Health related outcomes among people with type 2 diabetes by country of birth: Result from the 45 and Up Study.

BACKGROUND: Ethnic variation in the occurrence of type 2 diabetes, complications, mortality, and health behaviours has been reported. The current research examined patterns of health-related outcomes by country of birth in people with diabetes aged 45years and over in New South Wales, Australia.

METHODS: This study was based on the baseline data of 266,848 participants aged 45years and over from "The Sax Institute's 45 and Up Study" (2006-2009), NSW; Australia's most populous state. Health-related factors including self-rated overall health, Quality of Life (QoL), eyesight, subjective memory complaint, hearing loss, psychological distress and functional limitation were examined according to country of birth among 23,112 people with type 2 diabetes. Logistic regression modelling was used to compare the odds of poor outcomes between Australian-born and overseas-born participants, adjusting for potential confounding and mediating variables. Both age-sex and fully adjusted odds ratios (aORs) are reported.

RESULTS: Nearly half of the people with diabetes in the sample reported hearing loss and high levels of functional limitations, a third reported poor overall health. Compared to people with diabetes born in Australia, people born in South East Europe, North Africa, the Middle East had significantly greater odds of poor outcomes across the majority of examined health-related factors, with the largest odds observed in the elevated level of psychological distress outcome (aOR=3.4 in North African and the Middle East group). Higher aORs of poor overall health, QoL, memory problems and poor eyesight, and lower aORs for hearing loss, were also found among those born in the Asian countries.

CONCLUSIONS: The results demonstrated significant ethnic disparity in the prevalence of health-related outcomes. These findings provide important context for the formulation of culturally sensitive secondary prevention strategies.