249201 Relationship between marginalization, socioeconomic position, and diabetes risk in Latino children and adolescents

Wednesday, November 2, 2011

Rebecca Hasson, PhD , Family and Community Medicine, University of California San Francisco, San Francisco, CA
Swapna Mahurkar, PhD , Preventive Medicine, University of Southern California, Los Angeles, CA
Tanja Adam, PhD , Preventive Medicine, University of Southern California, Los Angeles, CA
Claudia Toledo-Corral, PhD , Preventive Medicine, University of Southern California, Los Angeles, CA
Ya-Wen Hsu , Preventive Medicine, University of Southern California, Alhambra, CA
Jaimie Davis, PhD , Preventive Medicine, University of Southern California, Los Angeles, CA
Donna Spruijt-Metz, PhD , Preventive Medicine, University of Southern California, Alhambra, CA
Michael Goran, PhD , Preventive Medicine, University of Southern California, Los Angeles, CA
Statement of Problem: The social environment, particularly acculturation and socioeconomic position (SEP) have been associated with increased type 2 diabetes risk in Latino adults; less information is available for Latino youth. The purpose of this study was to examine the relationships between acculturation and SEP with diabetes risk in Latino children and adolescents. Methods: A convenience sample of 113 obese Latino boys and girls aged 8-18 years living in the greater Los Angeles area were included in this analysis. Acculturation was assessed using the Acculturation, Habits, and Interests, Multicultural Scale for Adolescents (AHIMSA) questionnaire. Household SEP was calculated using the Hollingshead Two-Factor Index of Social Position. An intravenous glucose tolerance test (IVGTT) was used to calculate insulin sensitivity (SI), acute insulin response (AIR), and disposition index (DI). Diabetes risk was defined as lower SI and/or higher AIR and DI. Partial correlations assessed the relationship between AHIMSA orientation scales (i.e., Assimilation, Separation, Integration, Marginalization), SEP and IVGTT parameters, after controlling biological, behavioral and social-contextual factors known to influence diabetes risk. Results: SEP was positively associated with AIR (r=0.29, p<0.01) and DI (r=0.32, p<0.01), with no significant relationships between acculturation and IVGTT parameters. However, there was a positive association with Marginalization and SEP (r=0.25, p<0.05). Conclusions: Social-contextual factors appear to have unique and distinct roles for type 2 diabetes risk in Latino youth. Increased diabetes risk was associated with increased SEP (as represented by increased AIR and DI). This relationship however, may be mediated by the association between greater feelings of marginalization reported in Latino youth at higher SEP. Although these metabolic mechanisms may be able to maintain glucose homeostasis in the short term, increased AIR and DI may eventually lead to pancreatic beta-cell failure and type 2 diabetes later in life.

Learning Areas:
Basic medical science applied in public health
Chronic disease management and prevention
Diversity and culture
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Identify social-contextual factors that contribute to increased diabetes risk in obese Latino children and adolescents.

Keywords: Hispanic Youth, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee data collection, data analysis and interpretation of disease prevention programs.
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.

See more of: Roundtable Discussions: Understanding and Addressing Health Issues in the Latino Community
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