Abstract
Evidence for a bi-directional relationship of depression and type 2 diabetes suggests that social distress plays a role in depression among people with diabetes. In this study, we examine the relationship between subjective distress and depression in 121 first- and second-generation Mexican immigrant women seeking diabetes care at a safety-net hospital in Chicago. We used a mixed-methods approach including narrative interview, survey, and finger-stick blood HbA1c data. Using grounded theory analysis, we identified seven life stressors from narrative interviews: interpersonal abuse, stress related to health, family, neighborhood violence, immigration status, and work, and feeling socially detached. Women reported unusually high rates of interpersonal abuse (65%) and disaggregated physical abuse (54%) and sexual abuse (23%). We evaluated depression using CES-D cut-off points of 16 and 24 and assessed rates to be 49 and 34%, respectively. We found that interpersonal abuse was a significant predictor of depression (CESD ≥ 24) in bivariate (OR 3.97; 95% CI 1.58–10.0) and multivariate (OR 5.51; 95% CI 1.85, 16.4) logistic regression analyses. These findings suggest that interpersonal abuse functions as an important contributor to depression among low-income Mexican immigrant women and should be recognized and addressed in diabetes care.
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Acknowledgment
The authors wish to thank the women at John H. Stroger, Jr. Hospital of Cook County for participating in this study and sharing so openly their stories. In addition, thank you to the staff at the GMC for providing support and space for this study amidst their busy schedules. Thank you to Erin P. Finley and Kenneth Maes for reading early drafts of the manuscript and to the anonymous reviewers for their insightful comments. Emily Mendenhall was supported by the National Science Foundation (Grant #1024116), Cells to Society at Northwestern University, and The Graduate School at Northwestern University. We are also grateful to the Russell Sage Foundation because they supported Dr. Elizabeth Jacob and the preliminary work that inspired this study.
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Mendenhall, E., Jacobs, E.A. Interpersonal Abuse and Depression Among Mexican Immigrant Women with Type 2 Diabetes. Cult Med Psychiatry 36, 136–153 (2012). https://doi.org/10.1007/s11013-011-9240-0
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DOI: https://doi.org/10.1007/s11013-011-9240-0