title: Financial strain, inflammatory factors, and haemoglobin A1c levels in African American women.
abstract: OBJECTIVE
  Type 2 diabetes disproportionately affects African American women, a population exposed to high levels of stress, including financial strain (Centers for Disease Control & Prevention, 2011, http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf). We tested a mediational model in which chronic financial strain among African American women contributes to elevated serum inflammation markers, which, in turn, lead to increased haemoglobin A1C (HbA1c) levels and risk for type 2 diabetes.
  
  
  METHODS
  We assessed level of financial strain four times over a 10-year period and tested its effect on two serum inflammation markers, C-reactive protein (CRP) and soluble interleukin-6 receptor (sIL-6R) in year 11 of the study. We tested the inflammation markers as mediators in the association between chronic financial strain and HbA1c, an index of average blood glucose level over several months.
  
  
  METHODS
  Data were from 312 non-diabetic African American women from the Family and Community Health Study (FACHS; Cutrona et al., 2000, J. Pers. Soc. Psychol., 79, 1088).
  
  
  RESULTS
  Chronic financial strain predicted circulating sIL-6R after controlling for age, BMI, health behaviours, and physical health measures. In turn, sIL-6R significantly predicted HbA1c levels. The path between chronic financial strain and HbA1c was significantly mediated by sIL-6R. Contrary to prediction, CRP was not predicted by chronic financial strain.
  
  
  CONCLUSIONS
  Results support the role of inflammatory factors in mediating the effects of psychosocial stressors on risk for type 2 diabetes. Findings have implications for interventions that boost economic security and foster effective coping as well as medical interventions that reduce serum inflammation to prevent the onset of type 2 diabetes.
authors.affiliation: Iowa State University, Ames, Iowa, USA.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Cutrona
authors.affiliation: Iowa State University, Ames, Iowa, USA.
authors.forename: William T
authors.initials: WT
authors.lastname: Abraham
authors.affiliation: Iowa State University, Ames, Iowa, USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Russell
authors.affiliation: University of Georgia, Athens, Georgia, USA.
authors.forename: Steven R H
authors.initials: SR
authors.lastname: Beach
authors.affiliation: University of Connecticut, Storrs, Connecticut, USA.
authors.forename: Frederick X
authors.initials: FX
authors.lastname: Gibbons
authors.affiliation: University of Connecticut, Storrs, Connecticut, USA.
authors.forename: Meg
authors.initials: M
authors.lastname: Gerrard
authors.affiliation: University of Iowa, Iowa, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Monick
authors.affiliation: University of Iowa, Iowa, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Philibert
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000276:immunology*; D004467:Economics / Q000706:statistics & numerical data*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007249:Inflammation; D008137:Longitudinal Studies; D008875:Middle Aged; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data*; D019947:Receptors, Interleukin-6 / Q000276:immunology*; D012044:Regression Analysis; D013315:Stress, Psychological / Q000276:immunology / Q000378:metabolism* / Q000523:psychology; D014930:Women
chemical_list: D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D019947:Receptors, Interleukin-6; C508603:IL6R protein, human; C517652:hemoglobin A1c protein, human
keywords: African American; financial strain; inflammatory factors; psychosocial stress; type 2 diabetes