TY - JOUR
T1 - Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study
T2 - A Syndemic Framework
AU - McCurley, Jessica L.
AU - Gutierrez, Angela P.
AU - Bravin, Julia I.
AU - Schneiderman, Neil
AU - Reina, Samantha A.
AU - Khambaty, Tasneem
AU - Castañeda, Sheila F.
AU - Smoller, Sylvia
AU - Daviglus, Martha L.
AU - O'Brien, Matthew J.
AU - Carnethon, Mercedes R.
AU - Isasi, Carmen R.
AU - Perreira, Krista M.
AU - Talavera, Greg A.
AU - Yang, Mingan
AU - Gallo, Linda C.
N1 - Funding Information:
J. L. McCurley was additionally supported by a National Institutes of Health T32 training grant in Cardiovascular Epidemiology from the National Heart, Lung, and Blood Institute and University of California San Diego (5T32HL079891–06) and a GloCal Health Fellowship funded by the Fogarty International Center, National Heart, Lung, and Blood Institute, and the University of California Global Health Institute (R25 TW009343).
Funding Information:
Funding The Hispanic Community Health Study/Study of Latinos was supported by contracts from the National Heart, Lung, and Blood Institute to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following institutes/centers/offices contribute to the HCHS/SOL through a transfer of funds to the National Heart, Lung, and Blood Institute: the National Center on Minority Health and Health Disparities, the National Institute of Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. The Hispanic Community Health Study/ Study of Latinos Sociocultural Ancillary Study was supported by Grant 1 RC2 HL101649 from the National Institutes of Health/ National Heart, Lung, and Blood Institute (Gallo/Penedo PIs).
Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the Society of Behavioral Medicine. All rights reserved.
PY - 2019/3/27
Y1 - 2019/3/27
N2 - 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.
AB - 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.
KW - Depression
KW - Diabetes
KW - Hispanic/Latino
KW - Psychosocial
KW - Structural
KW - Syndemic
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U2 - 10.1093/abm/kaz009
DO - 10.1093/abm/kaz009
M3 - Article
C2 - 30951585
AN - SCOPUS:85072993146
SN - 0883-6612
VL - 53
SP - 975
EP - 987
JO - Annals of Behavioral Medicine
JF - Annals of Behavioral Medicine
IS - 11
ER -
