Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework

Jessica L. McCurley; Angela P. Gutierrez; Julia I. Bravin; Neil Schneiderman; Samantha A. Reina; Tasneem Khambaty; Sheila F. Castañeda; Sylvia Smoller; Martha L. Daviglus; Matthew J. O'Brien; Mercedes R. Carnethon; Carmen R. Isasi; Krista M. Perreira; Greg A. Talavera; Mingan Yang; Linda C. Gallo

doi:10.1093/abm/kaz009

Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework

Jessica L. McCurley^*, Angela P. Gutierrez, Julia I. Bravin, Neil Schneiderman, Samantha A. Reina, Tasneem Khambaty, Sheila F. Castañeda, Sylvia Smoller, Martha L. Daviglus, Matthew J. O'Brien, Mercedes R. Carnethon, Carmen R. Isasi, Krista M. Perreira, Greg A. Talavera, Mingan Yang, Linda C. Gallo

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

Background: U.S. Hispanics/Latinos experience high lifetime risk for Type 2 diabetes and concurrent psychological depression. This comorbidity is associated with poorer self-management, worse disease outcomes, and higher mortality. Syndemic theory is a novel social epidemiological framework that emphasizes the role of economic and social adversity in promoting disease comorbidity and health disparities. Purpose: Informed by the syndemic framework, this study explored associations of socioeconomic and psychosocial adversity (low income/education, trauma history, adverse childhood experiences, ethnic discrimination, neighborhood problems [e.g., violence]) with comorbidity of diabetes and depression symptoms in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and Sociocultural Ancillary Study. Methods: Participants were 5,247 Latino adults, aged 18-74, enrolled in four U.S. cities from 2008 to 2011. Participants completed a baseline physical exam and measures of depression symptoms and psychosocial adversity. Multinomial logistic regression analyses were conducted to examine associations of adversity variables with comorbid diabetes and high depression symptoms. Results: Household income below $30,000/year was associated with higher odds of diabetes/depression comorbidity (odds ratio [OR] = 4.61; 95% confidence interval [CI]: 2.89, 7.33) compared to having neither condition, as was each standard deviation increase in adverse childhood experiences (OR = 1.41; 95% CI: 1.16, 1.71), ethnic discrimination (OR = 1.23; 95% CI: 1.01, 1.50), and neighborhood problems (OR = 1.53; 95% CI: 1.30, 1.80). Conclusion: Low household income, adverse childhood experiences, ethnic discrimination, and neighborhood problems are related to comorbid diabetes and depression in U.S. Latinos. Future studies should explore these relationships longitudinally.

Original language	English (US)
Pages (from-to)	975-987
Number of pages	13
Journal	Annals of Behavioral Medicine
Volume	53
Issue number	11
DOIs	https://doi.org/10.1093/abm/kaz009
State	Published - Mar 27 2019

Funding

J. L. McCurley was additionally supported by a National Institutes of Health T32 training grant in Cardiovascular Epidemiology from the National Heart, Lung, and Blood Institute and University of California San Diego (5T32HL079891–06) and a GloCal Health Fellowship funded by the Fogarty International Center, National Heart, Lung, and Blood Institute, and the University of California Global Health Institute (R25 TW009343). Funding The Hispanic Community Health Study/Study of Latinos was supported by contracts from the National Heart, Lung, and Blood Institute to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following institutes/centers/offices contribute to the HCHS/SOL through a transfer of funds to the National Heart, Lung, and Blood Institute: the National Center on Minority Health and Health Disparities, the National Institute of Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. The Hispanic Community Health Study/ Study of Latinos Sociocultural Ancillary Study was supported by Grant 1 RC2 HL101649 from the National Institutes of Health/ National Heart, Lung, and Blood Institute (Gallo/Penedo PIs).

Keywords

Depression
Diabetes
Hispanic/Latino
Psychosocial
Structural
Syndemic

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/abm/kaz009

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McCurley, J. L., Gutierrez, A. P., Bravin, J. I., Schneiderman, N., Reina, S. A., Khambaty, T., Castañeda, S. F., Smoller, S., Daviglus, M. L., O'Brien, M. J., Carnethon, M. R., Isasi, C. R., Perreira, K. M., Talavera, G. A., Yang, M., & Gallo, L. C. (2019). Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework. Annals of Behavioral Medicine, 53(11), 975-987. https://doi.org/10.1093/abm/kaz009

@article{84bb8944ed3b418782140fe16c0850c4,

title = "Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework",

abstract = "Background: U.S. Hispanics/Latinos experience high lifetime risk for Type 2 diabetes and concurrent psychological depression. This comorbidity is associated with poorer self-management, worse disease outcomes, and higher mortality. Syndemic theory is a novel social epidemiological framework that emphasizes the role of economic and social adversity in promoting disease comorbidity and health disparities. Purpose: Informed by the syndemic framework, this study explored associations of socioeconomic and psychosocial adversity (low income/education, trauma history, adverse childhood experiences, ethnic discrimination, neighborhood problems [e.g., violence]) with comorbidity of diabetes and depression symptoms in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and Sociocultural Ancillary Study. Methods: Participants were 5,247 Latino adults, aged 18-74, enrolled in four U.S. cities from 2008 to 2011. Participants completed a baseline physical exam and measures of depression symptoms and psychosocial adversity. Multinomial logistic regression analyses were conducted to examine associations of adversity variables with comorbid diabetes and high depression symptoms. Results: Household income below $30,000/year was associated with higher odds of diabetes/depression comorbidity (odds ratio [OR] = 4.61; 95% confidence interval [CI]: 2.89, 7.33) compared to having neither condition, as was each standard deviation increase in adverse childhood experiences (OR = 1.41; 95% CI: 1.16, 1.71), ethnic discrimination (OR = 1.23; 95% CI: 1.01, 1.50), and neighborhood problems (OR = 1.53; 95% CI: 1.30, 1.80). Conclusion: Low household income, adverse childhood experiences, ethnic discrimination, and neighborhood problems are related to comorbid diabetes and depression in U.S. Latinos. Future studies should explore these relationships longitudinally.",

keywords = "Depression, Diabetes, Hispanic/Latino, Psychosocial, Structural, Syndemic",

author = "McCurley, {Jessica L.} and Gutierrez, {Angela P.} and Bravin, {Julia I.} and Neil Schneiderman and Reina, {Samantha A.} and Tasneem Khambaty and Casta{\~n}eda, {Sheila F.} and Sylvia Smoller and Daviglus, {Martha L.} and O'Brien, {Matthew J.} and Carnethon, {Mercedes R.} and Isasi, {Carmen R.} and Perreira, {Krista M.} and Talavera, {Greg A.} and Mingan Yang and Gallo, {Linda C.}",

year = "2019",

month = mar,

day = "27",

doi = "10.1093/abm/kaz009",

language = "English (US)",

volume = "53",

pages = "975--987",

journal = "Annals of Behavioral Medicine",

issn = "0883-6612",

publisher = "Oxford University Press",

number = "11",

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McCurley, JL, Gutierrez, AP, Bravin, JI, Schneiderman, N, Reina, SA, Khambaty, T, Castañeda, SF, Smoller, S, Daviglus, ML, O'Brien, MJ , Carnethon, MR, Isasi, CR, Perreira, KM, Talavera, GA, Yang, M & Gallo, LC 2019, 'Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework', Annals of Behavioral Medicine, vol. 53, no. 11, pp. 975-987. https://doi.org/10.1093/abm/kaz009

Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework. / McCurley, Jessica L.; Gutierrez, Angela P.; Bravin, Julia I. et al.
In: Annals of Behavioral Medicine, Vol. 53, No. 11, 27.03.2019, p. 975-987.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

T2 - A Syndemic Framework

AU - McCurley, Jessica L.

AU - Gutierrez, Angela P.

AU - Bravin, Julia I.

AU - Schneiderman, Neil

AU - Reina, Samantha A.

AU - Khambaty, Tasneem

AU - Castañeda, Sheila F.

AU - Smoller, Sylvia

AU - Daviglus, Martha L.

AU - O'Brien, Matthew J.

AU - Carnethon, Mercedes R.

AU - Isasi, Carmen R.

AU - Perreira, Krista M.

AU - Talavera, Greg A.

AU - Yang, Mingan

AU - Gallo, Linda C.

PY - 2019/3/27

Y1 - 2019/3/27

N2 - Background: U.S. Hispanics/Latinos experience high lifetime risk for Type 2 diabetes and concurrent psychological depression. This comorbidity is associated with poorer self-management, worse disease outcomes, and higher mortality. Syndemic theory is a novel social epidemiological framework that emphasizes the role of economic and social adversity in promoting disease comorbidity and health disparities. Purpose: Informed by the syndemic framework, this study explored associations of socioeconomic and psychosocial adversity (low income/education, trauma history, adverse childhood experiences, ethnic discrimination, neighborhood problems [e.g., violence]) with comorbidity of diabetes and depression symptoms in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and Sociocultural Ancillary Study. Methods: Participants were 5,247 Latino adults, aged 18-74, enrolled in four U.S. cities from 2008 to 2011. Participants completed a baseline physical exam and measures of depression symptoms and psychosocial adversity. Multinomial logistic regression analyses were conducted to examine associations of adversity variables with comorbid diabetes and high depression symptoms. Results: Household income below $30,000/year was associated with higher odds of diabetes/depression comorbidity (odds ratio [OR] = 4.61; 95% confidence interval [CI]: 2.89, 7.33) compared to having neither condition, as was each standard deviation increase in adverse childhood experiences (OR = 1.41; 95% CI: 1.16, 1.71), ethnic discrimination (OR = 1.23; 95% CI: 1.01, 1.50), and neighborhood problems (OR = 1.53; 95% CI: 1.30, 1.80). Conclusion: Low household income, adverse childhood experiences, ethnic discrimination, and neighborhood problems are related to comorbid diabetes and depression in U.S. Latinos. Future studies should explore these relationships longitudinally.

AB - Background: U.S. Hispanics/Latinos experience high lifetime risk for Type 2 diabetes and concurrent psychological depression. This comorbidity is associated with poorer self-management, worse disease outcomes, and higher mortality. Syndemic theory is a novel social epidemiological framework that emphasizes the role of economic and social adversity in promoting disease comorbidity and health disparities. Purpose: Informed by the syndemic framework, this study explored associations of socioeconomic and psychosocial adversity (low income/education, trauma history, adverse childhood experiences, ethnic discrimination, neighborhood problems [e.g., violence]) with comorbidity of diabetes and depression symptoms in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and Sociocultural Ancillary Study. Methods: Participants were 5,247 Latino adults, aged 18-74, enrolled in four U.S. cities from 2008 to 2011. Participants completed a baseline physical exam and measures of depression symptoms and psychosocial adversity. Multinomial logistic regression analyses were conducted to examine associations of adversity variables with comorbid diabetes and high depression symptoms. Results: Household income below $30,000/year was associated with higher odds of diabetes/depression comorbidity (odds ratio [OR] = 4.61; 95% confidence interval [CI]: 2.89, 7.33) compared to having neither condition, as was each standard deviation increase in adverse childhood experiences (OR = 1.41; 95% CI: 1.16, 1.71), ethnic discrimination (OR = 1.23; 95% CI: 1.01, 1.50), and neighborhood problems (OR = 1.53; 95% CI: 1.30, 1.80). Conclusion: Low household income, adverse childhood experiences, ethnic discrimination, and neighborhood problems are related to comorbid diabetes and depression in U.S. Latinos. Future studies should explore these relationships longitudinally.

KW - Depression

KW - Diabetes

KW - Hispanic/Latino

KW - Psychosocial

KW - Structural

KW - Syndemic

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U2 - 10.1093/abm/kaz009

DO - 10.1093/abm/kaz009

M3 - Article

C2 - 30951585

AN - SCOPUS:85072993146

SN - 0883-6612

VL - 53

SP - 975

EP - 987

JO - Annals of Behavioral Medicine

JF - Annals of Behavioral Medicine

IS - 11

ER -

Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework

Abstract

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UN SDGs

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