When Traditional Health Care Isn’t Enough: Re-examining Diabetes Care for African American and Latino Men

Diabetes is among one of the leading causes of death in the United States (Center for Disease Control, 2008).  According to the Centers for Disease Control and Prevention (2008), 7% of the US population lives with diabetes.  Diabetes is found in African American men (8%) and Latino men (7.1%) at higher rates than white men (5.4%).  Diabetes also places men at risk for other health conditions such as kidney failure, obesity, and heart disease. While early access to health care and preventive services can play an important role in preventing and reducing diabetes related complications, poor quality of care and access have been reported for low-income African American and Latino men with diabetes (Correa-de-Araujo, McDermott, & Moy, 2006).  Prior studies suggest that men have different health and health seeking behaviors than women, such as a reluctance to seek medical treatment, which may impact their participation in diabetes treatment and self-management (O’Brien, Hunt & Hart, 2005). Although many studies have examined the effectiveness of interventions in addressing racial and ethnic disparities in diabetes (Mauldon, Melkus, & Cagganello, 2006; Samuel-Hodge, Keyserling, Johnston, Gizlice, & Bandgdiwala, 2009), few address gender disparities.

Culturally appropriate lifestyle programs for African Americans and Latinos can lead to improvements in diabetes control, and self-management. Considering the increasing importance of diabetes treatment programs in effective diabetes self-management and control, it is important to examine whether gender influences diabetes intervention participation and outcomes. Among African Americans, self-care and health care utilization are largely dependent on culture, coping styles, family relationships, spirituality, education levels, socioeconomic status, larger structural or institutional variables (e.g. health care delivery systems and patient-provider relationships) and gender socialization. For Latinos, factors such as acculturation, and language barriers should also be considered. Each of these factors play out differently depending on the environment and racial group. Future studies should tailor interventions by gender and examine their effects in service of decreasing gender disparities and improving diabetes mortality rates among both men and women of color.  Interventions would benefit from explicitly addressing the role of discrimination and racism and cumulative disadvantage based on intersecting social positions (race, class and gender).

*Jaclynn Hawkins, MSW is a Doctoral Student in the Joint Doctoral program in Social Work and Sociology at the University of Michigan

References:

Correa-de-Araujo R., McDermott K., & Moy E. (2006). Gender differences across racial and ethnic groups in the quality of care for diabetes. Womens Health Issues. 16(2), 56-65.

Centers for Disease Control and Prevention. (2008). Fact sheet: Number of americans with diabetes continues to increase. Retrieved January, 1, 2011, from http://www.cdc.gov/Features/diabetesfactsheet

Mauldon, M., Melkus, G. D., & Cagganello, M. (2006). Tornado control: A culturally appropriate diabetes education program for spanish-speaking individuals with type 2 diabetes mellitus—evaluation of a pilot project. Diabetes Education, 32(5), 439-760.

O’Brien, R., Hunt, K., & Hart, G. (2005). ‘It’s caveman stuff, but that is to a certain extent how guys still operate’: Men’s accounts of masculinity and help seeking. Social Science & Medicine, 61(3), 503-516.

Samuel-Hodge, C. D., Keyserling, S. P., Johnston, L. F., Gizlice, Z., & Bandgdiwala, S. I. (YEAR). A randomized trial of a church-based diabetes self-management program for african americans with type 2 diabetes. Diabetes Education, 35, 439-453.

Williams, D.R. (2003). The health of men: structured inequalities and opportunities. American Journal of Public Health, 98(9 Suppl), S150-7.