The Meaning of Type II Diabetes Among At-Risk Latino Students

By

Maria T. Hurtado-Ortiz, Silvia Santos & Etna Jimenez

APA, August 2007

 

Diabetes is increasing at an alarming rate in the Hispanic community.  For example, according to the American Diabetes Association (2002), two million or 10.2% of all Hispanic Americans have diabetes. Mexican Americans represent the largest subgroup of Hispanics in the United States.  They are twice as likely to have diabetes as compared to non-Hispanic Whites of similar age.  “Mexican Americans tend to be diagnosed at younger ages, and exhibit more severe forms of diabetes complications” making diabetes a major health concern for this ethnic group (Stern & Haffner, 1990, p. 41).  Because of California’s large and rapidly growing Hispanic population the high incidence of diabetes in this ethnic group poses a serious problem for the already strained public health system.

            Studies reveal that the numbers of Hispanic adolescents and young adults diagnosed with pre-diabetes and type II diabetes has soared (e.g., Brown et al., 2002; National Institute of Health, 2004).  In a recent publication by the National Institute of Health (2004), it was reported that over the past ten years the rate of obesity has doubled among Hispanic youth, and that a “large number of overweight youth already have obesity related complications including impaired glucose tolerance, which can lead to diabetes.”

            Hispanics in college exhibit similar lifestyle patterns observed in the general population that are linked to obesity and an increased risk for diabetes.  In a national study of college students that compared the levels of physical activity among different ethnic groups, it was found that ethnic minorities, among them Hispanics, reported lower levels of physical activity when compared to White students (Suninski, Petosa, Utter, & Zhang, 2002). In regard to dietary patterns, Patten (1994) noted that students’ poor dietary practices (high fat, refined sugar and carbohydrates) were of particular concern when it came to Hispanic students who were three times more likely to develop diabetes.

There is a paucity of research on diabetes in college students.  The little research that has been done focuses primarily on individuals afflicted with type I diabetes, which has its onset during childhood or early adolescence.  Systematic studies have not been conducted on ethnic minority students who present a high-risk profile for developing type II diabetes.  Accordingly, the present research project fills this void in the literature by examining the mental models of Hispanic students who are at risk for type II diabetes.

 

Method

Participants.  Focus group participants will consist of a total of 30 Latino students who are at high risk for developing type II diabetes (i.e., have a parent or sibling currently afflicted with the disease).  Currently 16 men and women have participated in small focus group discussions concerning their beliefs surrounding type II diabetes.  Participants were compensated with $20.00 for their involvement in this study. (The remaining data collection – 14 more participants - will be completed by February 2007.)

Focus Group Methodology.  The interview protocol explores the following content areas: (1) knowledge of diabetes and the nature of the disease; (2) causes and misconceptions of diabetes; (3) effects of diabetes on family functioning; (4) level of involvement in caring for afflicted relative; (5) perceived risk for acquiring the disease; and (6) changes in lifestyles as a result of experiencing diabetes within the family.

Focus groups are moderated by bilingual investigators, who instruct participants on the ground rules for dialogue and discussion.  Interview sessions take approximately 60-90 minutes.  An educational debriefing follows the focus group discussions and consists of diabetes informational brochures, an educational diabetes video clip, and a question-and-answer period.  Finally, participants are referred to the campus health center and/or advised to see their primary care physician for pre-diabetes testing and a general health evaluation.

 

Results and Discussion

Preliminary comparative analyses of the focus group data revealed several emerging themes concerning Latinos’ beliefs regarding diabetes and the impact of the disease on themselves and on their families.  The majority of the focus group participants believed that (1) diabetes was an inherited disease that affected the blood and was caused and/or impacted by poor diet and a sedentary lifestyle.  Furthermore, several noted that (2) the onset of the disease could be triggered by a major life event or stressor.  In relation to the impact of diabetes on the family, many participants noted that (3) a key stressor for their families was the lack of adequate medical insurance to cover the costs of office visits and medications.  Some discussed that (4) their family members resort to folk remedies as an alternative medicine and trust these sources more so than the traditional medical establishment.  (5) Most participants were involved in their diabetic relative’s care as language brokers or providing other instrumental/emotional types of support.  Other themes to emerge from participants’ commentaries were that (6) developing diabetes in the future was a major concern and that (7) they worried mostly of the impact that having diabetes would have on their present/future children.  Similarly, participants were concerned that their own children (present and/or future) may inherit the disease from them. Most participants were acutely aware of (8) the potentially devastating effects of type II diabetes on an individual’s health and many spoke of (9) having taken steps to reduce their risk of developing diabetes by changing their diets and/or exercise habits.  Finally, most participants spoke of (10) the tremendous need for educating the Latino community about type II diabetes and that diabetes was a disease that affected Latinos most acutely.

 

Conclusion

In short, the high incidence of diabetes reported among Hispanics is said to pose a serious public health problem for the state of California (County of Los Angeles Health Services, 2003). Because of genetic factors and changes in lifestyle due to acculturation, Hispanic men and women tend to be diagnosed with diabetes at younger ages and to develop more serious forms of the disease (American Diabetes Association, 2002). Because of Hispanics’ heightened risk for type II diabetes, this type of research that examines the experiences of young Hispanics living in Southern California is particularly important.