Table 2.

Logit Regression Coefficients for Glycemic Control (HbA1c < 8%) by Depression and Patient Location, Adjusted for Covariates at Patient, Practice, and Neighborhood Levels

	Without Depression-Rural Interactions in Model		With Depression-Rural Interactions in Model
	Coefficient	P Value	Coefficient	P Value
Depression*	−0.150	<.001	−0.162	<.001
Residential location^† (ref. group Urban)
Large rural town	0.018	.031	0.012	.289
Small rural town	−0.002	.734	−0.015	.139
Interactions terms (ref. group Depression* Urban area)
(Depression)* (Large rural town)			0.019	.135
(Depression)* (Small rural town)			0.051	<.001
Patient-level control variables
Annual trend	−0.036	<.001	−0.036	<.001
Patient age, years (ref. group aged 65 to 75)
18 to 44	−0.840	<.001	−0.840	<.001
45 to 54	−0.609	<.001	−0.609	<.001
55 to 64	−0.273	<.001	−0.273	<.001
Female	0.122	<.001	0.122	<.001
Ischemic vascular disease*	−0.210	<.001	−0.210	<.001
Type 1 diabetes	−0.844	<.001	−0.844	<.001
Insurance (ref. group Commercial)
Medicare	0.195	<.001	0.195	<.001
Medicaid	−0.224	<.001	−0.224	<.001
Dual Medicare/Medicaid	−0.181	<.001	−0.181	<.001
No insurance	−0.401	<.001	−0.401	<.001
Unknown	−0.018	.038	−0.018	.039
Practice-level control variables
Certified as a patient-centered medical home	0.049	<.001	0.049	<.001
Practice ownership^‡ (ref. group Large medical group)
Single-site medical group	−0.104	.006	−0.104	.006
Small medical group	−0.087	<.001	−0.087	<.001
Neighborhood-level (Patient ZIP Code) ACS control variables^§
Percent of population White, non-Hispanic	0.0027	<.001	0.0027	<.001
Percent of adults with high school degree only	−0.0039	<.001	−0.0039	<.001
Percent of adults with 4-year college degree	0.0008	.306	0.0008	.319
Percent of households under the federal poverty level	−0.0031	<.001	−0.0030	<.001
Intercept	1.680	<.001	1.684	<.001

ACS, American Community Survey.
↵* Depression and ischemic vascular disease were reported by the primary care practice to MN Community Measurement (MNCM). MNCM suggested the use of the Major Depression or Dysthymia (DEP-01) Value Set and Ischemic Vascular Disease Value Set, but stated that “Any documentation of a new or existing diagnosis of depression [IV.D] during the measurement period [for IV.D: or year prior] is accepted.”
↵† Rurality was determined by mapping patient ZIP code to Rural-Urban Commuting Areas, and summarizing to the WWAMI Rural Health Research Center’s Categorization B. (https://depts.washington.edu/uwruca/index.php).
↵‡ Small medical groups were defined as 2 to 11 primary care sites; large medical groups were defined as 12 or more primary care sites.
↵§ Coefficients represent the impact of a one percentage-point increase in the ACS-based statistic (e.g., 50% to 51%). Educational distribution was represented by percentage of adults with a high school degree but no 4-year college degree, and percentage with a 4-year college degree. We omitted the percentage without a high school degree to avoid collinearity in the estimation. A U-shaped impact of educational distribution in the patient’s neighborhood was evident, with neighborhoods more heavily weighted toward the high-school-only category showing poorer glycemic control.