Shervin Assari1,2, Maryam Moghani Lankarani3, John D Piette4,5,6, James E Aikens7. 1. Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA. assari@umich.edu. 2. Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA. assari@umich.edu. 3. Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA. 4. VA Center for Clinical Management Research, Ann Arbor, MI, USA. 5. Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA. 6. Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA. 7. Department of Family Medicine, Michigan Medicine, Ann Arbor, MI, USA.
Abstract
BACKGROUND: Although some studies have shown a link between self-rated health (SRH) and glycemic control in type 2 diabetes (DM), other studies have failed to support this association. The purpose of this study was to determine whether these equivocal findings can be explained by specific interactions between gender, race, and SRH, as suggested by the intersectionality literature. METHODS: This cross-sectional study included 287 patients with DM (85 Black men, 78 Black women, 64 White men, and 60 White women). After adjusting for demographic and medical factors, we regressed HbA1c on SRH with and without interactions between gender, race, and SRH. We conducted additional subgroup analyses to further characterize gender by race group differences. RESULTS: Although there was no main effect of SRH upon HbA1c (b = .16, 95% CI: .08-.39), we found a significant interaction between gender and SRH on HbA1c (b = -.50, 95% CI: -.97 to -.03). In race by gender-stratified models, SRH (b = .53, 95% CI: .00-1.07) was associated with HbA1c in Black men. SRH was not associated with HbA1c in White men, White women, or Black women. CONCLUSION: Combined race and gender differences may exist in the link between SRH and glycemic control in DM. Specifically, Black men with DM may be more attuned to the relationship between their overall health and their glycemic control.
BACKGROUND: Although some studies have shown a link between self-rated health (SRH) and glycemic control in type 2 diabetes (DM), other studies have failed to support this association. The purpose of this study was to determine whether these equivocal findings can be explained by specific interactions between gender, race, and SRH, as suggested by the intersectionality literature. METHODS: This cross-sectional study included 287 patients with DM (85 Black men, 78 Black women, 64 White men, and 60 White women). After adjusting for demographic and medical factors, we regressed HbA1c on SRH with and without interactions between gender, race, and SRH. We conducted additional subgroup analyses to further characterize gender by race group differences. RESULTS: Although there was no main effect of SRH upon HbA1c (b = .16, 95% CI: .08-.39), we found a significant interaction between gender and SRH on HbA1c (b = -.50, 95% CI: -.97 to -.03). In race by gender-stratified models, SRH (b = .53, 95% CI: .00-1.07) was associated with HbA1c in Black men. SRH was not associated with HbA1c in White men, White women, or Black women. CONCLUSION: Combined race and gender differences may exist in the link between SRH and glycemic control in DM. Specifically, Black men with DM may be more attuned to the relationship between their overall health and their glycemic control.
Entities:
Keywords:
Diabetes; Ethnic groups; Gender; Glycemic control; Population differences; Race; Self-rated health
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