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Int. J. Environ. Res. Public Health 2017, 14(9), 1074;

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

Department of Family Medicine and Biobehavioral Health ,University of Minnesota Medical School, Duluth campus, 1035 University Drive, 235 SMed, Duluth, MN 55812, USA
Department of Sociology, Oklahoma State University, Stillwater, OK 74078, USA
Department of Pharmacy Practice, Ohio Northern University, Ada, OH 45810, USA
Department of Sociology, University of Nebraska, Lincoln, NE 68588, USA
Author to whom correspondence should be addressed.
Received: 15 August 2017 / Revised: 9 September 2017 / Accepted: 13 September 2017 / Published: 16 September 2017
(This article belongs to the Collection Health Care and Diabetes)
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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. View Full-Text
Keywords: American Indian; diabetes; stress; Native American American Indian; diabetes; stress; Native American

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Walls, M.L.; Sittner, K.J.; Aronson, B.D.; Forsberg, A.K.; Whitbeck, L.B.; Al’Absi, M. Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes. Int. J. Environ. Res. Public Health 2017, 14, 1074.

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