The Role of Perceived Discrimination and Other Psychosocial Factors in Explaining Diabetes Distress Among Older African American and White Adults

J Appl Gerontol. 2020 Jan;39(1):99-104. doi: 10.1177/0733464817750273. Epub 2018 Jan 1.

Abstract

Background: Diabetes distress, also referred to as diabetes-related emotional distress, has been shown to contribute to worsening diabetes status over time as well as increased depressive symptoms. Other psychosocial factors, including perceived discrimination, are also related to poorer diabetes outcomes. This study explores the relationships between diabetes distress and several psychosocial variables relevant to health disparities (i.e., race, cognition, social support, physician trust, and perceived discrimination) among older adults with type 2 diabetes mellitus. Design and Method: Structured telephone interviews were conducted with 148 African American and White adults (age ≥65) with type 2 diabetes mellitus. Results: Perceived discrimination and physician trust partially explain the relationship between African American race and diabetes distress. Younger age, less satisfaction with social support, and lower physician trust were associated with higher levels of diabetes distress. Conclusion: These results highlight the need to address unique stressors, such as perceived discrimination, among racial/ethnic minorities to improve diabetes-related outcomes.

Keywords: diabetes distress; discrimination; physician trust; type 2 diabetes mellitus.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alabama
  • Black or African American / psychology*
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / psychology
  • Female
  • Healthcare Disparities / ethnology
  • Humans
  • Linear Models
  • Male
  • Patient Acceptance of Health Care
  • Physician-Patient Relations
  • Racism / psychology*
  • Social Support
  • Stress, Psychological / ethnology*
  • Trust
  • White People / psychology*