Depression and Risk Perceptions in Older African Americans With Diabetes

Abstract

Objective. The purpose of this study is to describe the impact of depression on perceptions of risks to health, diabetes self-management practices, and glycemic control in older African Americans with type 2 diabetes. Methods. The authors analyzed data on depression, risk perceptions, diabetes self-management, and A1C in African Americans with type 2 diabetes. T-tests, χ2, and multivariate regression were used to analyze the data. Results. The sample included 177 African Americans (68% women) whose average age was 72.8 years. Thirty-four participants (19.2%) met criteria for depression. Compared to nondepressed participants, depressed participants scored significantly higher on Personal Disease Risk (the perception of being at increased risk for various medical problems), Environmental Risk (i.e., increased risk for environmental hazards), and Composite Risk Perception (i.e., overall perceptions of increased risk); adhered less to diabetes self-management practices; and had marginally worse glycemic control. Depression and fewer years of education were independent predictors of overall perception of increased health risks. Conclusion. Almost 20% of older African Americans with type 2 diabetes in this study were depressed. Compared to nondepressed participants, they tended to have fewer years of education, perceived themselves to be at higher risk for multiple health problems, and adhered less to diabetes self-management practices. It is important for diabetes educators to recognize the impact of low education and the fatalistic perceptions that depression engenders in this population.

“I put diabetes on the shelf”: African-American Women’s Perceptions of Risk for Diabetes Complications

“…The participants who reported more knowledge of DM and increased risk perceptions had at least a junior college education or were health care professionals ( n = 5). This trend is consistent with other research reports that people with less education are likely to report lower or higher severity of risk perceptions (Rovner et al, 2014).…”

“…This sense of powerlessness may be related to AA women’s cultural practices, experiencing stigma or discrimination, socio-economic status, historical experiences, and geographical locations. Similarly, other studies supported the possibility that limited knowledge or education might lead to both overestimation and underestimation of risks for disease and disease complications due to mistaken assessment of health status (Rovner et al, 2014).…”

“…These findings are consistent with the concept of perceived benefits in the Health Belief Model, that is, an individual’s positive health behavior is promoted by the perceived or expected benefits of the health behavior. The desirability of practicing the directed behavior in order to minimize or delay the risk of developing disease complications is motivated by perceived benefits (Rovner et al, 2014). The participants who reported more knowledge of DM and increased risk perceptions had at least a junior college education or were health care professionals ( n = 5).…”

Person‐Centered Fall Risk Awareness Perspectives: Clinical Correlates and Fall Risk

“…Depressive symptoms can influence risk judgments. For example, African Americans with diabetes mellitus and clinical depression perceived themselves to be at higher risk of multiple health problems and adhered less to diabetes mellitus self‐management practices than those without depression . Although participants cited being old as one of the reasons for a positive response on both fall risk awareness questions, chronological age was not significantly associated with positive responses on either question.…”

The Effect of COVID on Child Maltreatment: A Review

“…Similar studies have also shown that traumatized individuals who perceived the pandemic to be more severe and demonstrated psychological distress from COVID-19 were predicted to have poorer psychiatric outcomes across several countries (Li et al, 2020) [58,167,185]. Researchers believe that the combination of learned hopelessness and increased sensitivities to stress create poorer appraisals of taxing circumstances like fears involving infection and mortality [118,170,219]. These findings support the idea that individuals with histories of childhood trauma may be at higher risk for developing poorer psychological health during the COVID-19 pandemicespecially with regards to depression and other mood disorders.…”