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Published online December 10, 2007
Diabetes Care 31:427-429, 2008
DOI: 10.2337/dc07-2044
© 2008 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Research

Stress Burden and Diabetes in Two American Indian Reservation Communities

Luohua Jiang, PHD1, Janette Beals, PHD1, Nancy R. Whitesell, PHD1, Yvette Roubideaux, MD, MPH2, Spero M. Manson, PHD1 and the AI-SUPERPFP Team

1 American Indian and Alaska Native Programs, University of Colorado Denver, Denver, Colorado
2 Department of Family and Community Medicine, University of Arizona, Tucson, Arizona

Address correspondence and reprint requests to Luohua Jiang, American Indian and Alaska Native Programs, University of Colorado Denver, MS F800, P.O. Box 6508, Aurora, CO 80045-0508. E-mail: luohua.jiang{at}uchsc.edu

OBJECTIVE—To examine the association between psychosocial stress and diabetes in two American Indian reservation communities (Northern Plains and Southwest).

RESEARCH DESIGN AND METHODS—The American Indian Services Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP), a cross-sectional probability sample survey, interviewed 3,084 randomly selected members of two American Indian tribal groups. Included were a psychiatric epidemiological interview, a physical health problems checklist, and an extensive sociodemographic section.

RESULTS—Stress was common in these reservation communities, and the stress burden was greater among those with diabetes. After adjusting for sociodemographic characteristics, early-life interpersonal trauma and community family dysfunction were significantly associated with increased odds of diabetes in the Northern Plains, while discrimination and community addiction problems were significantly associated with increased odds of diabetes in the Southwest.

CONCLUSIONS—A number of psychosocial stresses were significantly associated with increased odds of self-reported diabetes in these two American Indian communities.

Abbreviations: AI-SUPERPFP, American Indian Services Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project


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Copyright © 2008 by the American Diabetes Association.