Lisa B. Signorello ^1*, David G. Schlundt ², Sarah S. Cohen ³, Mark D. Steinwandel ³, Maciej S. Buchowski ⁴, Joseph K. McLaughlin ⁵, Margaret K. Hargreaves ⁶, William J. Blot ⁵

¹ International Epidemiology Institute, Vanderbilt University, and the Vanderbilt-Ingram Cancer Center
² Vanderbilt University
³ International Epidemiology Institute
⁴ Vanderbilt University and Meharry Medical College
⁵ International Epidemiology Institute, Vanderbilt University, and Vanderbilt-Ingram Cancer Center
⁶ Meharry Medical College

^* To whom correspondence should be addressed. E-mail: lisa.signorello{at}intepi.org.

	Abstract

Objectives. We investigated whether racial disparities in the prevalence of type 2 diabetes exist beyond what may be attributable to differences in socioeconomic status (SES) and other modifiable risk factors.

Methods. We analyzed data from 34331 African American and 9491 White adults aged 40 to 79 years recruited into the ongoing Southern Community Cohort Study. Participants were enrolled at community health centers and had similar socioeconomic circumstances and risk factor profiles. We used logistic regression to estimate the association between race and prevalence of self-reported diabetes after taking into account age, SES, health insurance coverage, body mass index, physical activity, and hypertension.

Results. Multivariate analyses accounting for several diabetes risk factors did not provide strong support for higher diabetes prevalence rates among African Americans than among Whites (men: odds ratio [OR]=1.07; 95% confidence interval [CI]=0.95, 1.20); women: OR=1.13, 95% CI=1.04, 1.22).

Conclusions. Our findings suggest that major differences in diabetes prevalence between African Americans and Whites may simply reflect differences in established risk factors for the disease, such as SES, that typically vary according to race.

Key Words: Diabetes, Environment, Epidemiology, Genetics, African Americans/Blacks, Socioeconomic Factors