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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.

TitleAssociation of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework.
Publication TypePublication
Year2019
AuthorsMcCurley 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
JournalAnn Behav Med
Volume53
Issue11
Pagination975-987
Date Published2019 10 07
ISSN1532-4796
KeywordsAdolescent, Adult, Aged, Comorbidity, Depressive Disorder, Diabetes Mellitus, Type 2, Educational Status, Female, Health Status Disparities, Hispanic Americans, Humans, Life Change Events, Male, Middle Aged, Poverty, Psychosocial Deprivation, Risk Factors, Syndemic, United States, Young Adult
Abstract

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.

DOI10.1093/abm/kaz009
Alternate JournalAnn Behav Med
PubMed ID30951585
PubMed Central IDPMC6779072
Grant ListKL2 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
MS#: 
0577
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: San Diego (San Diego State University)
ECI: 
Yes
Manuscript Affiliation: 
Field Center: San Diego (San Diego State University)
Manuscript Status: 
Published