The Modifying Effect of Sociocultural Status on Risk Factors for Type 2 Diabetes in Older Mexican American Women


Book Description

The primary objective of this dissertation project was to describe the pattern of effect modification caused by sociocultural status on identified risk factors for Type 2 diabetes. This case-control study included 244 Mexican American women, between the ages of 50-79, who were enrolled in the Observational Study of the Women's Health Initiative (WHI) in San Diego, Tucson, or San Antonio between 1994-1997. Seventy-eight diabetics and 166 nondiabetics were included in the study. As a supplement to data already collected by the WHI, a telephone survey was used to gather information on acculturation and diabetes related knowledge and behavior. Results support previous findings that increased age; a positive family history of diabetes, obesity, and centralized adiposity; and a sedentary lifestyle are important independent predictors of diabetes. The risk of diabetes associated with obesity is moderated by acculturation in a nonlinear fashion. Specifically, risk of diabetes associated with obesity was lowest at either the high or the low end of the acculturation spectrum, but highest in the midrange. The risk of diabetes associated with a higher waist hip ratio increases with income and acculturation. With respect to educational status, the risk of disabetes is related in a nonlinear fashion and is magnified for women with 7th-12th grade education. However, in the presence of other risk factors such as family history of diabetes and age, the importance of sociocultural status as an effect modifier diminishes.










Hispanics and the Future of America


Book Description

Hispanics and the Future of America presents details of the complex story of a population that varies in many dimensions, including national origin, immigration status, and generation. The papers in this volume draw on a wide variety of data sources to describe the contours of this population, from the perspectives of history, demography, geography, education, family, employment, economic well-being, health, and political engagement. They provide a rich source of information for researchers, policy makers, and others who want to better understand the fast-growing and diverse population that we call "Hispanic." The current period is a critical one for getting a better understanding of how Hispanics are being shaped by the U.S. experience. This will, in turn, affect the United States and the contours of the Hispanic future remain uncertain. The uncertainties include such issues as whether Hispanics, especially immigrants, improve their educational attainment and fluency in English and thereby improve their economic position; whether growing numbers of foreign-born Hispanics become citizens and achieve empowerment at the ballot box and through elected office; whether impending health problems are successfully averted; and whether Hispanics' geographic dispersal accelerates their spatial and social integration. The papers in this volume provide invaluable information to explore these issues.




Perceptions and Meanings of Type II Diabetes Among Mexican American Farmworking Women


Book Description

The purpose of this phenomenological study was to explore the perceptions and meanings of type II diabetes among Mexican American farmworking women working in California's Northern San Joaquin Valley. Perceptions of type II diabetes play a major role in how Mexican American farmworking women feel about diabetes and these perceptions influence diabetes treatment strategies and health care decisions. Yet, little is known about the perceptions and meanings that farmworking women attribute to type II diabetes. A qualitative interdisciplinary research methodology (integrating knowledge from social work and nursing) involving open-ended, in-depth interviews with a nonprobabilistic sample of 17 Mexican American farmworking women was used to gain an understanding of how farmworking women make meaning of type II diabetes. Based on Kleinman's (1980) explanatory model, salient themes in the areas of illness, causation, treatment and perceptions were identified. The study showed that farmworking women have a predominantly cultural perspective of diabetes. A large majority of women applied cultural beliefs and traditional home remedies to the treatment of diabetes; although many were not opposed to incorporating western medicine into cultural treatment strategies. Causation of diabetes was attributed to a transformation of blood and destabilization of the pancreas as a result of Susto (fright), an ethno-specific illness. Home remedy and dosing strategies were categorized and farmworking women revealed subjective definitions of high blood glucose and heredity that are dissimilar to western biomedicine. Understanding how farmworking women conceptualize and make meaning of type II diabetes and including these important culturally influenced beliefs and treatment strategies into interdisciplinary health care practices and service delivery systems can serve as a basis for modifying current medical theoretical orientations about diabetes education, treatment and maintenance strategies and service provision for this particularly vulnerable population. Additionally, the inclusion of cultural beliefs and treatment strategies can engender trust and facilitate meaningful, reciprocal relationships between patients and health care providers, which are considered essential for developing culturally meaningful, effective treatment, and competent and responsible service provision.













Syndemic Suffering


Book Description

In a major contribution to the study of diabetes, this book is the first to analyze the disease through a syndemic framework. An innovative, mixed-methods study, Emily Mendenhall shows how adverse social conditions, such as poverty and oppressive relationships, disproportionately stress certain populations and expose them to disease clusters. She goes beyond epidemiological research that has linked diabetes and depression, revealing how broad structural inequalities play out in the life histories of individuals, families, and communities, and lead to higher rates of mortality and morbidity. This intimate portrait of syndemic suffering is a model study of chronic disease disparity among the poor in high income countries and will be widely read in public health, medical anthropology, and related fields.