Aim: African Americans are disproportionately affected by type 2 diabetes. The purpose of this study was to assess to what extent African Americans' knowledge and awareness of family health history and related risk factors for developing type 2 diabetes influence their likelihood of adopting a preventive behavior. Methods: This study employed an anonymous pencil-and-paper, self-administered survey consisting of two sections. Section 1 was a modified version of the US Surgeon General's Family Health History Initiative and the American Diabetes Association Diabetes Risk Factor Survey. Section 2 of the survey was based on the constructs of the theory of planned behavior. Over 394 African American participants completed the survey. Results: ‘Perceived behavioral control' was the strongest predictor of ‘likelihood of adopting preventive behavior'. Participants were aware of their family history as a risk factor for type 2 diabetes, but it was not a significant predictor of behavior modifications based on that knowledge. Conclusion: The lack of perceived risk in this population shows the importance of not only knowing one's risk factors but translating those risk factors to a more personalized form that fits into the current lifestyle of the individual in a meaningful way.

Deaths due to hypertension in the US are highest among African Americans, who have a higher prevalence of hypertension and more severe hypertensive symptoms. Research indicates that there are both genetic and sociocultural risk factors for hypertension. Racial disparities in hypertension also likely involve genetic and sociocultural factors, but the factors may interact and manifest differently across racial groups. Here we use a biocultural approach to integrate genetic and social network data to better understand variation in blood pressure. We assay genetic variation at the angiotensin I converting enzyme gene (ACE) and analyze social network composition and structure in African Americans living in Tallahassee, FL (n = 138). We demonstrate that models including both genetic and social network data explain significantly more variation in blood pressure and have better model diagnostics than do models including only one datatype. Specifically, optimal models for systolic and diastolic blood pressure explain a notable 35% and 21%, respectively, of blood pressure variation. Analysis of the social networks reveals that individuals whose networks are dominated by family connections and are more fragmented have higher blood pressure. Historically, family support has been associated with better mental and physical health, but our results suggest that those family connections can also take a toll on health. These findings raise compelling questions regarding the roles of genetics, family, and social environment in hypertension in the African American community and suggest that interactions among these factors may help explain racial disparities in hypertension more accurately than any of the factors alone.

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