Diabetic people in low-income neighborhoods in California were up to 10 times more likely to lose a leg or a foot than diabetic patients in wealthier ZIP Codes, UCLA researchers have reported.
Their analysis, published online Monday by the journal Health Affairs, pinpointed amputation "hot spots" where as many as 10.7 out of 1,000 diabetic adults ages 45 and older wound up losing a lower limb because of complications of diabetes.
San Fernando, Compton and broad swaths of South and East L.A. had some of the highest amputation rates. In ZIP Codes with the lowest amputation rates -- including many affluent areas such as Malibu, Beverly Hills and Santa Clarita -- no more than 1.5 diabetics per 1,000 lost a limb to the disease.
On the Palos Verdes Peninsula, adjacent ZIP Codes landed on opposite ends of the scale, with South Bay cities having among the lowest levels of amputations among diabetics and San Pedro having among the highest.
"This represents an intolerable health disparity," said study lead author Carl Stevens, a professor of medicine at UCLA's David Geffen School of Medicine. "Where the poor people are is where the amputations are."
Stevens said that the higher incidence of amputations among diabetics in lower-income ZIP Codes was almost certainly related to two factors: difficulties patients in those neighborhoods had in getting access to primary care, and hurdles they faced in understanding how to manage their condition.
More ...
http://www.latimes.com/local/lanow/la-me-ln-diabetes-amputations-20140804-story.html?
