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Sex, race, and the role of relationships in diabetes health: intersectionality matters

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Abstract

Previous research has seldom used an intersectionality framework to consider how sex and race affect diabetes health, nor has it examined the role of sex and race in the well-established link between romantic relationship quality and health. This study targeted 200 adults with type 2 diabetes (46% Black; 45% female) and examined whether sex, race, and the interaction between sex and race predicted behavioral and psychological health, or moderated the link between relationship quality and health outcomes. Black women reported poorer diabetes self-care and lower self-efficacy compared to other groups. Relationship quality was associated with better self-care, increased self-efficacy, and lower depressive symptoms. The association between relationship quality and medication adherence was stronger for Black women, and the association between relationship quality and self-efficacy was stronger for both Black women and White men. Results suggest that Black women with diabetes experience more health disadvantages than other groups, but some of these disadvantages might be attenuated by supportive romantic relationships.

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Notes

  1. Household income was not measured during the initial assessment, but was measured during the 6-month follow-up interview. The average of patient and partner responses was taken. Missing data were imputed.

  2. When we conducted the analyses excluding interracial couples, findings largely remained the same: the marginal effect of sex on diabetes distress became significant, F(1,182) = 5.14, p = .03.

  3. When we conducted the analyses excluding couples with a less recent diagnosis, the significant interaction between sex and race on diabetes self-care became marginal, F(1,181) = 3.71, p = .06.

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Acknowledgements

This research was supported by the National Institutes of Health Grant R01 DK095780, and received recruiting assistance from the University of Pittsburgh Clinical and Translational Science Institute, which is supported by the National Institutes of Health Grant UL1TR000005. The authors are grateful to Tiona Jones, Gianna Davis, Jennifer Melynk, Shaquille Charles, Katilyn Mascatelli, Melissa Zajdel, and Charis Vanderpuye for interviewing the study participants, and to Phuong (Phoebe) Ngoc Dinh for her invaluable comments.

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Authors and Affiliations

  1. Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA, 15213, USA

    Jeanean B. Naqvi, Vicki S. Helgeson & Howard J. Seltman

  2. University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Tiffany L. Gary-Webb

  3. University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA, 15213, USA

    Mary T. Korytkowski

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  1. Jeanean B. Naqvi
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Correspondence to Jeanean B. Naqvi or Vicki S. Helgeson.

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Jeanean B. Naqvi, Vicki S. Helgeson, Tiffany L. Gary-Webb, Mary T. Korytkowski, and Howard J. Seltman declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Naqvi, J.B., Helgeson, V.S., Gary-Webb, T.L. et al. Sex, race, and the role of relationships in diabetes health: intersectionality matters. J Behav Med 43, 69–79 (2020). https://doi.org/10.1007/s10865-019-00057-w

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