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General Health and Well-Being

Women at High Risk for Diabetes: Access and Quality of Health Care, 20

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 non-Hispanic 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

Figure 1. General health and well-being in the past year among women age 18 years and over, by diabetes risk status, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes with various health issues. Fair/Poor Health, At risk, 15.6, not at risk, 10.8; Physical and Mental Health Limitation, at risk, 4.7, not at risk, 3.7; Activity Limitation, At Risk, 1.7, Not at Risk, 1.8.

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 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

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; Bar chart showing percentage of women at high risk and not at high risk for diabetes who were told they had hypertension or were overweight; Hypertension, at risk, 36, not at risk, 17.4; overweight, at risk, 68.1, not at risk, no data.

*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 age 18 years and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status, 2003-2006

Women age 18 and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes with LDL cholesterol below 130 mg/dL; at risk, 61.7, not at risk, 75.1.

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.

General health and well-being in the past year among women age 18 years and over, by diabetes risk status, 2003-2006

General health and well-being in the past year among women age 18 years and over, by diabetes risk status, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes who were current smokers or drinkers; current smokers, at risk, 20.3, not at risk, 26.5; 12 or more drinks per year, at risk, 62.1, not at risk, 73.6.

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.

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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

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; Bar chart showing percentage of women at high risk and not at high risk for diabetes in fair or poor health; Non-Hispanic White, at risk, 13.7, not at risk, 10.1; Non-Hispanic Black, at risk, 24.4, not at risk, 19.7; Mexican American, at risk, 30.5, not at risk, 24.6.

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.

Women age 18 years and over who reported fair or poor health in the past year, by diabetes risk status and education, 2003-2006

Women age 18 years and over who reported fair or poor health in the past year, by diabetes risk status and education, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes with fair or poor health; Less Than High School, at risk, 34.9, not at risk, 28.7; High School, at risk, 17.1, not at risk, 16.9; More Than High School, at risk, 10.9, not at risk, 6.4.

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.

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

General health and well-being in the past year among women aged 18 years and over, by diabetes risk status and family income, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes reporting fair or poor health; Poor, at risk, 32.1, not at risk,22.1, Near Poor, at risk, 25.9, not at risk,18.8, Middle Income, at risk, 14.7, not at risk, 11.7, High Income, at risk, 6.6, not at risk, 5.

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.

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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

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; Bar chart showing percentage of women at high risk and not at high risk for diabetes with hypertension; Non-Hispanic White, At Risk, 35.9, Not at Risk, 17.1; Non-Hispanic Black, At Risk, 36.6, Not at Risk, 20; Mexican-American, At Risk, 17.4, Not at Risk, 12.9.

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 Mexican- American 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 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

Figure 9. 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; Bar chart showing percentage of women at high risk and not at high risk for diabetes with hypertension; Less Than High School, At Risk, 35.7, Not at Risk, 22.8; High School, At Risk, 34.6, Not at Risk, 22.4; More Than High School, At Risk, 31.2, Not at Risk, 13.4.

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.

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

Figure 10. 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; Bar chart showing percentage of women at high risk and not at high risk for diabetes with hypertension; Poor, At Risk, 24.4, Not at Risk, 14.6; Near Poor, At Risk, 36.7, Not at Risk, 21.1; Middle Income, At Risk, 32.7, Not at Risk , 16.9; High Income, At Risk , 35.1, Not at Risk, 15.3.

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.

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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

Figure 11. Women at 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; Bar chart showing percentage of women at high risk for diabetes; Non-Hispanic White, 69.8, Non-Hispanic Black, 59.9, Mexican-American, 55.6; Less Than High School, 58.9, High School, 60, More Than High School, 73.8; Poor, 58.7, Near Poor, 62.2, Middle Income, 66.8, High Income, 76.3.

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.

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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

Figure 12. Women age 18 and over whose LDL-cholesterol was less than 130 mg/dL, by diabetes risk status and race/ethnicity, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes with LDL cholesterol below 130 mg/dL; Non-Hispanic White, At Risk, 59.7, Not at Risk, 74.8; Non-Hispanic Black, At Risk, 70.2, Not At Risk, 79; Mexican-American, At Risk, 70.7, Not at Risk, 76.5.

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 age 18 and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status and education, 2003-2006

Figure 13. Women age 18 and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status and education, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes with LDL cholesterol below 130 mg/dL; Less Than High School, At Risk, 67.8, Not at Risk, 71.9; High School, At Risk, 59.8, Not at Risk, 71.9; More Than High School, At Risk, 63, Not at Risk, 78.8.

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.

Women age 18 and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status and income, 2003-2006

Figure 14. Women age 18 and over whose LDL cholesterol was less than 130 mg/dL, by diabetes risk status and income, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes with LDL cholesterol below 130 mg/dL;Poor, At Risk, 68.9, Not at Risk 75.7; Near Poor, At Risk, 68.5, Not at Risk, 74.9; Middle Income, At Risk, 59.6, Not at Risk, 77.3; High Income, At Risk, 52, Not at Risk, 74.4.

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.

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Smoking

Women age 18 years and over who reported that they were current smokers, by diabetes risk status and race/ethnicity, 2003-2006

Figure 15. Women age 18 years and over who reported that they were current smokers, by diabetes risk status and race/ethnicity, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes who were smokers; Non-Hispanic White, At Risk, 20.9, Not at Risk, 27; Non-Hispanic Black, At Risk, 18.1, Not at Risk, 20.5; Mexican-American, At Risk, 11.5, Not at Risk, 13.5.

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.

Women age 18 years and over who reported that they were current smokers, by diabetes risk status and education, 2003-2006

Figure 16. Women age 18 years and over who reported that they were current smokers, by diabetes risk status and education, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes who were smokers; Less Than High School, At Risk, 23.3, Not at Risk, 35.3; High School, At Risk, 25.2, Not at Risk, 36.7; More Than High School, At Risk, 15.2, Not at Risk, 18.2.

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 age 18 years and over who reported that they were current smokers, by diabetes risk status and family income, 2003-2006

Figure 17. Women age 18 years and over who reported that they were current smokers, by diabetes risk status and family income, 2003-2006; Bar chart showing percentage of women at high risk and not at high risk for diabetes who were smokers; Poor, At Risk, 35.6, Not at Risk, 37.5; Near Poor, At Risk, 17.8, Not at Risk, 31.9; Middle Income, At Risk, 18.9, Not at Risk, 27; High Income, At Risk, 13.7, Not at Risk, 15.6.

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.

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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

Figure 18. 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; Bar chart showing percentage of women at high risk and not at high risk for diabetes who had 12 or more drinks; Non-Hispanic White, At Risk, 65.3, Not at Risk, 75.5; Non-Hispanic Black, At Risk, 46.9, Not at Risk, 50.1; Mexican-American, At Risk, 51.3, Not at Risk, 56.7.

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 age 18 years and over who had 12 or more alcoholic drinks in the past year, by diabetes risk status and education, 2003-2006

Figure 19. 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; Bar chart showing percentage of women at high risk and not at high risk for diabetes who had 12 or more drinks; Less Than High School, At Risk, 49.9, Not at Risk, 55.5; High School, At Risk, 57.7, Not at Risk, 64.3; More Than High School, At Risk, 66.4, Not at Risk, 75.7.

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.

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

Figure 20. 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; Bar chart showing percentage of women at high risk and not at high risk for diabetes who had 12 or more drinks; Poor, At Risk, 55.3, Not at Risk, 59.4; Near Poor, At Risk, 48.8, Not at Risk, 61.5; Middle Income, At Risk, 63.7, Not at Risk, 68.2; High Income, At Risk, 70.1, Not at Risk, 81.5.

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 near-poor 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.

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Page last reviewed January 2011
Internet Citation: General Health and Well-Being: Women at High Risk for Diabetes: Access and Quality of Health Care, 20. January 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/women-and-diabetes-2003-2006/wmhrdiab4.html