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Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes

Author

Listed:
  • Melissa L. Walls

    (Department of Family Medicine and Biobehavioral Health ,University of Minnesota Medical School, Duluth campus, 1035 University Drive, 235 SMed, Duluth, MN 55812, USA)

  • Kelley J. Sittner

    (Department of Sociology, Oklahoma State University, Stillwater, OK 74078, USA)

  • Benjamin D. Aronson

    (Department of Pharmacy Practice, Ohio Northern University, Ada, OH 45810, USA)

  • Angie K. Forsberg

    (Department of Family Medicine and Biobehavioral Health ,University of Minnesota Medical School, Duluth campus, 1035 University Drive, 235 SMed, Duluth, MN 55812, USA)

  • Les B. Whitbeck

    (Department of Sociology, University of Nebraska, Lincoln, NE 68588, USA)

  • Mustafa Al’Absi

    (Department of Family Medicine and Biobehavioral Health ,University of Minnesota Medical School, Duluth campus, 1035 University Drive, 235 SMed, Duluth, MN 55812, USA)

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.

Suggested Citation

  • Melissa L. Walls & Kelley J. Sittner & Benjamin D. Aronson & Angie K. Forsberg & Les B. Whitbeck & Mustafa Al’Absi, 2017. "Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes," IJERPH, MDPI, vol. 14(9), pages 1-11, September.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:9:p:1074-:d:112173
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    References listed on IDEAS

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    1. Chae, D.H. & Walters, K.L., 2009. "Racial discrimination and racial identity attitudes in relation to self-rated health and physical pain and impairment among two-spirit American Indians/Alaska Natives," American Journal of Public Health, American Public Health Association, vol. 99(S1), pages 144-151.
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    Cited by:

    1. Melissa E. Lewis & Hannah I. Volpert-Esmond & Jason F. Deen & Elizabeth Modde & Donald Warne, 2021. "Stress and Cardiometabolic Disease Risk for Indigenous Populations throughout the Lifespan," IJERPH, MDPI, vol. 18(4), pages 1-24, February.

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