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Effect of perceived racial discrimination on self-care behaviors, glycemic control, and quality of life in adults with type 2 diabetes

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Abstract

Objective: This study used a large sample size of black and white patients with type 2 diabetes to investigate the influence of perceived racial discrimination on biologic measures (glycemic control, blood pressure, and LDL cholesterol), the mental component of quality of life (MCS), and health behaviors known to improve diabetes outcomes. Methods: 602 patients were recruited from two adult primary care clinics in the southeastern United States. Linear regression models were used to assess the associations between perceived racial discrimination, self-care, clinical outcomes, MCS, adjusting for relevant covariates. Race-stratified models were conducted to examine differential associations by race. Results: The mean age was 61 years, with 64.9 % non-Hispanic black, and 41.6 % earning less than $20,000 annually. Perceived discrimination was significantly negatively associated with MCS (β = −0.56, 95 % CI −0.90, 0.23), general diet (β = −0.37, CI −0.65, −0.08), and specific diet (β = −0.25, CI −0.47, −0.03). In African Americans, perceived discrimination was significantly associated with higher systolic blood pressure (β = 10.17, CI 1.13, −19.22). In Whites, perceived discrimination was significantly associated with lower MCS (β = −0.51, CI −0.89, −0.14), general diet (β = −0.40, CI −0.69, −0.99), specific diet (β = −0.25, CI −0.47, −0.03), and blood glucose testing (β = −0.43, CI −0.80, −0.06).Conclusions: While no association was found with biologic measures, perceived discrimination was associated with health behaviors and the MCS. In addition, results showed a difference in influence of perceived discrimination by race.

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Acknowledgments

Author Contributions

LEE obtained funding for the study. RJW and LEE designed the study, acquired, analyzed, and interpreted the data. AZD, RJW, JAC, and LEE developed the analysis, contributed to interpretation, and critically revised the manuscript for important intellectual content. All authors approved the final manuscript.

Funding source

This study was supported by Grant K24DK093699-01 from The National Institute of Diabetes and Digestive and Kidney Disease (PI: Leonard Egede).

Conflict of interest

The authors report no potential conflicts of interest relevant to this article.

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This article represents the views of the authors and not those of NIH, VHA or HSR&D.

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Authors and Affiliations

  1. Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, Room 280, PO Box 250593, Charleston, SC, 29425, USA

    Aprill Z. Dawson, Rebekah J. Walker, Jennifer A. Campbell & Leonard E. Egede

  2. Health Equity and Rural Outreach Innovation Center (HEROIC), Charleston VA HSR&D COIN, Ralph H. Johnson VAMC, Charleston, SC, USA

    Rebekah J. Walker & Leonard E. Egede

  3. Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Leonard E. Egede

Authors
  1. Aprill Z. Dawson
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  2. Rebekah J. Walker
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  3. Jennifer A. Campbell
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  4. Leonard E. Egede
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Correspondence to Leonard E. Egede.

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Dawson, A.Z., Walker, R.J., Campbell, J.A. et al. Effect of perceived racial discrimination on self-care behaviors, glycemic control, and quality of life in adults with type 2 diabetes. Endocrine 49, 422–428 (2015). https://doi.org/10.1007/s12020-014-0482-9

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