Role of Depressive Symptoms in Mediating Socioeconomic Disparities in Diabetes Risk Misperception.

OBJECTIVES

In the U.S., type 2 diabetes awareness remains low among individuals at risk. Unawareness poses risk of developing comorbidities, commonly depression, which would harm physical and mental health and well-being. This study builds off previous findings identifying significant differences in accurate diabetes perception by race/ethnicity, sex, age, and self-rated health. This study explores depressive symptoms as a mediator and potential explanation for significant associations between determinants of risk and incorrect perception of risk when at risk.

METHODS

This study uses 2011-2012 & 2013-2014 National Health and Nutrition Examination Survey data (NHANES). The sampling frame includes individuals identified with clinical risk of diabetes, who report not perceiving risk (N = 3238). Summary statistics, bivariates by outcome and mediator, unadjusted and adjusted logistic regression were conducted. The Sobel test was used for mediation analysis.

RESULTS

Depressive symptoms, female sex, Mexican American ethnicity or other/multiple race, younger age, or worse self-rated health were independently associated with lower odds of incorrectly perceiving no clinical risk. Depressive symptoms moderated most socioeconomic disparities.

CONCLUSIONS

Findings demonstrate that depressive symptoms explain disparities in incorrectly perceiving no diabetes risk by sex, age, and self-rated health but not race/ethnicity.