Correlates of elevated depressive symptoms among rural African American adults with type 2 diabetes.
OBJECTIVE
The study objective was to examine the health-related and sociocontextual correlates of elevated depressive symptoms among rural African American adults with type 2 diabetes mellitus.


METHODS
Cross sectional, observational study.


METHODS
Rural communities in central Georgia, United States.


METHODS
African American patients with type 2 diabetes mellitus (N = 200) were recruited from eight rural counties in Georgia by using community-based procedures.


METHODS
Participants were assessed on demographics (age, sex, and education), diabetes-related characteristics (health status, time since diagnosis, blood glucose control problems, and hemoglobin A1C level), and psychosocial variables (financial stress, community disadvantage, community support, social support, and patient-healthcare provider relationship quality). Elevated depressive symptoms, as assessed via the Center for Epidemiologic Studies-Depression scale, constituted the dependent variable.


RESULTS
Elevated depressive symptoms were present in 30% of the sample. Multiple logistic analysis of the contributors to depression predicted 57% of the variability in depression. Sex, neighborhood disadvantage, health status, hyperglycemic symptoms, social support, and patient-healthcare provider relationship quality predicted depression in multivariate analyses.


CONCLUSIONS
Both health-related and psychosocial stressors contribute to depressive symptoms among rural African Americans. Problems in patient-healthcare provider relationships may impede identification of depressive symptoms among these patients. Providers require training and support to identify and treat depression among rural African Americans.
Kogan
Steven M
SM
Center for Family Research, University of Georgia, Athens, Georgia, USA. smkogan@uga.edu
Brody
Gene H
GH
Crawley
Connie
C
Logan
Patricia
P
Murry
Velma McBride
VM
D001741:Black or African American; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000208:ethnology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012424:Rural Population; D013315:Stress, Psychological / Q000453:epidemiology