Table 2.
Prevalence ratios of diagnosed hypertension for beneficiaries with diabetes living in different community types (versus Large Central Metro), Medicare 2005–2017
| Model 1 Urban-Rural Only |
Model 2 Model 1 + Covariates |
Model 3 Model 2 + SVI |
|||||
|---|---|---|---|---|---|---|---|
| PR (95% CI) | P | PR (95% CI) | P | PR (95% CI) | P | ||
| Northeast | |||||||
| Urban-Rural Classification | Large Fringe Metro |
0.993 (0.989–0.998) |
0.0025 |
1.013 (1.009–1.018) |
< 0.0001 |
1.025 (1.019–1.031) |
< 0.0001 |
| Medium Metro |
1.003 (0.998–1.009) |
0.2284 |
1.024 (1.019–1.030) |
< 0.0001 |
1.032 (1.026–1.039) |
< 0.0001 | |
| Small Metro |
0.977 (0.970–0.985) |
< 0.0001 |
1.001 (0.993–1.009) |
0.8168 |
1.011 (1.002–1.020) |
0.0162 | |
| Micropolitan |
0.970 (0.962–0.978) |
< 0.0001 |
0.996 (0.987–1.004) |
0.3054 |
1.006 (0.997–1.015) |
0.2286 | |
| Non-Core |
0.958 (0.948–0.969) |
< 0.0001 |
0.983 (0.973–0.994) |
0.0025 |
0.994 (0.983–1.006) |
0.3298 | |
| Overall* | < 0.0001 | < 0.0001 | < 0.0001 | ||||
| Midwest | |||||||
| Urban-Rural Classification | Large Fringe Metro |
0.979 (0.975–0.984) |
< 0.0001 |
1.003 (0.998–1.008) |
0.2440 |
1.035 (1.029–1.041) |
< 0.0001 |
| Medium Metro |
0.961 (0.956–0.967) |
< 0.0001 |
0.982 (0.977–0.986) |
< 0.0001 |
1.003 (0.997–1.009) |
0.3309 | |
| Small Metro |
0.955 (0.950–0.961) |
< 0.0001 |
0.980 (0.974–0.986) |
< 0.0001 |
0.999 (0.993–1.005) |
0.7430 | |
| Micropolitan |
0.955 (0.950–0.960) |
< 0.0001 |
0.983 (0.978–0.989) |
< 0.0001 |
1.002 (0.996–1.009) |
0.4415 | |
| Non-Core |
0.934 (0.928–0.929) |
< 0.0001 |
0.962 (0.956–0.968) |
< 0.0001 |
0.988 (0.981–0.995) |
0.0006 | |
| Overall* | < 0.0001 | < 0.0001 | < 0.0001 | ||||
| South | |||||||
| Urban-Rural Classification | Large Fringe Metro |
0.988 (0.984–0.991) |
< 0.0001 |
0.997 (0.994–1.001) |
0.1105 |
1.004 (1.000-1.008) |
0.0323 |
| Medium Metro |
0.992 (0.989–0.996) |
< 0.0001 |
1.002 (0.998–1.005) |
0.3412 |
1.003 (0.999–1.007) |
0.0762 | |
| Small Metro |
1.006 (1.001–1.010) |
0.0084 |
1.016 (1.012–1.020) |
< 0.0001 |
1.017 (1.013–1.021) |
< 0.0001 | |
| Micropolitan |
0.997 (0.993–1.001) |
0.1725 |
1.006 (1.002–1.010) |
0.0062 |
1.004 (0.999–1.008) |
0.0638 | |
| Non-Core |
0.993 (0.989–0.997) |
0.0012 |
1.002 (0.997–1.006) |
0.4881 |
1.001 (0.997–1.005) |
0.7109 | |
| Overall* | < 0.0001 | < 0.0001 | < 0.0001 | ||||
| West | |||||||
| Urban-Rural Classification | Large Fringe Metro |
0.971 (0.964–0.979) |
< 0.0001 |
0.986 (0.978–0.993) |
0.0002 |
1.005 (0.997–1.013) |
0.2355 |
| Medium Metro |
0.967 (0.962–0.973) |
< 0.0001 |
0.982 (0.976–0.988) |
< 0.0001 |
0.985 (0.979–0.990) |
< 0.0001 | |
| Small Metro |
0.962 (0.955–0.970) |
< 0.0001 |
0.984 (0.977–0.992) |
< 0.0001 |
0.985 (0.978–0.993) |
0.0001 | |
| Micropolitan |
0.934 (0.926–0.942) |
< 0.0001 |
0.958 (0.950–0.967) |
< 0.0001 |
0.963 (0.955–0.971) |
< 0.0001 | |
| Non-Core |
0.893 (0.882–0.904) |
< 0.0001 |
0.916 (0.904–0.927) |
< 0.0001 |
0.935 (0.923–0.946) |
< 0.0001 | |
| Overall* | < 0.0001 | < 0.0001 | < 0.0001 | ||||
PR = Prevalence Ratio, 95% CI = 95% Confidence Interval
*Overall P-value indicates the 5 df joint likelihood ratio test of any difference between the NCHS urban-rural classification groups
Note Model 1 = NCHS Urban-Rural Classification; Model 2 = Model 1 + age, sex, race, and Medicare-Medicaid dual eligibility; Model 3 = Model 2 + social vulnerability index (SVI)