Document Type
Article
Recommended Citation
Walls, M. L., Sittner, K. J., Aronson, B. D., Forsberg, A. K., Whitbeck, L. B., & al'Absi, M. (2017). Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes. International journal of environmental research and public health, 14(9), 1074. doi:10.3390/ijerph14091074
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.
Publication Date
9-16-2017
DOI
10.3390/ijerph14091074
Included in
Endocrinology, Diabetes, and Metabolism Commons, Epidemiology Commons, Indigenous Studies Commons, Psychiatric and Mental Health Commons
Notes
This article was published in the International Journal of Environmental Research and Public Health in 2017. The article can be found on the publisher's website using this link.