Diabetes disparities in Latino adults in US-Mexico border: Are social context-related stressors contributing?
Tuesday, November 5, 2013
Mexican-descent persons living at the border have high rates of diabetes. Health consequences are further exacerbated by SES and health care access disparities, and within Arizona, an intense socio-political environment associated with immigration enforcement. This work examines context-relevant stressors as well as a more general stress and mental health problems, in relating to diabetes. The participants are from proportional household samples of adult Latino farmworkers (Southwest Arizona; N=299) and of Latino adults (Southeast Arizona; N = 648). The data were part of community-based participatory research involving diverse partnerships of academics, promotoras and other community advocates, and other public health professionals requesting surveillance, programmatic and policy-related data. Response rates were over 85%, a testament to the community partnerships and strong community rapport. Except for social-ecologic stress (1st sample only; from the Border Community and Immigration Stress Scale) and glucose (2nd sample only), measures were derived from standard behavior/health surveillance instruments. In the farmworker sample 16% reported physician diabetes diagnosis, while in the other sample the rate was 21% (including 1% detected from the glucose test alone). These rates are about 2-3 times that for non-Hispanic whites in the US, and 25-50% higher than the national rates for Latino or Mexican American adults. Models tested in both samples showed among stress and mental health indicators, only the BCISS related to significantly excess (AOR=1.7) risk for diabetes. Efforts to reduce diabetes should consider a broad range of culturally and context-relevant stressors, and consider ways to intervene on the individual, group and policy level.
Chronic disease management and prevention
Diversity and culture
Public health or related public policy
Public health or related research
Social and behavioral sciences
Define disparities in diabetes within border residing Latinos.
Differentiate general stress and mental health indicators from those informed from social ecological contexts (e.g., discrimination and border environments).
Evaluate whether stress measures and paradigms may have utility in understanding and eliminating chronic disease disparities in Latinos.
Keyword(s): Latinos, Chronic Diseases
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I work for Arizona Prevention Research Center (a research sponsor) as a research associate and was directly involved in most phases of the statistical analysis. I am familiar with models of stress and social ecology as well as disparities in Latinos chronic disease that will be described.
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.