Socio-Economic Status and Hemoglobin A1c Levels
Socio-Economic Status and Hemoglobin A1c Levels
We found a small, inverse relationship between SES and Hgb A1c; this was not clinically significant. Lower SES was not an independent predictor of higher Hgb A1c in three out of four models, after adjusting for covariates associated with an increased risk of incident diabetes. This study does not support the inclusion of SES levels as an additional independent risk factor in clinical decision support tools informing diabetes screening with Hgb A1c in this primary care setting.
Postal codes were available in 99% of records we extracted from the EMRs. Given the limited extent and quality of SES data available in clinical records, an ecologic approach as used in this study appears to be a feasible method of examining deprivation in Canadian EMR databases. This could be used in future research on chronic disease management and prevention as well as for program planning that addresses local population needs in primary care settings.
Conclusions
We found a small, inverse relationship between SES and Hgb A1c; this was not clinically significant. Lower SES was not an independent predictor of higher Hgb A1c in three out of four models, after adjusting for covariates associated with an increased risk of incident diabetes. This study does not support the inclusion of SES levels as an additional independent risk factor in clinical decision support tools informing diabetes screening with Hgb A1c in this primary care setting.
Postal codes were available in 99% of records we extracted from the EMRs. Given the limited extent and quality of SES data available in clinical records, an ecologic approach as used in this study appears to be a feasible method of examining deprivation in Canadian EMR databases. This could be used in future research on chronic disease management and prevention as well as for program planning that addresses local population needs in primary care settings.