Psychosocial Factors That Influence Health Care Use and Self-Management for African American and Latino Men with Type 2 Diabetes: An Exploratory Study

By Hawkins, Jaclynn; Watkins, Daphne C. et al. | The Journal of Men's Studies, Spring 2015 | Go to article overview

Psychosocial Factors That Influence Health Care Use and Self-Management for African American and Latino Men with Type 2 Diabetes: An Exploratory Study


Hawkins, Jaclynn, Watkins, Daphne C., Kieffer, Edith, Spencer, Michael, Espitia, Nicolous, Anderson, Michael, The Journal of Men's Studies


Diabetes affects 25.8 million people of all ages and 8.3% of the U.S. population with an additional 7 million undiagnosed cases (National Institutes of Diabetes and Digestive and Kidney Diseases [NIDDK], 2011). Among men, nationally, 12% (or 13 million) have a diabetes diagnosis, with the highest prevalence of diabetes found in African American men and Hispanic men compared with non-Hispanic White men, according to the Centers for Disease Control and Prevention (Centers for Disease Control [CDC], 2012, 2013). Despite these statistics, men of color continue to have the poorest health outcomes and often go unnoticed in health care system and in health research (Satcher, 2003; Williams, 2003). Research shows that, in general, African Americans and Latinos are more likely to be diagnosed with diabetes and experience complications related to diabetes such as end-stage renal disease (NIDDK, 2014; Office of Minority Health [OMH], 2014a; 2014b). They are also more likely to be hospitalized for diabetes-related complications and have higher incidence of death as a result of diabetes (OMH, 2014). For certain diabetes-related conditions, men of color are at an even greater risk. For instance, African American and Hispanic men are more likely to be diagnosed with end-stage renal failure related to diabetes compared with women (OMH, 2014). Furthermore, African American and Hispanic men are more likely to die from diabetes than women (OMH, 2014). However, efforts to better understand diabetes self-management and health care use in men of color have been few in number (Sherman, McKyer, Singer, Larke, & Guidry, 2014; Williams, 2003).

Although research remains limited, studies of minority populations with type 2 diabetes suggest that factors such as social support, socioeconomic status, and culture play critical roles in self-management and health care utilization behaviors and health outcomes (Gary, Narayan, Gregg, Beckles, & Saaddine, 2003; Sherman et al., 2014). However, a more focused examination of psychosocial factors related to self-management and health care use among African American and Latino men with diabetes is lacking.

African American and Latino Men, Self-Care, and Health Care Utilization

Diabetes self-management is defined as maintaining control of glucose levels, checking for foot-sores and adhering to physician prescribed medication, exercise, and diet regimens (Lindenmeyer et al., 2006). In terms of health care use for diabetes specifically, persons with a new diagnosis of diabetes should receive an initial evaluation and, moving forward, medical care from an interdisciplinary team including physicians, nurses, mental health professionals, and dieticians (American Diabetes Association, 2010). Furthermore, persons with diabetes should receive a blood glucose test administered by their health care provider every 3 months and should see a physician for a follow-up appointment every 6 months, at a minimum, or more frequently depending on stability of the disease (Turner, Williams, Taichntan, & Vijan, 2010).

The relationship between gender and diabetes self-management and health care use has been investigated in the literature, but a dearth of research still remains (Liburd et al., 2007; Sherman et al., 2014). In a study of 19 African American men, Shennan, McKyer, Singer, Larke, and Guidry (2014) found that social support from friends and family played a critical role in facilitating successful diabetes self-management in adult African American men. Conversely, a lack of social support can serve as a barrier to diabetes self-care in men (Chlebowy, Hood, & LaJoie, 2013). In addition, social support has been found in multiple studies to increase medical care utilization (Broadhead, Gehlbach, & Kaplan, 1989; Kouzis & Eaton, 1998). Research has also found that traditional sex roles can impede the acceptance of social support. For instance, in African American men, the need to maintain autonomy can lead men to set limitations to the type and extent of social support they participate in (Liburd et al. …

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