Ethnic Identity, Education, and Diabetes in Adult Latinos: Evidence of Ethnic Identity as an Underlying Mechanism of the Latino Health Advantage

Type 2 diabetes is a chronic disease that continues to disproportionately affects Latinos; however, the determinants of variation in diabetes risk within the Latino population are not well understood.  Research indicates that aspects of acculturation, like ethnic identity, are related to mental health in Latinos; however, ethnic identity has not been extensively applied to understanding risk of chronic conditions associated with aging, like diabetes. The objectives of this study are to understand the association between ethnic identity and diabetes, and to evaluate whether educational attainment modifies this relationship.  Data come from the National Latinos and  Asian American Study (N=2522).  Ethnic identity was measured using the Ethnic Identity scale (α = .75). Logistic regression, accounting for the complex study design, was used to assess the relationship between ethnic identity, education, and their interaction on prevalent diabetes. Results reveal that adult Latinos with higher levels of ethnic identity are less likely to have diabetes (OR = .94, 95% CI: .88 - .99) after accounting for age, gender, income, and education.  Education was also significantly related to diabetes (OR = .86, 95% CI: .75 - .99); however, the interaction between ethnic identity and education was not significant (OR = 1.03, 95% CI: .97 – 1.10) indicating that the protective effect of ethnic identity on diabetes declines as education increases. In sum, having a strong ethnic identity is associated with a lower likelihood of diabetes among older Latinos. Future research should examine how ethnic identity may inform prevention and management efforts for this group.