141st APHA Annual Meeting and Exposition

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Online Program

292696
Comorbid depression and diabetes and self-rated health: Can health ratings differences be explained by race and ethnicity?


Tuesday, November 5, 2013 : 11:15 a.m. - 11:30 a.m.

Julia Hastings, MSW, PhD, School of Public Health and School of Social Welfare, University at Albany, SUNY, Rensselaer, NY
     
Background: Self-rated health based on a single item has been found to be a strong predictor of health care utilization (Thomas, Sansing, Davis, et al., 2010) and has been examined extensively for individual chronic conditions (Benson, 2010; Maty, James, & Kaplan, 2010). However, few studies examine the predictive nature of self-rated health in the health disparities literature as it relates to African Americans and Caribbean Blacks who experience dual conditions demanding consistent health care.

Objective: To examine the effects of comorbid depression and diabetes on self-rated health.

Methods: Data from the National Survey of American Life sample of 6,082 African Americans, Caribbean Blacks, and Whites were analyzed using descriptive statistics and three logistic regression models on main effects and interaction terms.

Results: Unadjusted Odds Ratios indicated a significant association between comorbidity and self-rated health. Respondents with good health (OR=10.07; 95% CI: 2.92-34.75, P<0.000) were 10.07 more times more likely to have comorbid diabetes and depression compared to respondents with excellent or very good health. Those with fair or poor health (OR=34.17; 95% CI: 11.01-106.00, P<0.000) were 34.17 times more likely to have the comorbidity compared to those with excellent or very good health. Foreign-born individuals rated their health less favorably than native-born Americans. Significant interaction effects were observed.

Conclusions: Results suggest a strong association between comorbid diabetes and depression and self-rated health. Interestingly, analysis did not support “healthy immigrant” effect arguments. Future studies are needed to investigate additional relationships that might help social workers improve treatment access among racial/ethnic populations.

Learning Areas:

Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Describe the epidemiology of comorbid depression and diabetes among African Americans and Caribbean Blacks. Identify, cite, and understand the role of social and community factors that influence self-ratings of health. Explain how professional ethics and practices relate to differences in treatment access among persons experiencing comorbid conditions.

Keyword(s): Co-morbid, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am assistant professor of social welfare and public health. I have been the principal investigator of federally funded grants focusing on African American mental health and health outcomes. I authored book chapters on Health Insurance and Access and data collection among African Americans. Moreover, I have authored several manuscripts and coordinated symposiums on diagnosing depression among African Americans. I am the MSW-MPH program Advisor and teach a Poverty, Behavioral Health, and Health Policy course.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4148.0: Strengthening access to care for at-risk populations