Mortality Among Low-Income African Americans andWhitesWith Diabetes

OBJECTIVEdTo estimate mortality rates and risk factors for mortality in a low-socioeconomic status (SES) population of African Americans and whites with diabetes. RESEARCH DESIGN AND METHODS dWe determined mortality among African Americans and whites aged 40–79 years with (n = 12,498) and without (n = 49,914) diabetes at entry into a cohort of participants recruited from government-funded community health centers. Multivariable Cox analysis was used to estimate mortality hazard ratios (HRs) (95% CI) among those with versus those without diabetes and among those with diabetes according to patient characteristics. RESULTSdDuring follow-up (mean 5.9 years), 13.5 % of those with and 7.3 % of those with-out diabetes died. All-cause mortality risk was higher among those with versus without diabetes for both African Americans (HR 1.84 [95 % CI 1.71–1.99]) and whites (1.80 [1.58–2.04]), although among those with diabetes, mortality was lower among African Americans than whites (0.78 [0.69–0.87]). Mortality risk increased with duration of diabetes and was greater among patients on insulin therapy and reporting histories of cardiovascular disease (CVD), hyperten-sion, and stroke. The HRs associated with these multiple risk factors tended to be similar by se