Diabetes and Emotional Distress Among African Americans and Latinos

Friday, 14 January 2005 - 2:00 PM

This presentation is part of: Psychosocial Impact of Medical Illness and Disability

Diabetes and Emotional Distress Among African Americans and Latinos

Michael Spencer, PhD, University of Michigan, Edith Kieffer, PhD, University of Michigan, Gloria Palmisano, MA, REACH Detroit Partnership, Brandy Sinco, MPH, University of Michigan, Nancy Shore, BA, University of Michigan, Ricardo Guzman, MSW, CHASS, Inc, and Michele Heisler, MD, University of Michigan Health Systems.

Purpose

African Americans and Latinos experience a 50-100% higher burden of illness and mortality due to type 2 diabetes than White Americans (Smedley, Stith, Nelson, & Institute of Medicine, 2002). Emotional distress is twice as common among patients with diabetes compared to other primary care patients, and is associated with poorer glycemic control, greater number of complications, reduced quality of life, and higher medical expenses (Lustman, Anderson, Freedland, et al., 2000). The purpose of this study is to examine the prevalence of emotional distress and its association with biomedical and social indicators among African Americans and Latinos with type 2 diabetes.

Method

This study is part of a larger community-based, participatory research project aimed at reducing health disparities and promoting healthy lifestyles among African American and Latino residents in the eastside and southwest Detroit communities. The study is funded by the Centers for Disease Control and Prevention (CDC) as part of the “Racial and Ethnic Approaches to Community Health 2010” (REACH) Initiative. The study uses data from our baseline questionnaire (n=171) and client medical records. Our measure of emotional distress is the Problem Areas in Diabetes Scale (PAID; Polonsky, Anderson, Lohrer, et al, 1995), a self-report questionnaire that consists of 20 statements measuring psychological distress in managing and dealing with diabetes and its complications.

Results

Over 17% of our sample scored one standard deviation above the mean (transformed) on the PAID, 27% reported a serious problem on at least one of the PAID items, and 50% reported that at least one problem was somewhat serious. PAID scores were over twice as high for Latinos than African Americans. Women scored 1.6 times higher than men, individuals without a high school degree scored 1.7 times higher than those with at least a high school degree, and younger clients (<55 years) scored 1.8 times higher than those over age 55. Our findings suggest that data suggest that emotional distress is significantly associated with higher levels of blood glucose (HbA1c), and less satisfaction and perceived support from health care providers.

Implications for Social Work Practice/Policy

Socially disadvantaged groups in the United States suffer a disproportionate burden of type 2 diabetes and its associated complications. Our data suggest that Latinos, women, lower SES, and younger respondents with diabetes are at higher risk for emotional distress and that psychological factors associated with diabetes may impede access to, delivery, and quality of clinical preventive services. Therefore, it is critical that social work address emotional distress among clients with diabetes and its associated barriers to utilization of services through educational and psychosocial interventions that are culturally appropriate and available in English and Spanish.

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