208708 Negative self-image and diabetes in Appalachian Kentucky: Implications for local public health officials

Monday, November 9, 2009: 4:45 PM

Tania B. Basta, PhD, MPH , School of Public Health Services & Professions, Ohio University, Athens, OH
Lindsay J. Della, PhD , Dept of Communication, University of Louisville, Louisville, KY
Background: Rural Appalachia is characterized by higher-than-average diabetes rates. Extant qualitative research has identified social stigma as a corollary to diabetes diagnoses in Appalachian communities (Smith & Tessaro, 2005). Method: To quantify the level of social stigma in Appalachian Kentucky, we collected N = 168 quantitative intercept surveys at local shopping venues (e.g., Wal-Mart). Study participants were queried about their level of concern regarding different facets of social stigma that might accompany a diabetes diagnosis. Participants were Caucasian, 25 to 55 years old, and at-risk for diabetes. Nearly two-thirds (65%) were classified as being at moderate risk while more than one-third (35%) were considered at high risk for developing the disease. Additionally, 56% were female and 79% had a high school diploma. Results: Younger individuals (age 25-44) were significantly more likely to be concerned with negative self-image issues t(166) = 2.65, p = .009 than older individuals (age 45-55). For example, younger individuals felt that having diabetes would “make them feel like a bad person” more than the older individuals, t(166) = 2.55, p = 0.01 and that they would “not feel as good as others” if they had diabetes, t(166) = 2.97, p = .003. Implications: This finding highlights the importance of addressing self-image in diabetes prevention efforts with younger adults in Appalachian Kentucky. Local health officials may want to consider designing interventions that not only promote self-image enhancing behavior (e.g., healthy eating and physical activity), but also contemplate including intervention components that address participants' mental health.

Learning Objectives:
1)Identify the cultural factors that contribute to high prevalence of diabetes in Appalachia, 2)Describe the differences between older and younger individuals’ attitudes toward diabetes in Appalachia, and 3)Discuss methods for addressing negative self-image in the prevention of diabetes in Appalachia.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I hold a Masters of Public Health from Indiana University and a Ph.D. in Health Promotion and Behavior from the University of Georgia. I am collaborating on local Appalachian health initiatives in my community and have studied mental health issues in other stigmatized populations in the U.S.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.