department * * *

Women age 18 and over who reported 

an office or outpatient visit in the past 

12 months 83.2 87.8 91.4 -2.25 -1.70

Women age 18 and over who reported 

an inpatient discharge in the past 

12 months 14.6 13.1 8.5 1.91 1.83

Women age 18 and over who tried to 

lose weight in the past 12 months 17.7 30.1 35.5 -5.05 -1.61

Women age 18 and over who tried to 

lose weight by dieting in the past 

12 months 19.3 26.3 35.4 -4.35 -2.61

Women age 18 and over who tried to 

lose weight by exercising in the past 

12 months 11.0 21.4 29.4 -6.70 -2.39

a Estimates are adjusted to the age distribution of the 2000 Census population. Denominator excluded all missing values.

b The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

The degree of freedom for denominator is 30. Z-scores are formatted to bold blue if the difference between estimates is significant at 0.05 level.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 110
Table 6c. Age-standardized percentage of women not at high risk for diabetes who received preventive

care,a by family income,b United States, 2003-2006

Category Measures Percent Z-score, vs. high income

Negative/ Near Middle High Negative/ Near Middle

poor poor/low income income poor poor/low income

Access to carec Women ages 18-64 with any type of 

insurance during the year 60.6 58.4 82.6 95.3 -6.74 -9.91 -3.65

Women ages 18-64 with any private 

insurance during the year 25.5 44.3 74.7 91.8 -14.58 -11.88 -4.89

Women ages 18-64 with only public 

insurance during the year 34.0 13.6 7.9 3.4 5.90 5.05 2.46

Women ages 18-64 uninsured all year, 

2003-2004 data only 35.2 32.2 * * * **

Women ages 18-64 with any period of 

public insurance during the year 36.5 16.2 12.1 8.5 5.36 3.01 1.62

General health Women ages 18-64 with any period of 

and well-being uninsurance during the year 48.8 46.7 22.0 7.8 8.17 8.92 4.20

Women age 18 and over who reported fair 

or poor health in the past year 24.6 18.7 12.8 5.8 5.90 4.53 2.41

Women age 18 and over with physical 

and mental health limitations * ** * * * *

Women age 18 and over who are current 

smokers 35.9 33.9 27.3 14.7 5.21 4.97 3.60

Women age 18 and over who had at least 

12 alcohol drinks/1 yr 60.4 62.7 67.6 80.7 -4.10 -4.77 -3.28

Women age 18 and over who have alcohol 

at least 1 day per year 55.9 62.4 72.0 82.9 -6.49 -5.37 -2.90

Specific to Women age 18 and over who drink alcohol, 

cardiovascular mean number of alcoholic drinks per week in 

disease the past 12 months 4.2 4.4 3.3 3.0 1.52 1.27 0.48

Women age 18 and over whose provider 

measured their blood pressure within the 

past 2 years-2003-2004 data only 82.2 93.2 95.5 100.0 -3.08 -4.64 -2.08

Women age 18 and over who had a lipid 

profile in the past 2 years 38.5 46.8 57.1 61.7 -4.79 -3.57 -1.15

Women age 18 and over whose LDL 

cholesterol was less than 130 mg/dL 68.6 73.1 77.0 74.6 -1.02 -0.31 0.46

Women age 18 and over who exercise 

150 minutes/week 43.6 27.5 29.0 29.9 2.54 -0.67 -0.26

Obese women who were told that they 

were overweight * ** * * * *

Obese women with high cholesterol who 

were given advice that they should exercise 

for cholesterol reduction * ** * * * *

Obese women with high cholesterol who 

were given advice about eating fewer high-fat 

or high-cholesterol foods for cholesterol 

reduction * ** * * * *

Women age 18 and over with activity 

limitation in the past year 1.6 1.8 1.8 1.8 -4.74 -1.95 -2.23

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 111
Table 6c. Age-standardized percentage of women not at high risk for diabetes who received preventive

care,a by family income,b United States, 2003-2006 (continued)

Category Measures Percent Z-score, vs. high income

Negative/ Near Middle High Negative/ Near Middle

poor poor/low Income Income poor poor/low Income

New measures Women age 18 and over who have ever 

been told by a doctor or other health 

professional that they had hypertension 19.8 20.1 17.6 18.4 0.41 0.48 -0.23

Women age 18 and over who had a specific 

source of ongoing care 81.1 79.0 89.6 93.4 -8.49 -10.07 -3.30

Women age 18 and over whose source of 

ongoing care is clinic or health center 32.3 21.3 16.9 9.8 13.08 7.57 5.04

Women age 18 and over whose source of 

ongoing care is doctor's office or health 

maintenance organization 56.8 74.3 80.1 89.2 -7.08 -4.21 -3.05

Women age 18 and over whose source of 

ongoing care is hospital outpatient department * 2.9 * * * **

Women age 18 and over who reported an

office or outpatient visit in the past 12 months 82.0 85.1 87.3 95.1 -4.13 -3.66 -3.51

Women age 18 and over who reported an 

inpatient discharge in the past 12 months 12.5 10.9 11.2 8.1 1.48 1.17 1.27

Women age 18 and over who tried to lose 

weight in the past 12 months 24.0 21.7 34.2 37.0 -2.30 -3.90 -0.68

Women age 18 and over who tried to lose 

weight by dieting in the past 12 months 24.6 23.5 33.3 34.7 -2.06 -2.56 -0.31

Women age 18 and over who tried to lose

weight by exercising in the past 12 months 18.0 15.5 25.7 31.0 -3.36 -4.33 -1.34

a Estimates are adjusted to the age distribution of the 2000 Census population. Denominator excluded all missing values.

b Negative/poor refers to household incomes below the Federal poverty line; near poor/low, over the poverty line to just below 200 percent of the

poverty line; middle income, 200 percent to just below 400 percent of the poverty line; and high income, 400 percent of the poverty line and over.

c The Health Insurance questionnaire was completely redesigned for 2005-2006. In addition, it used to be administered at the family level where one

reference person in the family responded for each individual survey participant (SP) in the family. Now SPs respond for themselves, except in 

situations where a proxy is needed. The questions are no longer entirely comparable to the questions provided in 2003-2004 and earlier.

* Data do not meet the criteria for statistical reliability, data quality, or confidentiality.

The degree of freedom for denominator is 30. Z-scores are formatted to bold blue if the difference between estimates is significant at 0.05 level.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

WOMEN AT RISK FOR DIABETES: QUALITY OF HEALTH CARE 112

AHRQ Publication No. 11-0002

January 2011

U.S. Department of 

Health and Human Services

Agency for Healthcare Research and Quality

540 Gaither Road

Rockville, MD 20850