Too little, too late: Socioeconomic disparities in the experience of women living with diabetes

Abstract

The purpose of this article is to examine whether or not subjective social status (SSS) contributes to diabetes diagnosis and disease discovery experiences. Eighteen diabetic women participated in semi-structured interviews. Interview transcripts were reviewed and coded using interpretative phenomenological analysis. Several general themes emerged from the data analysis: SSS shaped different experiences through (a) situations of diabetes discovery (including the circumstances and stage of diabetes at the time of diagnosis), (b) the degree to which participants considered diabetes to be manageable, (c) the extent of diabetes-related knowledge and experience before diagnosis, and (d) opportunities to gain knowledge shortly thereafter. Due to these constraints, lower SSS individuals had particularly adverse disease discovery experiences. The findings are consistent with the theory of constrained choices. Implications for practitioners and for future research are discussed.

Diet modification challenges faced by marginalized and nonmarginalized adults with type 2 diabetes: A systematic review and qualitative meta-synthesis

“…Others may seek comfort from stress in food. 33,51,52,54,97,108,109 When experiencing challenges with their self-management regimens, patients may experience guilt or anger, 46,51,52,54,58,64,65,76,110–112 which may in turn cause stress and further challenge their self-management efforts, creating a cycle of defeat.…”

“…28,33,40,58,60,61,73,74,85,94,96,98,102 The stress of everyday life may include busy routines as a result of work or family commitments, 33,40,58,60 caregiving stress, 60,94,103 or stress from living in poverty or experiencing discrimination and racism. 85,96,99,104 Diabetes itself may be a cause of stress, as patients try to cope with the diagnosis of diabetes and the many self-management activities they are instructed to engage in. 49,65,80,85,89,93,98 Participants also describe feelings of stress related to the fear of diabetic side-effects and their consequences, 28,74,89,105,106 including a fear of hypoglycemic events.…”

Assessing Diabetes and Factors Associated with Foregoing Medical Care among Persons with Diabetes: Disparities Facing American Indian/Alaska Native, Black, Hispanic, Low Income, and Southern Adults in the U.S. (2011–2015)

“…This is consistent with earlier studies using similar data among the general population (i.e., not stratified by diagnosis or not of diabetes) when assessing forgone medical care [ 25 ]. Further, health disparities experienced over the life course may relate to social institutions and cultural differences [ 26 ]. Even more, one’s diagnosis of diabetes and subsequent health behaviors and decisions (e.g., disease management) may be impacted by economic constraints, individual priorities, and access to care among other things [ 26 ].…”

“…Further, health disparities experienced over the life course may relate to social institutions and cultural differences [ 26 ]. Even more, one’s diagnosis of diabetes and subsequent health behaviors and decisions (e.g., disease management) may be impacted by economic constraints, individual priorities, and access to care among other things [ 26 ]. The fact that these factors continue to translate to disparities particularly among at-risk populations gives urgency to policy makers or other decision makers seeking ways to reduce the burden of diabetes estimated to cost $174 billion in 2007 [ 1 ] already rising to $245 billion in 2012 [ 27 ] and forgone medical care in the U.S.…”

Access to Care and Diabetes Management Among Older American Indians With Type 2 Diabetes

“…The diabetes diagnosis process can be challenging, particularly among patients with constrained personal or community financial resources (Nicklett & Damiano, 2014). In addition to new or changed interactions with the health care system, patients are introduced to new regimens that can be demanding and complex.…”