The role of socioeconomic status in understanding ethnic differences among remerging adults with type 1 diabetes

Emerging adulthood is often characterized as a "high-risk period" for emerging adults (EAs) with T1D as they have higher HbA1c (a metric of glucose control across the last 3- 4 months) and poorer self-management compared to other age groups. Emerging adults may also experience disparities associated with ethnicity and SES that can create challenges in maintaining target HbA1c and self-management. The present study examines ethnic differences in HbA1c and self-management in EAs while controlling for a number of measures of socioeconomic status. Additionally, this study examines the disparities that exist in insurance. The data came from the READY longitudinal study of EAs with T1D recruited at two clinical sites in Utah and Texas. Two-hundred thirty-six individuals (M=17.79, 61% female, 73.9% non-Latino White) who lived with a parent and had no condition that would prohibit study completion were recruited in their final year of high school. The present sample includes individuals who completed baseline measures and for whom census data were available. HbA1c was gathered through home test kits and selfmanagement, measures of SES (neighborhood disorder, subjective social status, household income, and maternal education) and ethnicity were gathered from self-report. Hispanic individuals and those with lower SES had higher HbA1c, and there were no ethnic or SES differences in self-management. Ethnic differences in HbA1c were eliminated after accounting for SES. Higher neighborhood disorder (e.g., SES) was reported for those on public insurance. Ethnic differences in HbA1c can be explained by SES. Policy implications of the importance of SES for maintaining HbA1c near targets are made from a public health perspective. Socioeconomic Status and Ethnic Differences in Type 1 Diabetes Management