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2型糖尿病拉丁裔人群中的种族/族裔歧视与糖尿病相关结局

Racial/Ethnic Discrimination and Diabetes-Related Outcomes Among Latinos with Type 2 Diabetes.

作者信息

LeBrón Alana M W, Spencer Michael, Kieffer Edith, Sinco Brandy, Palmisano Gloria

机构信息

Department of Population Health & Disease Prevention, University of California, Irvine, 653 E. Peltason Drive, Anteater Instruction and Research Building (AIRB) 2026, Irvine, CA, 92697-3957, USA.

Department of Chicano/Latino Studies, University of California, Irvine, 3151 Social Science Plaza, Irvine, CA, 92697-5100, USA.

出版信息

J Immigr Minor Health. 2019 Feb;21(1):105-114. doi: 10.1007/s10903-018-0710-0.

Abstract

Discrimination is associated with adverse health outcomes, but few studies have examined the association of discrimination with diabetes-related outcomes including mental health and glycemic control, particularly for immigrant and US-born Latinos. We analyzed survey data (n = 222) collected at baseline of a diabetes intervention. Using multiple linear regression, we examined the association of racial/ethnic discrimination with depressive symptoms, diabetes-related distress, and HbA1c, and variation in these associations by nativity and, for immigrants, length of US residence. Racial/ethnic discrimination was positively associated with depressive symptoms (b = 2.57, SE = 0.45, p < 0.01) and diabetes-related distress (b = 0.30, SE = 0.09, p < 0.01). We could not reject the null hypothesis of no cross-sectional association of racial/ethnic discrimination with HbA1c (b = - 0.27, SE = 0.18, p = 0.14). Although racial/ethnic discrimination did not directly affect HbA1c, racial/ethnic discrimination had a significant mediating effect on HbA1c through diabetes-related distress (p = 0.02). Results suggest that racial/ethnic discrimination is detrimental for health for Latinos with diabetes.

摘要

歧视与不良健康结果相关,但很少有研究探讨歧视与包括心理健康和血糖控制在内的糖尿病相关结果之间的关联,尤其是针对移民和在美国出生的拉丁裔。我们分析了在一项糖尿病干预基线时收集的调查数据(n = 222)。使用多元线性回归,我们研究了种族/族裔歧视与抑郁症状、糖尿病相关困扰和糖化血红蛋白(HbA1c)之间的关联,以及这些关联在出生情况方面的差异,对于移民而言,还研究了在美国居住时长方面的差异。种族/族裔歧视与抑郁症状呈正相关(b = 2.57,标准误 = 0.45,p < 0.01)以及与糖尿病相关困扰呈正相关(b = 0.30,标准误 = 0.09,p < 0.01)。我们不能拒绝种族/族裔歧视与糖化血红蛋白无横断面关联的零假设(b = -0.27,标准误 = 0.18,p = 0.14)。尽管种族/族裔歧视并未直接影响糖化血红蛋白,但种族/族裔歧视通过糖尿病相关困扰对糖化血红蛋白有显著的中介作用(p = 0.02)。结果表明,种族/族裔歧视对患有糖尿病的拉丁裔健康有害。

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