Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes

Melissa L. Walls, Kelley J. Sittner, Benjamin D. Aronson, Angie K. Forsberg, Les B. Whitbeck and Mustafa Al’Absi
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Melissa L. Walls: Department of Family Medicine and Biobehavioral Health ,University of Minnesota Medical School, Duluth campus, 1035 University Drive, 235 SMed, Duluth, MN 55812, USA
Kelley J. Sittner: Department of Sociology, Oklahoma State University, Stillwater, OK 74078, USA
Benjamin D. Aronson: Department of Pharmacy Practice, Ohio Northern University, Ada, OH 45810, USA
Angie K. Forsberg: Department of Family Medicine and Biobehavioral Health ,University of Minnesota Medical School, Duluth campus, 1035 University Drive, 235 SMed, Duluth, MN 55812, USA
Les B. Whitbeck: Department of Sociology, University of Nebraska, Lincoln, NE 68588, USA
Mustafa Al’Absi: Department of Family Medicine and Biobehavioral Health ,University of Minnesota Medical School, Duluth campus, 1035 University Drive, 235 SMed, Duluth, MN 55812, USA

IJERPH, 2017, vol. 14, issue 9, 1-11

Abstract: American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose–response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients.

Keywords: American Indian; diabetes; stress; Native American (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2017
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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