Discrimination and Depression among Urban Hispanics with Poorly Controlled Diabetes

Ethn Dis. 2015 Spring;25(2):130-7.

Abstract

Objectives: We had three objectives for our study: 1) to describe the prevalence and burden of experiences of discrimination among Hispanics with poorly controlled diabetes; 2) to evaluate associations among discrimination experiences and their burden with comorbid depression among Hispanics with poorly controlled diabetes; and 3) to evaluate whether discrimination encountered in the health care context itself was associated with comorbid depression for Hispanic adults with diabetes.

Design: We conducted a cross-sectional analysis of baseline data of a randomized controlled trial (RCT).

Setting: We collected data in the context of an RCT in a clinical setting in New York City.

Participants: Our sample comprised 221 urban-dwelling Hispanics, largely of Caribbean origin.

Main outcome measures: The main outcome measure was major depression, measured by the Euro-D (score > 3).

Results: Of 221 participants, 58.8% reported at least one experience of everyday discrimination, and 42.5% reported at least one major experience of discrimination. Depression was associated significantly with counts of experiences of major discrimination (OR = 1.46, 95% CI = 1.09 - 1.94, P = .01), aggregate counts of everyday and major discrimination (OR = 1.13, 95% CI = 1.02 - 1.26, P = .02), and the experience of discrimination in getting care for physical health (OR = 6.30, 95% CI= 1.10-36.03).

Conclusions: Discrimination may pose a barrier to getting health care and may be associated with depression among Hispanics with diabetes. Clinicians treating Caribbean-born Hispanics should be aware that disadvantage and discrimination likely complicate a presentation of diabetes.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Depressive Disorder / ethnology*
  • Diabetes Mellitus, Type 2 / ethnology*
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy
  • Female
  • Hispanic or Latino / psychology*
  • Humans
  • Male
  • Middle Aged
  • New York City
  • Prevalence
  • Racism / ethnology*
  • Racism / psychology*
  • Racism / statistics & numerical data
  • Urban Health / ethnology