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LeBrón AMW, Montiel GI, Arpero S, Jimenez J, Torres G, Ortiz H, Mejía N, Bracho A. Talents, Tears, Stories of Our Identities, and Community Building: Toward Community-Based Ecosystems of Latiné Health Driven by Promotores. Am J Public Health 2024; 114:S525-S533. [PMID: 39083749 PMCID: PMC11292289 DOI: 10.2105/ajph.2024.307763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 08/02/2024]
Abstract
This essay describes a process for integrating US Latiné communities as drivers of a grassroots vision for healthy Latiné communities and health equity planning that addresses racial injustices. Transforming structural conditions to promote Latiné community health happens alongside creating conditions for community-level self-determination to foster community-based ecosystems of health. Integrating a life course perspective, we describe a vision for community-based ecosystems of Latiné health that is rooted in forging connections and cultivating community; building community power to address structural drivers of health; leveraging the expertise and assets of promotores to reach, engage, and mobilize communities; scaling solutions through policy, system, and environment changes; and grounding research processes in community-driven priorities. Such processes must affirm the expertise of promotores and Latiné communities and recognize the interconnectedness of communities and systems (e.g., food, housing, living wages) to nurture health at local levels. Research can advance the science and evidence-based models that support community-based ecosystems of Latiné health. (Am J Public Health. 2024;114(S6):S525-S533. https://doi.org/10.2105/AJPH.2024.307763) [Formula: see text].
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Affiliation(s)
- Alana M W LeBrón
- Alana M. W. LeBrón is with the Department of Health, Society, and Behavior in the Program in Public Health and the Department of Chicano/Latino Studies in the School of Social Sciences, University of California, Irvine. Gloria I. Montiel is with AltaMed Health Services Corporation and Latino Health Access, Santa Ana, CA. S. Arpero, J. Jimenez, G. Torres, H. Ortiz, N. Mejía, and A. Bracho are with Latino Health Access
| | - Gloria Itzel Montiel
- Alana M. W. LeBrón is with the Department of Health, Society, and Behavior in the Program in Public Health and the Department of Chicano/Latino Studies in the School of Social Sciences, University of California, Irvine. Gloria I. Montiel is with AltaMed Health Services Corporation and Latino Health Access, Santa Ana, CA. S. Arpero, J. Jimenez, G. Torres, H. Ortiz, N. Mejía, and A. Bracho are with Latino Health Access
| | - Saraí Arpero
- Alana M. W. LeBrón is with the Department of Health, Society, and Behavior in the Program in Public Health and the Department of Chicano/Latino Studies in the School of Social Sciences, University of California, Irvine. Gloria I. Montiel is with AltaMed Health Services Corporation and Latino Health Access, Santa Ana, CA. S. Arpero, J. Jimenez, G. Torres, H. Ortiz, N. Mejía, and A. Bracho are with Latino Health Access
| | - Josefina Jimenez
- Alana M. W. LeBrón is with the Department of Health, Society, and Behavior in the Program in Public Health and the Department of Chicano/Latino Studies in the School of Social Sciences, University of California, Irvine. Gloria I. Montiel is with AltaMed Health Services Corporation and Latino Health Access, Santa Ana, CA. S. Arpero, J. Jimenez, G. Torres, H. Ortiz, N. Mejía, and A. Bracho are with Latino Health Access
| | - Gina Torres
- Alana M. W. LeBrón is with the Department of Health, Society, and Behavior in the Program in Public Health and the Department of Chicano/Latino Studies in the School of Social Sciences, University of California, Irvine. Gloria I. Montiel is with AltaMed Health Services Corporation and Latino Health Access, Santa Ana, CA. S. Arpero, J. Jimenez, G. Torres, H. Ortiz, N. Mejía, and A. Bracho are with Latino Health Access
| | - Hilda Ortiz
- Alana M. W. LeBrón is with the Department of Health, Society, and Behavior in the Program in Public Health and the Department of Chicano/Latino Studies in the School of Social Sciences, University of California, Irvine. Gloria I. Montiel is with AltaMed Health Services Corporation and Latino Health Access, Santa Ana, CA. S. Arpero, J. Jimenez, G. Torres, H. Ortiz, N. Mejía, and A. Bracho are with Latino Health Access
| | - Nancy Mejía
- Alana M. W. LeBrón is with the Department of Health, Society, and Behavior in the Program in Public Health and the Department of Chicano/Latino Studies in the School of Social Sciences, University of California, Irvine. Gloria I. Montiel is with AltaMed Health Services Corporation and Latino Health Access, Santa Ana, CA. S. Arpero, J. Jimenez, G. Torres, H. Ortiz, N. Mejía, and A. Bracho are with Latino Health Access
| | - America Bracho
- Alana M. W. LeBrón is with the Department of Health, Society, and Behavior in the Program in Public Health and the Department of Chicano/Latino Studies in the School of Social Sciences, University of California, Irvine. Gloria I. Montiel is with AltaMed Health Services Corporation and Latino Health Access, Santa Ana, CA. S. Arpero, J. Jimenez, G. Torres, H. Ortiz, N. Mejía, and A. Bracho are with Latino Health Access
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Eseadi C, Amedu AN, Ilechukwu LC, Ngwu MO, Ossai OV. Accessibility and utilization of healthcare services among diabetic patients: Is diabetes a poor man's ailment? World J Diabetes 2023; 14:1493-1501. [PMID: 37970126 PMCID: PMC10642413 DOI: 10.4239/wjd.v14.i10.1493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/03/2023] [Accepted: 09/06/2023] [Indexed: 10/09/2023] Open
Abstract
Diabetes is a non-communicable ailment that has adverse effects on the individual's overall well-being and productivity in society. The main objective of this study was to examine the empirical literature concerning the association between diabetes and poverty and the accessibility and utilization of medical care services among diabetic patients. The diabetes literature was explored using a literature review approach. This review revealed that diabetes is an ailment that affects all individuals irrespective of socioeconomic status; however, its pre-valence is high in low-income countries. Hence, despite the higher prevalence of diabetes in developing countries compared with developed countries, diabetes is not a poor man's ailment because it affects individuals of all incomes. While the number of diabetic patients that access and utilize diabetes medical care services has increased over the years, some personal and institutional factors still limit patients' access to the use of diabetes care. Also, there is a lacuna in the diabetes literature concerning the extent of utilization of available healthcare services by diabetic patients.
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Affiliation(s)
- Chiedu Eseadi
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | - Amos Nnaemeka Amedu
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | | | - Millicent O Ngwu
- Department of Sociology and Anthropology, University of Nigeria, Nsukka 41001, Enugu, Nigeria
| | - Osita Victor Ossai
- Department of Childhood Education, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
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Formagini T, Saint Onge JM, O’Brien MJ, Ramírez M, Brooks JV. The Experience of Spanish-Speaking Latinos in Maintaining Dietary and Physical Activity Changes after the National Diabetes Prevention Program. AMERICAN JOURNAL OF HEALTH EDUCATION 2023; 54:224-232. [PMID: 40083333 PMCID: PMC11905423 DOI: 10.1080/19325037.2023.2187487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/21/2022] [Indexed: 04/08/2023]
Abstract
Background The impact of the National Diabetes Prevention Program (N-DPP) for Latinos post-program participation is uncertain. Purpose We examine the experiences of Latinos who participated in the N-DPP in continuing the dietary and physical activity changes learned in the program. Methods This is a qualitative descriptive interview study. We recruited 19 Latino adults who participated in a culturally and linguistically adapted N-DPP. Thematic analysis was used to analyze the data and report emerging themes. Results Participants discussed how the program improved their knowledge about healthier lifestyles, and shared specific tools and strategies that they used to maintain learned program behaviors. Factors related to discontinuation of behaviors included missing the group social support, losing commitment over time, and avoiding family conflict. Maintenance of behaviors was mainly facilitated by family support. Discussion Our study suggests that Latinos who participated in the N-DPP gained useful knowledge on healthier behaviors and learning strategies for implementation into their lifestyle, but barriers remain. Translation to Health Education Practice Adaptations of the program for Latinos should consider the important roles of family and social support to improve N-DPP outcomes for this group and better support Latinos in preventing diabetes.
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Sheehan CM, Gotlieb EE, Ayers SL, Tong D, Oesterle S, Vega-López S, Wolfersteig W, Ruelas DM, Shaibi GQ. Neighborhood Conditions and Type 2 Diabetes Risk among Latino Adolescents with Obesity in Phoenix. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137920. [PMID: 35805578 PMCID: PMC9265310 DOI: 10.3390/ijerph19137920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/20/2022] [Accepted: 06/25/2022] [Indexed: 12/10/2022]
Abstract
Type 2 Diabetes (T2D) has reached epidemic levels among the pediatric population. Furthermore, disparities in T2D among youth are distributed in a manner that reflects the social inequality between population sub-groups. Here, we investigated the neighborhood determinants of T2D risk among a sample of Latino adolescents with obesity residing in Phoenix, Arizona (n = 133). In doing so we linked together four separate contextual data sources: the American Community Survey, the United States Department of Agriculture Food Access Research Atlas, the Arizona Healthy Community Map, and the National Neighborhood Data Archive to systematically analyze how and which neighborhood characteristics were associated with T2D risk factors as measured by fasting and 2-h glucose following a 75 g oral glucose tolerance test. Using linear regression models with and without individual/household covariates, we investigated how twenty-two housing and transportation sociodemographic and built and food environment characteristics were independently and jointly associated with T2D risk. The main finding from these analyses was the strong association between the density of fast food restaurants and 2-h glucose values (b = 2.42, p < 0.01). This association was independent of individual, household, and other neighborhood characteristics. Our results contribute to an increasingly robust literature demonstrating the deleterious influence of the neighborhood food environment, especially fast food, for T2D risk among Latino youth.
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Affiliation(s)
- Connor M. Sheehan
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ 85281, USA
- Correspondence: ; Tel.: +1-(480)-965-0354
| | - Esther E. Gotlieb
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ 85004, USA; (E.E.G.); (S.L.A.); (S.O.)
| | - Stephanie L. Ayers
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ 85004, USA; (E.E.G.); (S.L.A.); (S.O.)
| | - Daoqin Tong
- School of Geographical Sciences & Urban Planning, Arizona State University, Tempe, AZ 85281, USA;
| | - Sabrina Oesterle
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ 85004, USA; (E.E.G.); (S.L.A.); (S.O.)
| | - Sonia Vega-López
- College of Health Solutions and Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ 85004, USA;
| | - Wendy Wolfersteig
- School of Social Work, Arizona State University, Tempe, AZ 85281, USA;
| | - Dulce María Ruelas
- College of Nursing & Healthcare Professions, Grand Canyon University, Phoenix, AZ 85017, USA;
| | - Gabriel Q. Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA;
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Page-Reeves J, Regino L, Schleder T. Policy Implications of Structural Violence and Syndemic Dynamics: A Lens for Addressing Latinx Immigrant Diabetes Health Disparities. Curr Diab Rep 2022; 22:137-145. [PMID: 35212889 PMCID: PMC8874099 DOI: 10.1007/s11892-022-01450-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to explore using theoretical frameworks of structural violence and syndemics to understand Latinx health disparities with a focus on type 2 diabetes (T2D). We propose that combining these frameworks is a valuable approach for revealing complex root-cause dynamics and explaining the nuances of how and why health disparities exist. We discuss the importance of the relationship between T2D, fear, and stigma. RECENT FINDINGS Immigration policy creates structural conditions that invite unauthorized immigration while simultaneously excluding undocumented immigrants from access to healthcare resources. Structural exclusion then breeds fear of immigration status disclosure and deportation and, in the highly politicized immigration context that has emerged over the past two decades, also assigns social sigma to immigration status. Undocumented immigrants lack access to healthcare and health insurance; they cannot afford state-of-the-art drugs, they tend to be socially isolated and lack social capital to navigate systems; they are financially limited by poverty and lack of resources, emotionally taxed by the experience of discrimination, humiliation, and language-related challenges; and they have a toxic immigration stress load in the form of multidimensional fear. Potential areas for policy change are identified. Type 2 diabetes (T2D) follows racial, ethnic, and class fault lines that reflect unequal social and structural dynamics. Latinx immigrants are at disproportionate risk and explaining immigrant T2D social geography requires a holistic lens.
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Affiliation(s)
- Janet Page-Reeves
- Department of Family & Community Medicine and Office for Community Health, University of New Mexico, Albuquerque, NM USA
| | - Lidia Regino
- Office for Community Health, University of New Mexico, Albuquerque, NM USA
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Berggreen-Clausen A, Hseing Pha S, Mölsted Alvesson H, Andersson A, Daivadanam M. Food environment interactions after migration: a scoping review on low- and middle-income country immigrants in high-income countries. Public Health Nutr 2022; 25:136-158. [PMID: 34509180 PMCID: PMC8825972 DOI: 10.1017/s1368980021003943] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 08/19/2021] [Accepted: 09/06/2021] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To map and characterise the interactions between the food environment and immigrant populations from low- and middle-income countries living in high-income countries. DESIGN A scoping review was carried out following the framework outlined by Arksey and O’Malley, as well as Levac et al. Peer-reviewed studies in English published between 2007 and 2021 were included. Two reviewers screened and selected the papers according to predefined inclusion criteria and reporting of results follows the PRISMA-ScR guidelines. A ‘Best fit’ framework synthesis was carried out using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. SETTING High-income countries. PARTICIPANTS Immigrants from low- and middle-income countries. RESULTS A total of sixty-eight articles were included, primarily based in the USA, as well as Canada, Australia and Europe, with immigrants originating from five regions of the globe. The analysis identified three overarching themes that interconnected different aspects of the food environment in addition to the four themes of the ANGELO framework. They demonstrate that in valuing fresh, healthy and traditional foods, immigrants were compelled to surpass barriers in order to acquire these, though children’s demands, low incomes, time scarcity and mobility influenced the healthiness of the foods acquired. CONCLUSION This study brought together evidence on interactions between immigrant populations and the food environment. Immigrants attempted to access fresh, traditional, healthier food, though they faced structural and family-level barriers that impacted the healthiness of the food they acquired. Understanding the food environment and interactions therein is key to proposing interventions and policies that can potentially impact the most vulnerable.
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Affiliation(s)
- Aravinda Berggreen-Clausen
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Husargatan 3, Box 560, Uppsala75122, Sweden
| | - Sai Hseing Pha
- Department of Global Public Health, Karolinska Institutet, Solna, Stockholm, Sweden
| | | | - Agneta Andersson
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Husargatan 3, Box 560, Uppsala75122, Sweden
| | - Meena Daivadanam
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Husargatan 3, Box 560, Uppsala75122, Sweden
- Department of Global Public Health, Karolinska Institutet, Solna, Stockholm, Sweden
- International Child Health and Nutrition Research Group, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Haghravan S, Mohammadi-Nasrabadi F, Rafraf M, Asghari Jafarabadi M. Evaluation of the effects of the national diabetes control and prevention program on a sample of iranian people with type 2 diabetes. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2021. [DOI: 10.3233/mnm-211528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diabetes prevention programs have been developed in the different countries and it is therefore necessary to gain a better understanding of factors affecting the effectiveness of these programs for each society. Accordingly, the purpose of this study was to evaluate the effect of the National Diabetes Control and Prevention Program (NDCPP) on the biochemical and anthropometric indices among a sample of Iranian patients with type 2 diabetes mellitus (T2DM). A total of 384 patients with T2DM from the primary health care system of Tehran and Tabriz cities during January to June 2020, were included in the study. A two-part questionnaire consisting of items related to socio-economic and demographic characteristics was used and biochemical and anthropometric indices were measured at the beginning and the end of the 3-month intervention period. There was a significant difference in fasting blood sugar (FBS), hemoglobin glycosides (HbA1 C), systolic blood pressure (SBP) and weight before and after the NDCPP (P < 0.001). Also, there was significant improvement in carbohydrate (P = 0.015) and protein intake (P = 0.027) after the NDCPP compared to before the study. No significant difference was observed in waist circumference (WC) (P = 0.689), body mass index (P = 0.784), diastolic blood pressure (P = 0.647), and other dietary nutrient intake before and after the NDCPP. Repeated measure ANOVA revealed a significant decrease in FBS (Time effect P = 0.019) and weight (Time effect P = 0.006) after the NDCPP. Also, residing in different cities had a significant effect on FBS (time×city effect P < 0.001), HbA1 C (time×city effect P < 0.001), and SBP (time×city effect P = 0.037) after the NDCPP. The NDCPP resulted in weight loss, improved HbA1 C, and FBS. These findings suggested that NDCPP had a positive effect on controlling T2DM among Iranian population and can be considered as a way to prevent complications of T2DM.
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Affiliation(s)
- Simin Haghravan
- Students Research Committee, Tabriz University ofMedical Sciences, Tabriz, Iran
| | - Fatemeh Mohammadi-Nasrabadi
- PhD in Nutrition(Minor: Economics), Research Department of Food and Nutrition Policyand Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, ShahidBeheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rafraf
- Nutrition Research Center, Faculty of Nutritionand Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
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Twarog JP, Russo BN, Russo AT, Krichevsky AF, Peraj E, Sonneville KR. Self-perceived risk for diabetes among non-diabetic adolescents with overweight/obesity: Findings from NHANES. Prim Care Diabetes 2021; 15:156-161. [PMID: 33129750 DOI: 10.1016/j.pcd.2020.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 05/04/2020] [Accepted: 05/18/2020] [Indexed: 11/26/2022]
Abstract
AIMS The prevalence of Type 2 Diabetes Mellitus among adolescents in the United States continues to rise, following the trajectory of the obesity epidemic which posits not only a substantial health burden to our society, but also a significant threat to the wellbeing of America's youth. While a number of studies have explored the perception of the risk for developing diabetes in the adult population in the United States, this data is minimal for the adolescent population. In this study, we examined the self-perceived risk of diabetes among adolescents with overweight/obesity. METHODS Cross-sectional study of 808 non-diabetic U.S. adolescents overweight or obese, ages 12-19, who completed a physical exam and in-home interview during the 2011-2014 National Heath and Nutritional Examination Survey (NHANES). RESULTS Of adolescents with obesity, African Americans (aOR 0.27, 95% CI: 0.15, 0.51) and Hispanic Americans (aOR 0.50, 95% CI: 0.28, 0.90) were significantly less likely to perceive themselves as being at risk for developing diabetes/prediabetes compared to Non-Hispanic Whites. Additionally, individuals with overweight (aOR 13.1, 95% CI: 4.54, 37.5) and obesity (aOR 3.40, 95% CI: 1.71, 6.74) who had been informed by their physician that they were at risk for diabetes, were significantly more likely to perceive themselves to be at risk for diabetes. CONCLUSIONS Significant racial differences exist in the self-perceived risk for diabetes among U.S. adolescents with overweight and obesity. Further investigation focused on preventing the development of diabetes among at-risk adolescents who do not comprehend their risk, i.e. through more effective healthcare communication, is warranted.
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Affiliation(s)
- John P Twarog
- New York College of Podiatric Medicine, New York, NY, USA.
| | - Brittany N Russo
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Ashley T Russo
- New York College of Podiatric Medicine, New York, NY, USA
| | | | - Elizabet Peraj
- New York College of Podiatric Medicine, New York, NY, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Isaacs A, Burns N, Macdonald S, O’Donnell CA. ‘I don’t think there’s anything I can do which can keep me healthy’: how the UK immigration and asylum system shapes the health & wellbeing of refugees and asylum seekers in Scotland. CRITICAL PUBLIC HEALTH 2020. [DOI: 10.1080/09581596.2020.1853058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Anna Isaacs
- General Practice and Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Nicola Burns
- General Practice and Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Sara Macdonald
- General Practice and Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Catherine A. O’Donnell
- General Practice and Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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O'Donnell S. 'Your wealth is your health': the fundamental causes of inequalities in diabetes management outcomes: a qualitative analysis. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:1626-1641. [PMID: 33460137 DOI: 10.1111/1467-9566.13156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Fundamental Cause Theory (FCT) is among the most influential explanations for health inequalities. The theory posits that the social gradient in health persists because higher-socioeconomic status (SES) groups are systematically more able to take advantage of new medical innovations and health-enhancing knowledge due to their greater access to resources. Taking the life histories of people with diabetes (PwD) (N = 17) in the Republic of Ireland as a case study, this paper aims to elucidate the behaviours and agencies underlying 'fundamental causality' through examining how PwD of contrasting SES respond to disease management information. Findings highlight how the most common barriers to effective diabetes control were chronic psychological distress, combined with the cultural significance of alcohol consumption, which was central to both the social and economic subsistence of male participants in particular. However, higher-SES groups were more likely to experience a 'turnabout' in their life, whereby they could remove themselves from the conditions giving rise to their distress and move into a social space where more health-enhancing behaviours were possible. It concludes with a discussion of potential mechanisms that may explain why such turnabouts were more likely to occur in the case of higher-SES groups and the implications for FCT.
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Affiliation(s)
- Shane O'Donnell
- School of Sociology, University College Dublin, Dublin, Ireland
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Martinez-Cardoso A, Jang W, Baig AA. Moving Diabetes Upstream: the Social Determinants of Diabetes Management and Control Among Immigrants in the US. Curr Diab Rep 2020; 20:48. [PMID: 32857197 PMCID: PMC9328159 DOI: 10.1007/s11892-020-01332-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Relative to the US-born population, immigrants are less likely to successfully manage and control their diabetes, leading to a host of diabetes-related complications. This review draws on the social determinants of health framework (SDoH) to summarize the multilevel factors that shape diabetes care and management among immigrants in the USA. RECENT FINDINGS While the diabetes literature is replete with research on individual-level risk factors and health behaviors, empirical literature linking the SDoH to diabetes management among immigrants is limited. However, housing precarity, food insecurity, poverty, uninsurance and underinsurance, and limited support for immigrants in healthcare systems are consistently shown to deter diabetes management and care. Immigrants with diabetes face a multitude of structural constraints to managing their diabetes. More research that theorizes the role of SDoH in diabetes management along with empirical qualitative and quantitative studies are needed. Interventions to address diabetes also require a more upstream approach in order to mitigate the drivers of diabetes disparities among immigrants.
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Affiliation(s)
- Aresha Martinez-Cardoso
- Department of Public Health Sciences, University of Chicago, 5841 South Maryland Ave, MC 2000, Chicago, IL, 60637, USA.
| | - Woorin Jang
- The College, University of Chicago, Chicago, IL, USA
| | - Arshiya A Baig
- Department of Medicine, University of Chicago, Chicago, IL, USA
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Joachim-Célestin M, Gamboa-Maldonado T, Dos Santos H, Montgomery SB. A Qualitative Study on the Perspectives of Latinas Enrolled in a Diabetes Prevention Program: Is the Cost of Prevention Too High? J Prim Care Community Health 2020; 11:2150132720945423. [PMID: 32755275 PMCID: PMC7543125 DOI: 10.1177/2150132720945423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Latinas are among the groups most affected by diabetes health disparities, yet they often benefit less from diabetes interventions even when these are culturally adapted. The purpose of this qualitative study was to explore readiness of Latinas enrolled in a diabetes prevention program to adopt recommended preventive behaviors, and to identify factors associated with the adoption and maintenance of these recommended lifestyle changes. Insights gained will be used to inform future efforts at reducing diabetes disparities and the burden of chronic diseases among Latinas. Methods: Nine focus group discussions (FGDs) and 3 key informant interviews (KIIs) were conducted after the completion of a culturally adapted diabetes prevention program led by Latino community health workers. A grounded theory approach by Charmaz informed by the transtheoretical model guided the questions. Discussions and interviews were audio-taped with participants’ permission, transcribed, coded, and themed. Results: Forty low-income Latinas contributed to FGDs and KIIs. Baseline readiness to engage in new behaviors varied. Negative personal and family health events and physician referral impacted most readiness to enroll and to adopt preventive behaviors. Built environment, financial constraints, and threat of social alienation constituted major barriers to behavior adoption and maintenance, while physician involvement, awareness of diabetes complications, and social support partially mitigated these impediments. Conclusions: Our results suggest that timing of enrollment, physician-patient dynamics, and the emotional personal/family cost of behavior modification should all be considered when planning diabetes prevention programs for low-income Latinas. Besides appropriately timing referrals to accessible culturally informed prevention programs, health educators and health care providers should be aware of the potentially negative impact of behavior modification on family dynamics and be prepared to address resulting repercussions. Future research on Latinas should also include and report data on physician involvement, family context, and social determinants of health for more consistent program comparisons.
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de la Cruz JPS, Morales DLG, González-Castro TB, Tovilla-Zárate CA, Juárez-Rojop IE, López-Narváez L, Hernández-Díaz Y, Ble-Castillo JL, Pérez-Hernández N, Rodriguez-Perez JM. Quality of life of Latin-American individuals with type 2 diabetes mellitus: A systematic review. Prim Care Diabetes 2020; 14:317-334. [PMID: 31564515 DOI: 10.1016/j.pcd.2019.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 09/02/2019] [Accepted: 09/06/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Diabetes mellitus is a serious public health problem that causes a decrease in the patients' quality of life. The present study was aimed to analyze the quality of life of patients with diabetes mellitus in Latin-American population through a systematic review, using the two instruments of greater validity and reliability at international level, SF-36 and WHOQOL. METHODS We performed extensive searches in Redalyc, SciELO, PubMed, Scopus and Web of Science databases. To delimit our search, we only included countries that are members of the Latin American Association of Diabetes. We identified 2168 articles, where 35 were considered relevant for this systematic review. RESULTS Our results showed that patients that regularly receive guidance and treatment to control the diabetes, showed better quality of life; in contrast, patients with foot ulcers or comorbidities showed the worse quality of life. CONCLUSION The current literature analysis suggests that this disease greatly influences in the quality of life of the patients.
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Affiliation(s)
- Juan Pablo Sánchez de la Cruz
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico
| | - Diana Laura González Morales
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico
| | - Thelma Beatriz González-Castro
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico.
| | - Isela Esther Juárez-Rojop
- Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco, Mexico
| | | | - Yazmin Hernández-Díaz
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, Mexico
| | - Jorge Luis Ble-Castillo
- Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco, Mexico
| | - Nonancit Pérez-Hernández
- Department of Molecular Biology, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico
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Chaufan C, Saliba D. The global diabetes epidemic and the nonprofit state corporate complex: Equity implications of discourses, research agendas, and policy recommendations of diabetes nonprofit organizations. Soc Sci Med 2019; 223:77-88. [PMID: 30711782 DOI: 10.1016/j.socscimed.2019.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/03/2018] [Accepted: 01/09/2019] [Indexed: 11/17/2022]
Abstract
Important insights have been gained from studying how corporate social actors -- such as Big Tobacco or Big Food -- influence how global health issues are framed, debated, and addressed, and in so doing contribute to reproducing health inequities. Less attention has been paid to the role of nonprofit organizations (NPOs), even when all too often NPOs actively contribute to these inequities through normalizing discourses and practices that legitimize establishment views, poor public policies and existing relations of power. Our study attempts to fill this gap by assessing the influence on global health inequities of major NPOs -- specifically three disease associations -- whose mission includes preventing type 2 diabetes (henceforth diabetes) or reducing inequities in the global diabetes epidemic. No longer considered a "disease of prosperity", diabetes is known to affect the poor and racialized minorities disproportionately, in countries at all levels of income. While the contribution of the social and political determinants of health is well established, major NPOs ostensibly committed to eradicate, or at least moderate the effects of, diabetes give short shrift to these determinants, framing them at best as the context that promotes behaviours that combine with genetic predispositions to drive the inequitable, global distribution of diabetes. Drawing from Marxian theory and critical discourse analysis, we assess publicly available information - on educational and policy prescriptions, funding sources, corporate affiliations, funded research and social media presence -- pertaining to one Canadian, one US and one international NPO to identify discourses and practices that may contribute to the global, unequal distribution of diabetes and elaborate on their implications for health equity more broadly.
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Affiliation(s)
- Claudia Chaufan
- 4700 Keele Street, HNES Building, Room # 418, York University Toronto, M3J 1P3, Canada.
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15
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Engelman M, Ye LZ. The Immigrant Health Differential in the Context of Racial and Ethnic Disparities: The Case of Diabetes. ADVANCES IN MEDICAL SOCIOLOGY 2019; 19:147-171. [PMID: 31057317 PMCID: PMC6494443 DOI: 10.1108/s1057-629020190000019008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE Social and economic disparities between racial/ethnic groups are a feature of the American context into which immigrants are incorporated, and a key determinant of population health. We ask whether racial/ethnic disparities in diabetes vary by nativity and whether native-immigrant disparities in diabetes vary by race and over time in the United States. METHODS Using the 2000-2015 National Health Interview Survey, we estimate logistic regressions to examine the interaction of race/ethnicity, nativity, and duration in the U.S. in shaping diabetes patterns. RESULTS Relative to their native-born co-ethnics, foreign-born Asian adults experience a significant diabetes disadvantage, while foreign-born Hispanic, Black, and White adults experience a significant advantage. Adjusting for obesity, education, and other covariates eliminates the foreign-born advantage for Black and White adults, but it persists for Hispanic adults. The same adjustment accentuates the disadvantage for foreign-born Asian adults. For Black and Hispanic adults, the protective foreign-born effect erodes as duration in the U.S. increases. For foreign-born Asian adults, the immigrant disadvantage appears to grow with duration in the U.S. Relative to native-born White adults, all non-white groups regardless of nativity see a diabetes disadvantage because the racial/ethnic disadvantage either countervails a foreign-born advantage or amplifies a foreign-born disadvantage. DISCUSSION Racial/ethnic differentials in diabetes are considerable, and are influenced by each group's nativity composition. Obesity and (for the foreign-born) time in the U.S. influence these disparities, but do not explain them. These findings underscore the importance of unmeasured, systemic determinants of health in America's race-conscious society.
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Affiliation(s)
- Michal Engelman
- Department of Sociology, Center for Demography and Ecology, University of Wisconsin-Madison
| | - Leafia Zi Ye
- Department of Sociology, Center for Demography and Ecology, University of Wisconsin-Madison
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16
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Weaver RG, Beets MW, Brazendale K, Brusseau TA. Summer Weight Gain and Fitness Loss: Causes and Potential Solutions. Am J Lifestyle Med 2018; 13:116-128. [PMID: 30800015 DOI: 10.1177/1559827617750576] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/05/2017] [Accepted: 12/06/2017] [Indexed: 12/20/2022] Open
Abstract
Over the past 3 decades, public health professionals have worked to stem the rising childhood obesity epidemic. Despite the field's best efforts, no progress has been made in reducing child obesity. One reason for this failure may be that obesity prevention and treatment efforts have predominately been delivered during the 9-month school year. However, recent evidence suggests that the summer, not the school year, is when unhealthy changes in body composition (ie, accelerated increases in percent body fat) and fitness losses occur. This unhealthy change in body composition and fitness loss during the summer could be explained by the "Structured Days Hypothesis," which posits that children engage in a greater number of unhealthy obesogenic behaviors on unstructured days when compared with structured days. Furthermore, the summer may be contributing to a widening "health gap" between children from low-income and middle- to upper-income families. During summer, fewer opportunities exist for children from low-income households to access healthy structured programs that do not require fees for participation. Moving forward, public health professionals should prioritize efforts to mitigate unhealthy changes in body composition and fitness loss during the summer by identifying ways to provide access to structured programming during this timeframe for children from low-income households.
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Affiliation(s)
- R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (RGW, MWB, KB).,Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, Utah (TAB)
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (RGW, MWB, KB).,Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, Utah (TAB)
| | - Keith Brazendale
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (RGW, MWB, KB).,Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, Utah (TAB)
| | - Timothy A Brusseau
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (RGW, MWB, KB).,Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, Utah (TAB)
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Weaver LJ, Fasel CB. A Systematic Review of the Literature on the Relationships between Chronic Diseases and Food Insecurity. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/fns.2018.95040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Thomas A, Ashcraft AS, Owen DC, Conway-Phillips R. Making It All Work: Qualitative Descriptions of Hispanic Adults Managing Type 2 Diabetes With Limited Resources. Glob Qual Nurs Res 2017; 4:2333393617691860. [PMID: 28462356 PMCID: PMC5302170 DOI: 10.1177/2333393617691860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 01/23/2023] Open
Abstract
The greater prevalence of type 2 diabetes is a critical issue among the U.S. Hispanic population. This study examined the struggles of Hispanic adults managing type 2 diabetes with limited resources. Ten Hispanic adults (enrolled in a larger study to determine the effects of diabetes self-management intervention), 25 to 80 years of age and living in a rural West Texas county in the United States, were selected. Three categories of challenges emerged: (a) diabetes self-care behaviors and challenges, (b) challenges with limited resources, and (c) challenges with support mechanisms. "Making it all work" was the overarching theme that tied all the categories together. This study offers lessons for health care providers and policymakers on how to maximize the availability of resources for Hispanic individuals with type 2 diabetes living within the constraints of limited resources.
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Affiliation(s)
- Annie Thomas
- Loyola University Chicago, Chicago, Illinois, USA
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19
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Lee DC, Long JA, Sevick MA, Yi SS, Athens JK, Elbel B, Wall SP. The local geographic distribution of diabetic complications in New York City: Associated population characteristics and differences by type of complication. Diabetes Res Clin Pract 2016; 119:88-96. [PMID: 27497144 DOI: 10.1016/j.diabres.2016.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/26/2016] [Accepted: 07/15/2016] [Indexed: 01/13/2023]
Abstract
AIMS To identify population characteristics associated with local variation in the prevalence of diabetic complications and compare the geographic distribution of different types of complications in New York City. METHODS Using an all-payer database of emergency visits, we identified the proportion of unique adults with diabetes who also had cardiac, neurologic, renal and lower extremity complications. We performed multivariable regression to identify associations of demographic and socioeconomic factors, and diabetes-specific emergency department use with the prevalence of diabetic complications by Census tract. We also used geospatial analysis to compare local hotspots of diabetic complications. RESULTS We identified 4.6million unique New York City adults, of which 10.5% had diabetes. Adjusting for demographic and socioeconomic factors, diabetes-specific emergency department use was associated with severe microvascular renal and lower extremity complications (p-values<0.001), but not with severe macrovascular cardiac or neurologic complications (p-values of 0.39 and 0.29). Our hotspot analysis demonstrated significant geographic heterogeneity in the prevalence of diabetic complications depending on the type of complication. Notably, the geographic distribution of hotspots of myocardial infarction were inversely correlated with hotspots of end-stage renal disease and lower extremity amputations (coefficients: -0.28 and -0.28). CONCLUSIONS We found differences in the local geographic distribution of diabetic complications, which highlight the contrasting risk factors for developing macrovascular versus microvascular diabetic complications. Based on our analysis, we also found that high diabetes-specific emergency department use was correlated with poor diabetic outcomes. Emergency department utilization data can help identify the location of specific populations with poor glycemic control.
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Affiliation(s)
- David C Lee
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, 560 First Avenue, New York, NY 10016, United States; Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, United States.
| | - Judith A Long
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, United States; Center for Health Equity Research, Corporal Michael J. Crescenz Veterans Affairs Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104, United States
| | - Mary Ann Sevick
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, United States
| | - Stella S Yi
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, United States
| | - Jessica K Athens
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, United States
| | - Brian Elbel
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, United States; Wagner Graduate School of Public Service, New York University, 295 Lafayette Street, New York, NY 10012, United States
| | - Stephen P Wall
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, 560 First Avenue, New York, NY 10016, United States
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20
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Callander EJ, Schofield DJ. Type 2 diabetes mellitus and the risk of falling into poverty: an observational study. Diabetes Metab Res Rev 2016; 32:581-8. [PMID: 26663863 DOI: 10.1002/dmrr.2771] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 11/11/2015] [Accepted: 11/24/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Diabetes is known to be associated with low income; however, no longitudinal studies have documented whether developing type 2 diabetes mellitus (T2DM) is a risk factor for later falling into poverty. This paper aims to determine whether Australians who are diagnosed with type 2 diabetes have an elevated risk of falling into income poverty or multidimensional poverty. METHODS Data from a nationally representative, longitudinal survey conducted annually since 2001 are utilized. It identifies adults aged 21 years and over who were diagnosed with type 2 diabetes between 2007 and 2009 and compares their risk of falling into income poverty and multidimensional poverty between 2007 and 2012 relative to those who had never been diagnosed with type 2 diabetes using survival analysis with Cox regression models. RESULTS After adjusting for confounding factors, for men who were diagnosed with T2DM, the hazard ratio for falling into income poverty was 1.89 (95% CI: 1.03-3.44) and 2.52 (95% CI: 1.24-5.12) for falling into multidimensional poverty, relative men who had never been diagnosed with T2DM. There was no significant difference in the hazard ratio for falling into income poverty (p = 0.6554) or multidimensional poverty (p = 0.9382) for women who were diagnosed with T2DM compared with women who had never been diagnosed with T2DM. CONCLUSION Being diagnosed with type 2 diabetes increases the risk of men falling into poverty. The risk is higher for multidimensional poverty than income poverty. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Emily J Callander
- Faculty of Pharmacy, University of Sydney, Sydney, Australia
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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21
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Rodriguez PI, Dean J, Kirkpatrick S, Berbary L, Scott S. Exploring experiences of the food environment among immigrants living in the Region of Waterloo, Ontario. Canadian Journal of Public Health 2016; 107:5310. [PMID: 27281516 DOI: 10.17269/cjph.107.5310] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/02/2016] [Accepted: 03/06/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This exploratory study aimed to shed light on the role of the food environment in shaping food access among immigrants living in the Region of Waterloo, Ontario. METHODS In this qualitative case study, in-depth interviews aided by photovoice were conducted with nine immigrants, and key informant (KI) interviews were conducted with nine community stakeholders (e.g., settlement workers, planners) who held expert knowledge of the local context with respect to both the food system and experiences of immigrants in interacting with this system. In this paper, we focus specifically on insights related to the food environment, applying the Analysis Grid for Environments Linked to Obesity Framework to assess economic, physical, socio-cultural and political aspects. RESULTS Economic features of the food environment, including food prices and differential costs of different types of food, emerged as factors related to food access. However, interactions with the food environment were shaped by broader economic factors, such as limited employment opportunities and low income. Most immigrants felt that they had good geographic access to food, though KIs expressed concerns about the types of outlet and food that were most accessible. Immigrants discussed social networks and cultural food practices, whereas KIs discussed political issues related to supporting food security in the Region. CONCLUSION This exploratory case study is consistent with prior research in highlighting the economic constraints within which food access exists but suggests that there may be a need to further dissect food environments.
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Caspi CE, Lopez AM, Nanney MS. Geographic access to food shelves among racial/ethnic minorities and foreign-born residents in the Twin Cities. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016; 11:29-44. [PMID: 27066158 DOI: 10.1080/19320248.2015.1066735] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Place-based disparities in access to affordable food sources (e.g., supermarkets) have been well documented, but geographic access to emergency food sources (e.g., food panties, also known as food shelves) is unknown. This study examined the geography of emergency food in the Twin Cities, MN. U.S. Census and American Community Survey data were used to estimate the average distance to the closest food shelf according to area racial/ethnic composition and foreign-born group composition. In adjusted models, areas with the highest proportion of minority groups had shorter distances to the nearest food shelf (0.13-1.03 log-transformed miles, p <0.05), as did census tracts with more residents born in East Africa and Latin America (0.29-0.31 log-transformed miles, p< 0.001). Areas with more racial/ethnic minorities and foreign-born groups may have access to emergency food, but efforts are needed to evaluate the healthfulness and culturally relevance of these offerings.
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Affiliation(s)
- Caitlin Eicher Caspi
- University of Minnesota, Department of Family Medicine and Community Health, 717 Delaware Ave SE, Minneapolis, MN 55414; Minnesota Population Center, University of Minnesota, 50 Willey Hall, 225 - 19th Avenue South, Minneapolis, MN 55455
| | - Amy Maheswaran Lopez
- Greater Twin Cities United Way, 404 South Eighth Street, Minneapolis, MN 55404-1084
| | - Marilyn S Nanney
- University of Minnesota, Department of Family Medicine and Community Health, 717 Delaware Ave SE, Minneapolis, MN 55414; Minnesota Population Center, University of Minnesota, 50 Willey Hall, 225 - 19th Avenue South, Minneapolis, MN 55455
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23
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Grigsby-Toussaint DS, Jones A, Kubo J, Bradford N. Residential Segregation and Diabetes Risk among Latinos. Ethn Dis 2015; 25:451-8. [PMID: 26672728 DOI: 10.18865/ed.25.4.451] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To examine whether residence in ethnically segregated metropolitan areas is associated with increased diabetes risk for Latinos in the United States. METHODS Population data from the 2005 Behavioral Risk Factor Surveillance System and the 2005 American Community Survey were used to determine whether higher levels of Latino-White segregation across metropolitan statistical areas (MSAs) in the United States is associated with increased diabetes risk among Latinos (n=7462). RESULTS No significant relationship (P<.05) between levels of segregation and diabetes risk was observed. CONCLUSION The research literature examining the impact of residential segregation on health outcomes remains equivocal for Latinos.
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Affiliation(s)
- Diana S Grigsby-Toussaint
- 1. Department of Kinesiology and Community Health, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign
| | - Antwan Jones
- 2. Department of Sociology, George Washington University
| | - Jessica Kubo
- 3. Department of Statistics, Stanford University
| | - Natalie Bradford
- 1. Department of Kinesiology and Community Health, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign
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O'Donnell S. Changing social and scientific discourses on type 2 diabetes between 1800 and 1950: a socio-historical analysis. SOCIOLOGY OF HEALTH & ILLNESS 2015; 37:1102-1121. [PMID: 26094811 DOI: 10.1111/1467-9566.12292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Since the emergence of type 2 diabetes as a public health threat around the middle of the 20(th) century, accounts of disease causation have focused predominately on lifestyle or genetics, or both, while the role of broader structural issues such as psychosocial distress has been downplayed. Yet in the years prior to this emergence, when diabetes remained the preserve of the upper classes, medical experts drew upon multiple narratives when considering the condition, the most popular of which being the role of social organisation and the interplay between mind, body and environment. This article is based on a discourse analysis of the writings of the most prominent diabetes experts between 1800 and 1950 about both the causes and management of the illness. It highlights how, although the connection between lifestyle and diabetes was well established among physicians, individual-level explanations only fully supplanted the emphasis on social organisation as diabetes began to make the transition from being a disease of the rich to one of the poor. It argues that this discursive shift was shaped by the dynamics of class relations rather than any new forms of scientific evidence developed at the time.
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Spratt SE, Feinglos MN, Willis JM. Barriers to care for patients with diabetes in Durham, North Carolina, why are we withholding life-sustaining medications from the patients who need them the most? Expert Rev Endocrinol Metab 2015; 10:459-461. [PMID: 30298767 DOI: 10.1586/17446651.2015.1069704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The diabetes epidemic and its complications disproportionately affect minorities and the poor. Medical treatments that can prevent or delay diabetes complications are widely available but poverty underlies much of why there are disparities in diabetes care and outcomes. Lack of access to care, food insecurity and inability to pay for medications prevents adherence to a medication and lifestyle regimen that can be life-sustaining. At the very least, US policies should be changed to provide life-sustaining medications that prevent costly complications to patients who cannot afford them. Adopting value-based insurance design would benefit patients with diabetes who cannot afford to pay for medications but would also reduce healthcare costs in the long run.
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Affiliation(s)
- Susan E Spratt
- a 1 Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Durham, NC 27710, USA
| | - Mark N Feinglos
- a 1 Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Durham, NC 27710, USA
| | - Janese M Willis
- b 2 Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA
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Barnard LS, Wexler DJ, DeWalt D, Berkowitz SA. Material need support interventions for diabetes prevention and control: a systematic review. Curr Diab Rep 2015; 15:574. [PMID: 25620406 DOI: 10.1007/s11892-014-0574-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Unmet material needs, such as food insecurity and housing instability, are associated with increased risk of diabetes and worse outcomes among diabetes patients. Healthcare delivery organizations are increasingly held accountable for health outcomes that may be related to these "social determinants," which are outside the scope of traditional medical intervention. This review summarizes the current literature regarding interventions that provide material support for income, food, housing, and other basic needs. In addition, we propose a conceptual model of the relationship between unmet needs and diabetes outcomes and provide recommendations for future interventional research.
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Affiliation(s)
- Lily S Barnard
- Tufts University Biology and Community Health Programs, Medford, MA, USA
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Rossier C, Soura AB, Duthé G, Findley S. Non-Communicable Disease Mortality and Risk Factors in Formal and Informal Neighborhoods, Ouagadougou, Burkina Faso: Evidence from a Health and Demographic Surveillance System. PLoS One 2014; 9:e113780. [PMID: 25493649 PMCID: PMC4262303 DOI: 10.1371/journal.pone.0113780] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 10/30/2014] [Indexed: 11/26/2022] Open
Abstract
The expected growth in NCDs in cities is one of the most important health challenges of the coming decades in Sub-Saharan countries. This paper aims to fill the gap in our understanding of socio-economic differentials in NCD mortality and risk in low and middle income neighborhoods in urban Africa. We use data collected in the Ouagadougou Health and Demographic Surveillance System. 409 deaths were recorded between 2009–2011 among 20,836 individuals aged 35 years and older; verbal autopsies and the InterVA program were used to determine the probable cause of death. A random survey asked in 2011 1,039 adults aged 35 and over about tobacco use, heavy alcohol consumption, lack of physical activity and measured their weight, height, and blood pressure. These data reveal a high level of premature mortality due to NCDs in all neighborhoods: NCD mortality increases substantially by age 50. NCD mortality is greater in formal neighborhoods, while adult communicable disease mortality remains high, especially in informal neighborhoods. There is a high prevalence of risk factors for NCDs in the studied neighborhoods, with over one-fourth of the adults being overweight and over one-fourth having hypertension. Better-off residents are more prone to physical inactivity and excessive weight, while vulnerable populations such as widows/divorced individuals and migrants suffer more from higher blood pressure. Females have a significantly lower risk of being smokers or heavy drinkers, while they are more likely to be physically inactive or overweight, especially when married. Muslim individuals are less likely to be smokers or heavy drinkers, but have a higher blood pressure. Everything else being constant, individuals living in formal neighborhoods are more often overweight. The data presented make clear the pressing need to develop effective programs to reduce NCD risk across all types of neighborhoods in African cities, and suggest several entry points for community-based prevention programs.
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Affiliation(s)
- Clémentine Rossier
- Institute of Demographic and Life Course Studies, University of Geneva, Geneva, Switzerland
- Institut National d’Etudes Démographiques, Paris, France
- * E-mail:
| | - Abdramane Bassiahi Soura
- Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso
| | | | - Sally Findley
- Mailman School of Public Health, Columbia University, New York, New York, United States of America
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Pyatak EA, Sequeira PA, Whittemore R, Vigen CP, Peters AL, Weigensberg MJ. Challenges contributing to disrupted transition from paediatric to adult diabetes care in young adults with type 1 diabetes. Diabet Med 2014; 31:1615-24. [PMID: 24798586 PMCID: PMC4221576 DOI: 10.1111/dme.12485] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 01/13/2014] [Accepted: 04/28/2014] [Indexed: 12/25/2022]
Abstract
AIM To examine challenges contributing to disruptions in care during the transition from paediatric to adult care among young adults with Type 1 diabetes who are primarily in ethnic minority groups and have low socio-economic status. METHODS Participants (n = 20) were newly enrolled patients in a transition clinic for young adults with Type 1 diabetes with a history of loss to medical follow-up. Participants completed qualitative semi-structured interviews detailing their transition experiences in addition to demographic, HbA1c and psychosocial measures. Descriptive statistics were completed for quantitative data, and narrative thematic analysis of interviews was used to identify common themes. A mixed-method analysis was used to identify the associations between stressors identified in interviews and clinical and psychosocial variables. RESULTS Three categories of challenges contributing to loss to follow-up were identified: psychosocial challenges, health provider and health system challenges and developmental challenges. Participants experienced a high degree of stressful life circumstances which were associated with higher HbA1c (r = 0.60, P = 0.005), longer duration of loss to follow-up (r = 0.51, P = 0.02), greater emergency department utilization (r = 0.45, P = 0.05), and lower life satisfaction (r = -0.62, P = 0.003). CONCLUSIONS A confluence of challenges, including stressful life circumstances, healthcare system barriers and the developmental trajectory of young adulthood, contributes to a high risk of loss to follow-up and poor health in this population of young adults with Type 1 diabetes. An integrated approach to transition addressing medical and psychosocial needs may facilitate improved follow-up and health outcomes in clinical settings.
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Affiliation(s)
- E A Pyatak
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
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Clark ML, Utz SW. Social determinants of type 2 diabetes and health in the United States. World J Diabetes 2014; 5:296-304. [PMID: 24936251 PMCID: PMC4058734 DOI: 10.4239/wjd.v5.i3.296] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 04/19/2014] [Accepted: 05/14/2014] [Indexed: 02/05/2023] Open
Abstract
Diabetes is the sixth leading cause of death in the United States. To date, most research and resulting clinical strategies have focused on the individual with short-term health improvements that have not been maintained over time. Researchers more recently have recognized the need to consider the social determinants of diabetes and health along with individual factors. The purpose of this literature review is to examine current understanding of the social determinants affecting diabetes and health. A search of medical and nursing literature was conducted using PubMed, PsychInfo, CINAHL and MEDLINE databases, selecting articles published between 2000 and 2013. Search terms included: type 2 diabetes, social determinants, and health determinants. Inclusion criteria were: English language, human studies, social determinants of diabetes and health, and research in the United States. Additional search methods included reference chaining of the literature. Twenty research articles met the inclusion criteria for the review and analysis and included quantitative and qualitative methods. All studies selected for this review were descriptive in nature (n = 20). Fifteen studies were quantitative studies and five were qualitative studies. No intervention studies met inclusion criteria. Each study is summarized and critiqued. Study findings indicate that external or upstream factors consistently affect individuals diagnosed with diabetes, influencing self-management. Significant methodological limitations result directly from small sample sizes, convenience or nonprobability sampling, and low statistical power.
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Health and Diabetes Self-efficacy: A Study of Diabetic and Non-diabetic Free Clinic Patients and Family Members. J Community Health 2014; 39:783-91. [DOI: 10.1007/s10900-014-9831-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chaufan C, Constantino S, Davis M. 'You must not confuse poverty with laziness': a case study on the power of discourse to reproduce diabetes inequalities. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2013; 43:143-66. [PMID: 23527459 DOI: 10.2190/hs.43.1.j] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The disproportionate impact of type 2 diabetes (T2DM) on low-income groups and the social and biological processes linking poverty and T2DM inequalities are well-documented. Moreover, millions of dollars are invested annually in programs aimed at reducing T2DM inequalities, yet these remain stubbornly high. Our article explores how public discourses influence T2DM and related health inequalities in a low-income neighborhood in Northern California, through a thematic analysis of interviews and focus groups of staff and clients at a non-governmental organization. We probe participants' beliefs vis-a-vis the causes of, and solutions to, T2DM inequalities and explore whether and how the discourses normalizing them are challenged. We find that staff identify the ultimate source of T2DM inequalities within health sufferers (i.e., their lifestyle choices, psychological makeup, or cultural preferences), even as they acknowledge the widespread poverty, unemployment, and other social determinants that present serious barriers to their health. Notably, we find this normalizing discourse .among clients themselves. While our study is empirical, its goal is primarily conceptual: to add to the evolving understanding of discourse as a social practice that may contribute both to status quo reproduction and to social change and resistance.
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Affiliation(s)
- Claudia Chaufan
- University of California-San Francisco, San Francisco, CA 94118, USA.
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Lynch L, Waite R, Davey MP. Adverse Childhood Experiences and Diabetes in Adulthood: Support for a Collaborative Approach to Primary Care. CONTEMPORARY FAMILY THERAPY 2013. [DOI: 10.1007/s10591-013-9262-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dinca-Panaitescu M, Dinca-Panaitescu S, Raphael D, Bryant T, Pilkington B, Daiski I. The dynamics of the relationship between diabetes incidence and low income: Longitudinal results from Canada's National Population Health Survey. Maturitas 2012; 72:229-35. [DOI: 10.1016/j.maturitas.2012.03.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 03/29/2012] [Accepted: 03/30/2012] [Indexed: 11/25/2022]
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Chaufan C, Constantino S, Davis M. ‘It's a full time job being poor’: understanding barriers to diabetes prevention in immigrant communities in the USA. CRITICAL PUBLIC HEALTH 2012. [DOI: 10.1080/09581596.2011.630383] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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