Reactions to Race[ism]: The Relationship Between Differential Treatment Based on Race and Diagnosed Diabetes Status in U.S. Adults

OBJECTIVE: To examine associations between diabetes status and self-reported discrimination based on race among U.S. adults with and without diabetes. RESEARCH DESIGN AND METHODS: We analyzed 2022-2023 Behavioral Risk Factor Surveillance System data from 328,056 adults completing the Reactions to Race module and reporting diabetes status. Experiences of racial discrimination at work, in health care, or elsewhere, and related physical symptoms, were categorized as any versus none. Weighted prevalence and multivariable logistic regression were stratified by diabetes status. RESULTS: Discrimination based on race was reported by 14.2% of adults with diabetes and 12.5% without diabetes. Patterns were similar across age, metropolitan status, and employment subgroups. In both groups, discrimination was associated with race and ethnicity, age, sex, employment, poor mental health, and current smoking. CONCLUSIONS: Experiences of racial discrimination were common among U.S. adults and were reported more frequently by adults with diabetes. Because discrimination can contribute to chronic stress, reduced access to high-quality care, and barriers to diabetes self-management, consideration of racism-related exposures is important in efforts to understand and address diabetes disparities.