Preferences, beliefs, and self-management of diabetes: Chronic illness and nursing homes

Objective. To assess relationships between self-assessed control over life events, subjective beliefs about longevity, time and risk preference, and other factors on use of recommended care for diabetes mellitus (DM), self-assessed control of diabetes, general health, and laboratory measures of HbA1c levels. Data Sources. Health and Retirement Study (HRS) and 2003 HRS Diabetes Study (HRS-DS). Study Design. We used logit and ordered logit analyses to assess use of recommended care, and subjective and objective measures of health outcomes. Data Collection. Secondary analysis of HRS and HRS-DS data. Principal Findings. Individuals with higher self-assessed control over life events and higher subjective probabilities of living 10 years engaged in more recommended DM care practices and had better self-assessed DM control and general health. However, these beliefs did not influence HbA1c levels. More highly educated and cognitively able persons were more likely to follow care recommendations. There were differences by race/ethnicity in health outcomes, but not in health investment among Hispanics. Conclusions. Individuals' beliefs about control over life events and longevity influenced health investment and subjective health outcomes, although these beliefs did not translate into differences in HbA1c levels. Hispanics may realize lower returns on health investments, at least for diabetes care.