Educational Attainment and Preventive Eye and Foot Care Among U.S. Adults with Diabetes: An NHANES 2013–2018 Cross-Sectional Study Restricted; Files & ToC

Abstract

ABSTRACT

Educational Attainment and Preventive Eye and Foot Care Among U.S. Adults with Diabetes: An NHANES 2013–2018 Cross-Sectional Study

By El-Frida Adwoa Serwaa Pambo

Objectives:

This study estimates the prevalence of recommended preventive eye and foot care among U.S. adults aged ≥40 years with diagnosed diabetes and examines whether preventive-care utilization differs by educational attainment.

Methods:

A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2013–2018. The analytic sample included 1,966 adults aged ≥40 years with self-reported diabetes and complete exposure, outcome, and covariate information. Preventive-care adherence was defined as receipt of both a dilated eye examination within the past two years and a foot examination within the past 12 months. Educational attainment was categorized as less than high school, high school/GED, some college, or college graduate or higher. Survey-weighted logistic regression models were used to estimate unadjusted and adjusted associations while accounting for the complex sampling design.

Results:

The weighted mean age of participants was 62.6 years, and 53.4% were male. Overall, 64.3% of adults received both recommended preventive examinations. Preventive-care prevalence ranged from 53.3% among adults with less than a high school education to 73.3% among college graduates. After adjustment for age, sex, race/ethnicity, income, access to care, and insurance status, less than high school education remained associated with lower preventive-care utilization (adjusted OR = 0.53; 95% CI: 0.34–0.84).

Conclusions:

Educational attainment is associated with adherence to recommended preventive eye and foot care among U.S. adults with diabetes. Adults with less than a high school education are less likely to receive guideline-recommended examinations, indicating a persistent disparity in preventive-care utilization

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About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	Foot Care Diabetes Educational Attainment Education Eye care Eye and Foot care NHANES
Committee Chair / Thesis Advisor	Rodrigo M. Carrillo - Larco, Emory University

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