Socio-economic status, ethnicity and diabetes management: an analysis of time trends using the health survey for England.

BACKGROUND The National Health Service (NHS) has invested substantially in recent years to reduce variations in health care for chronic conditions such as diabetes. We examined trends in the management of diabetes in England between socio-economic and ethnic groups from 1998 to 2004. METHODS Secondary analyses of Health Survey for England data comparing achievement of national treatment target for blood glucose, blood pressure and cholesterol and use of medications in survey respondents with diabetes. RESULTS The proportion of respondents with diabetes achieving national treatment targets increased significantly between 1998 and 2004. There was a significantly lower increase in blood pressure control in the black group [13.9% (95% confidence interval (CI) 13.0-14.8%)] but higher increase in south Asian and white Irish groups when compared to the white British group [15.7% (95% CI 15.4-16.0%)]. Manual workers experienced lower improvements in blood pressure control [15.3% (95% CI 14.9-15.7%) versus 16.7% (95% CI 16.2-17.2%)] but higher improvements in cholesterol control [10.3% (95% CI 9.7-10.9%) versus 7.4% (95% CI 6.8-8.0%)] when compared to non-manual workers. CONCLUSION There were considerable improvements in the management of diabetes in England during a period of sustained investment in health care quality but these were not distributed uniformly across ethnic and socio-economic groups.