Online Program

Racial and ethnic variation: The association between diabetes and depression

Sunday, November 3, 2013

Allana T. Forde, MPH, MPhil, PhD-C, Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Kimberly J. Alvarez, MPH, Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Lisa M. Bates, PhD, Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Background: Research indicates that diabetics are at increased risk for depression. Though this co-morbidity has been studied extensively, few studies have explored the variation in this association by race and ethnicity. Racial/ethnic differences may be evident due to subgroup differences in diabetes management and overall risk for depressive disorders.

Methods: This study examined the relationship between self-reported diabetes and lifetime major depressive disorder (MDD) by racial and ethnic status in a nationally representative sample of African Americans (AAs), Afro-Caribbean Blacks (CBs) and Non-Latino Whites (NLWs). 5,899 non-institutionalized adults from the 2001-2003 National Survey of American Life (NSAL) were analyzed. Logistic regression models examined the moderating role of race/ethnicity between diabetes and MDD among AAs, CBs, and NLWs, adjusting for known confounders.

Results: Overall, diabetics were more likely to experience MDD compared to non-diabetics (OR=3.92; CI =1.52, 10.15). Tests for interaction revealed variation by race (p-value<0.02). Diabetic Blacks (AAs and CBs) were 86% less likely (OR=0.14; CI=0.09, 0.24) to report MDD relative to diabetic NLWs. In the analysis of ethnicity, no ethnic differences were observed among diabetic AAs (OR=0.15; CI=0.09, 0.25) and CBs (OR=0.14; CI=0.05, 0.37) when compared to diabetic NLWs.

Conclusions: Findings from this study suggest that the association between diabetes and MDD varies by race, with Black diabetics reporting less MDD than NLW diabetics. This study emphasizes the importance of considering racial and ethnic diversity in understanding the association between diabetes and important sequelae, such as depression.

Learning Areas:

Diversity and culture
Public health or related research

Learning Objectives:
Assess whether the association between diabetes and depression varies by race and ethnicity.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author on the content because I have an MPH in Epidemiology with a focus on chronic diseases, including diabetes. Throughout my PhD program in Epidemiology, my focus on diabetes expanded to include diabetes complications and comorbidities, such as depression. I have also been a Teaching assistant for Chronic Disease Epidemiology, as well as Epidemiology II, which refers to examples from psychiatric epidemiology.
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.