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
- 1American Indian and Alaska Native Programs, University of Colorado Denver, Denver, Colorado
- 2Department 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
Abstract
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.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 10 December 2007. DOI: 10.2337/dc07-2044.
Additional information for this article can be found in an online appendix at http://dx.doi.org/10.2337/dc07-2044.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted November 30, 2007.
- Received October 23, 2007.
- DIABETES CARE
