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Investigating Social Ecological Contributors to Diabetes within Hispanics in an Underserved U.S.-Mexico Border Community
Mel and Enid Zuckerman College of Public Health, Arizona Prevention Research Center, University of Arizona, 1295 N. Martin Ave, Tucson, AZ 85724, USA
Mayo Clinic Arizona, Department of Health Sciences Research, 13400 E. Shea Blvd, Scottsdale, AZ 85259, USA
Richard M. Fairbanks School of Public Health at IUPUI, Indiana University, 714 N. Senate Avenue EF 250, Indianapolis, IN 46202, USA
* Author to whom correspondence should be addressed.
Received: 18 June 2013; in revised form: 22 July 2013 / Accepted: 23 July 2013 / Published: 31 July 2013
Abstract: Hispanics bear a disproportionate burden of diabetes in the United States, yet relations of structural, socio-cultural and behavioral factors linked to diabetes are not fully understood across all of their communities. The current study examines disparities and factors associated with diabetes in adult Hispanics of Mexican-descent (N = 648) participating in a population survey of an underserved rural U.S.-Mexico border community. The overall rate of diabetes prevalence rate in the sample, based on self-report and a glucose testing, was 21%; much higher than rates reported for U.S. adults overall, for all Hispanic adults, or for Mexican American adults specifically. Acculturation markers and social determinants of health indicators were only significantly related to diabetes in models not accounting for age. Older age, greater BMI (>30), greater waist-to-hip ratio as well as lower fruit and vegetable consumption were significantly related to increased likelihood of diabetes when all structural, cultural, behavioral, and biological factors were considered. Models with sets of behavioral factors and biological factors each significantly improved explanation of diabetes relative to prior social ecological theory-guided models. The findings show a critical need for diabetes prevention efforts in this community and suggest that health promotion efforts should particularly focus on increasing fruit and vegetable consumption.
Keywords: diabetes; hispanics; U.S.-Mexico border; obesity; underserved; socio-ecological model; health disparities; health behaviors
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MDPI and ACS Style
Chang, J.; Guy, M.C.; Rosales, C.; Zapien, J.G.; Staten, L.K.; Fernandez, M.L.; Carvajal, S.C. Investigating Social Ecological Contributors to Diabetes within Hispanics in an Underserved U.S.-Mexico Border Community. Int. J. Environ. Res. Public Health 2013, 10, 3217-3232.
Chang J, Guy MC, Rosales C, Zapien JG, Staten LK, Fernandez ML, Carvajal SC. Investigating Social Ecological Contributors to Diabetes within Hispanics in an Underserved U.S.-Mexico Border Community. International Journal of Environmental Research and Public Health. 2013; 10(8):3217-3232.
Chang, Jean; Guy, Mignonne C.; Rosales, Cecilia; Zapien, Jill G.; Staten, Lisa K.; Fernandez, Maria L.; Carvajal, Scott C. 2013. "Investigating Social Ecological Contributors to Diabetes within Hispanics in an Underserved U.S.-Mexico Border Community." Int. J. Environ. Res. Public Health 10, no. 8: 3217-3232.