Effects of the COVID-19 Lockdown on HbA1c Levels of Ethnic Minorities and Low-income Groups with Type 2 Diabetes in Israel.

IF 3.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Galia Riklin, Michael Friger, Ilana Shoham-Vardi, Rachel Golan, Tamar Wainstock
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Abstract

Aims: To investigate the impact of low socioeconomic status (SES) and/or membership in ethnic minority has on HbA1c before and during the COVID-19 lockdown.

Methods: A retrospective cohort study was conducted between March 2019 and March 2021, based on data from electronic medical records of 17,072 patients with type-2 diabetes, collected by Clalit (Israel's largest health maintenance organization). Low SES was compared to high and ethnic minorities (Arabs and ultra-Orthodox Jews) were compared to the general Israeli population of mostly Jewish, but not ultra-Orthodox, Israeli citizens. Quantile regressions were used to examine the impact of SES and ethnic minority membership on HbA1c levels in the 0.10, 0.25, 0.50, 0.75, 0.90 quantiles before and during the lockdown.

Results: In the pre-lockdown period, patients with type-2 diabetes of low versus high SES, and Arabs versus the general population, had higher HbA1c. During the lockdown HbA1c levels of low versus high SES rose significantly in the 0.10 and 0.90 quantiles, and among Arabs HbA1c levels rose significantly across all quantiles, with a remarkable increment in the 0.90 quantile (from 0.316% in the pre-lockdown period to 0.730% in the lockdown period). Ultra-Orthodox Jewish diabetic patients had a marginally higher mean HbA1C level regardless of the period. Quantile regressions did not reveal a significant difference between the ultra-Orthodox Jewish and the general population.

Conclusion: The lockdown exacerbated disparities in glycemic control between low and high SES individuals and between Arab minority and the general population.

COVID-19封锁对以色列少数民族和低收入2型糖尿病患者HbA1c水平的影响
目的:调查低社会经济地位(SES)和/或少数民族成员在COVID-19封锁之前和期间对HbA1c的影响。方法:基于Clalit(以色列最大的健康维护组织)收集的17072例2型糖尿病患者的电子病历数据,于2019年3月至2021年3月进行了一项回顾性队列研究。社会经济地位低的人与社会经济地位高的人相比,少数民族(阿拉伯人和极端正统派犹太人)与以色列总人口(主要是犹太人,但不是极端正统派以色列公民)相比。分位数回归分析了经济地位和少数民族对封锁前和封锁期间0.10、0.25、0.50、0.75、0.90分位数的HbA1c水平的影响。结果:在封锁前,低SES与高SES、阿拉伯人与一般人群的2型糖尿病患者的HbA1c较高。在封锁期间,低SES与高SES的HbA1c水平在0.10和0.90分位数中显著上升,阿拉伯人的HbA1c水平在所有分位数中均显著上升,其中0.90分位数的HbA1c水平显著上升(从封锁前的0.316%上升到封锁期间的0.730%)。无论在哪个时期,极端正统派犹太糖尿病患者的平均HbA1C水平都略高。分位数回归并没有显示极端正统派犹太人和一般人群之间的显著差异。结论:封锁加剧了低SES和高SES个体以及阿拉伯少数民族和一般人群之间的血糖控制差异。
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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
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