Faculty Collaboration Database

Pathways Between Discrimination and Quality of Life in Patients with Type 2 Diabetes. Diabetes Technol Ther 2016 Mar;18(3):151-8

Date

02/13/2016

Pubmed ID

26866351

Pubmed Central ID

PMC4790216

DOI

10.1089/dia.2015.0305

Scopus ID

2-s2.0-84962501389 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

BACKGROUND: Discrimination is a social determinant that has been linked to poor physical and mental health outcomes. This study aimed to examine the pathway whereby discrimination influences quality of life in patients with type 2 diabetes.

SUBJECTS AND METHODS: Six hundred fifteen patients were recruited from two adult primary care clinics in the southeastern United States. Measures included perceived discrimination, perceived stress, social support, and social cohesion and were based on a theoretical model for the pathways by which perceived discrimination influences mental and physical health. Quality of life was measured using the SF-12 questionnaire.

RESULTS: The final model [χ(2)(106) = 157.35, P = 0.009, R(2) = 0.99, root mean square error of approximation = 0.03, comparative fit index = 0.99] indicates direct effects of higher perceived stress (r = -1.02, P < 0.05) and lower social support (r = 0.36, P < 0.001) significantly related to decreased mental health component score (MCS) of quality of life. Discrimination and social cohesion were not significantly directly related to MCS. However, higher discrimination (r = 0.47, P < 0.001), higher social cohesion (r = 0.14, P < 0.05), and lower social support (r = -0.43, P < 0.001) were significantly directly related to increased stress. No significant paths were found for the physical component score of quality of life.

CONCLUSIONS: Perceived discrimination was significantly associated with stress and served as a pathway to influence the mental health component of quality of life (MCS). Social support had a direct and an indirect effect on MCS through a negative association with stress. These results suggest that future interventions should be developed to decrease stress and increase social support surrounding discrimination to improve the MCS of quality of life in patients with diabetes.

Author List

Achuko O, Walker RJ, Campbell JA, Dawson AZ, Egede LE

Authors

Jennifer Annette Campbell PhD, MPH Assistant Professor in the Medicine department at Medical College of Wisconsin
Aprill Z. Dawson PhD, MPH Assistant Professor in the Medicine department at Medical College of Wisconsin
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Cost of Illness
Diabetes Mellitus, Type 2
Female
Humans
Incidence
Male
Middle Aged
Models, Psychological
Primary Health Care
Psychiatric Status Rating Scales
Quality of Life
Self Report
Social Discrimination
Social Identification
Social Support
Southeastern United States
Stress, Physiological
Stress, Psychological