|Title||Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework.|
|Authors||McCurley JL, Gutierrez AP, Bravin JI, Schneiderman N, Reina SA, Khambaty T, Castañeda SF, Smoller S, Daviglus ML, O'Brien MJ, Carnethon MR, Isasi CR, Perreira KM, Talavera GA, Yang M, Gallo LC|
|Journal||Ann Behav Med|
|Date Published||2019 Oct 07|
|Keywords||Adolescent, Adult, Aged, Comorbidity, Depressive Disorder, Diabetes Mellitus, Type 2, Educational Status, Female, Health Status Disparities, Hispanic or Latino, Humans, Life Change Events, Male, Middle Aged, Poverty, Psychosocial Deprivation, Risk Factors, Syndemic, United States, Young Adult|
BACKGROUND: U.S. Hispanics/Latinos experience high lifetime risk for Type 2 diabetes and concurrent psychological depression. This comorbidity is associated with poorer self-management, worse disease outcomes, and higher mortality. Syndemic theory is a novel social epidemiological framework that emphasizes the role of economic and social adversity in promoting disease comorbidity and health disparities.PURPOSE: Informed by the syndemic framework, this study explored associations of socioeconomic and psychosocial adversity (low income/education, trauma history, adverse childhood experiences, ethnic discrimination, neighborhood problems [e.g., violence]) with comorbidity of diabetes and depression symptoms in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and Sociocultural Ancillary Study.METHODS: Participants were 5,247 Latino adults, aged 18-74, enrolled in four U.S. cities from 2008 to 2011. Participants completed a baseline physical exam and measures of depression symptoms and psychosocial adversity. Multinomial logistic regression analyses were conducted to examine associations of adversity variables with comorbid diabetes and high depression symptoms.RESULTS: Household income below $30,000/year was associated with higher odds of diabetes/depression comorbidity (odds ratio [OR] = 4.61; 95% confidence interval [CI]: 2.89, 7.33) compared to having neither condition, as was each standard deviation increase in adverse childhood experiences (OR = 1.41; 95% CI: 1.16, 1.71), ethnic discrimination (OR = 1.23; 95% CI: 1.01, 1.50), and neighborhood problems (OR = 1.53; 95% CI: 1.30, 1.80).CONCLUSION: Low household income, adverse childhood experiences, ethnic discrimination, and neighborhood problems are related to comorbid diabetes and depression in U.S. Latinos. Future studies should explore these relationships longitudinally.
|Alternate Journal||Ann Behav Med|
|PubMed Central ID||PMC6779072|
|Grant List||KL2 TR002545 / TR / NCATS NIH HHS / United States |
P30 DK111022 / DK / NIDDK NIH HHS / United States
P30 DK020541 / DK / NIDDK NIH HHS / United States
RC2 HL101649 / HL / NHLBI NIH HHS / United States
P30 DK092949 / DK / NIDDK NIH HHS / United States
P2C HD050924 / HD / NICHD NIH HHS / United States
Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework.
Field Center: San Diego (San Diego State University)