Discrimination and Depression among Urban Hispanics with Poorly Controlled Diabetes

• Published in: Ethnicity & disease 2015-01, Vol.25 (2), p.130-137
• Main Authors: March, Dana, Williams, Jasmine, Wells, Shayla, Eimicke, Joseph P., Teresi, Jeanne A., Almonte, Casandra, Link, Bruce G., Findley, Sally E., Palmas, Walter, Carrasquillo, Olveen, Luchsinger, José A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cross-Sectional Studies; Depressive Disorder - ethnology; Diabetes Mellitus, Type 2 - ethnology; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Female; Hispanic Americans - psychology; Humans; Male; Middle Aged; New York City; Original Reports: Mental Health; Prevalence; Racism - ethnology; Racism - psychology; Racism - statistics & numerical data; Urban Health - ethnology
• ISSN: 1049-510X; 1945-0826

We had three objectives for our study: 1) to describe the prevalence and burden of experiences of discrimination among Hispanics with poorly controlled diabetes; 2) to evaluate associations among discrimination experiences and their burden with comorbid depression among Hispanics with poorly controlled diabetes; and 3) to evaluate whether discrimination encountered in the health care context itself was associated with comorbid depression for Hispanic adults with diabetes. We conducted a cross-sectional analysis of baseline data of a randomized controlled trial (RCT). We collected data in the context of an RCT in a clinical setting in New York City. Our sample comprised 221 urban-dwelling Hispanics, largely of Caribbean origin. The main outcome measure was major depression, measured by the Euro-D (score > 3). Of 221 participants, 58.8% reported at least one experience of everyday discrimination, and 42.5% reported at least one major experience of discrimination. Depression was associated significantly with counts of experiences of major discrimination (OR = 1.46, 95% CI = 1.09 - 1.94, P = .01), aggregate counts of everyday and major discrimination (OR = 1.13, 95% CI = 1.02 - 1.26, P = .02), and the experience of discrimination in getting care for physical health (OR = 6.30, 95% CI= 1.10-36.03). Discrimination may pose a barrier to getting health care and may be associated with depression among Hispanics with diabetes. Clinicians treating Caribbean-born Hispanics should be aware that disadvantage and discrimination likely complicate a presentation of diabetes.