ABSTRACT
This chapter provides some mechanisms by which the inverse relationship between Lower socioeconomic status (SES) and health outcomes might be produced among persons with diabetes. Diabetes is a major cause of morbidity and mortality in the United States, and its prevalence is increasing dramatically. Diabetes incidence, complications, and mortality have all been shown to be related to SES. The clinics were selected to provide an optimal contrast of the socioeconomic diversity of persons with diabetes: "Park" Hospital serves a primarily white, upper- and middle-class population, whereas "County" Hospital has a largely minority, working-class, and underinsured clientele. Park has two endocrinologists and one nurse practitioner who see most patients, and all diabetes education occurs in a separate center housing several full-time educational staff. Diabetes education occurs through a certified diabetes educator who attends the clinic weekly on a volunteer basis.
