Abstract
Little research has examined associations of social support with diabetes (or other physical health outcomes) in Hispanics, who are at elevated risk. We examined associations between social support and diabetes prevalence in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Participants were 5,181 adults, 18–74 years old, representing diverse Hispanic backgrounds, who underwent baseline exam with fasting blood draw, oral glucose tolerance test, medication review, sociodemographic assessment, and sociocultural exam with functional and structural social support measures. In adjusted analyses, one standard deviation higher structural and functional social support related to 16 and 15 % lower odds, respectively, of having diabetes. Structural and functional support were related to both previously diagnosed diabetes (OR = .84 and .88, respectively) and newly recognized diabetes prevalence (OR = .84 and .83, respectively). Higher functional and structural social support are associated with lower diabetes prevalence in Hispanics/Latinos.
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Notes
We use “Hispanic” to encompass the terms Hispanic, Latino, and others that may be favored by certain ethnic or geographic groups, acknowledging that there are differences of opinion regarding the meaning and relevance of these terms.
Additional control for BMI did not substantively alter results. In addition, BMI is viewed as a pathway through which support could relate to diabetes, rather than a confounding factor; thus, BMI was excluded from models.
References
Adam, T. C., & Epel, E. S. (2007). Stress, eating and the reward system. Physiology & Behavior, 91, 449–458. doi:10.1016/j.physbeh.2007.04.011
American Diabetes Association. (2013a). Diagnosis and classification of diabetes mellitus. Diabetes Care, 36, S67–S74. doi:10.2337/dc13-S067
American Diabetes Association. (2013b). Economic costs of diabetes in the U.S. in 2012. Diabetes Care, 36, 1033–1046. doi:10.2337/dc12-2625
Arias, E., Eschbach, K., Schauman, W. S., Backlund, E. L., & Sorlie, P. D. (2010). The Hispanic mortality advantage and ethnic misclassification on US death certificates. American Journal of Public Health, 100, S171–S177. doi:10.2105/AJPH.2008.135863
Ayala, G. X., Carnethon, M., Arredondo, E., Delamater, A. M., Perreira, K., Van Horn, L., et al. (2014). Theoretical foundations of the Study of Latino (SOL) Youth: Implications for obesity and cardiometabolic risk. Annals of Epidemiology, 24, 36–43. doi:10.1016/j.annepidem.2013.10.011
Barth, J., Schneider, S., & Von Känel, R. (2010). Lack of social support in the etiology and the prognosis of coronary heart disease: A systematic review and meta-analysis. Psychosomatic Medicine, 72, 229–238.
Beaudry, J. L., & Riddell, M. C. (2012). Effects of glucocorticoids and exercise on pancreatic β-cell function and diabetes development. Diabetes/Metabolism Research and Reviews, 28, 560–573. doi:10.1002/dmrr.2310
Bell, C. N., Thorpe, R. J., Jr, & Laveist, T. A. (2010). Race/ethnicity and hypertension: The role of social support. American Journal of Hypertension, 23, 534–540. doi:10.1038/ajh.2010.28
Black, P. H. (2006). The inflammatory consequences of psychologic stress: Relationship to insulin resistance, obesity, atherosclerosis and diabetes mellitus, type II. Medical Hypotheses, 67, 879–891.
Bolger, N., Foster, M., Vinokur, A. D., & Ng, R. (1996). Close relationships and adjustments to a life crisis: The case of breast cancer. Journal of Personality and Social Psychology, 70, 283–294.
Brissette, I., Cohen, S., & Seeman, T. E. (2000). Measuring social integration and social networks. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 53–85). New York, NY: Oxford University Press.
Buren, J., & Eriksson, J. W. (2005). Is insulin resistance caused by defects in insulin’s target cells or by a stressed mind? Diabetes/Metabolism Research and Reviews, 21, 487–494. doi:10.1002/dmrr.567
Buttenheim, A. M., Pebley, A. R., Hsih, K., Chung, C. Y., & Goldman, N. (2013). The shape of things to come? Obesity prevalence among foreign-born vs. US-born Mexican youth in California. Social Science and Medicine, 78, 1–8. doi:10.1016/j.socscimed.2012.10.023
Campbell, J., Walker, R., Smalls, B., & Egede, L. (2012). Glucose control in diabetes: The impact of racial differences on monitoring and outcomes. Endocrine, 42, 471–482. doi:10.1007/s12020-012-9744-6
Caplan, S. (2007). Latinos, acculturation, and acculturative stress: A dimensional concept analysis. Policy, Politics, & Nursing Practice, 8, 93–106. doi:10.1177/1527154407301751
Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M., Jr. (1997). Social ties and susceptibility to the common cold. JAMA, 277, 1940–1944. doi:10.1001/jama.1997.03540480040036
Cohen, S., Mermelstein, R., Kamarck, T., & Hoberman, H. M. (1985). Measuring the functional components of social support. In I. G. Sarason & B. R. Sarason (Eds.), Social support: Theory, research, and applications (pp. 73–94). The Hague: Martinus Nijhoff. doi:10.1007/978-94-009-5115-0_5
Cortes-Bergoderi, M., Goel, K., Murad, M. H., Allison, T., Somers, V. K., Erwin, P. J., et al. (2013). Cardiovascular mortality in Hispanics compared to non-Hispanic whites: A systematic review and meta-analysis of the Hispanic paradox. European Journal of Internal Medicine, 24, 791–799. doi:10.1016/j.ejim.2013.09.003
Cosgrove, M. P., Sargeant, L. A., Caleyachetty, R., & Griffin, S. J. (2012). Work-related stress and Type 2 diabetes: Systematic review and meta-analysis. Occupational Medicine, 62, 167–173.
Cowie, C. C., Rust, K. F., Ford, E. S., Eberhardt, M. S., Byrd-Holt, D. D., Li, C., et al. (2009). Full accounting of diabetes and pre-diabetes in the U.S. population in 1988–1994 and 2005–2006. Diabetes Care, 32, 287–294.
Coyne, J. C., Rohrbaugh, M. J., Shoham, V., Sonnega, J. S., Nicklas, J. M., & Cranford, J. A. (2001). Prognostic importance of marital quality for survival of congestive heart failure. American Journal of Cardiology, 88, 526–529.
Daviglus, M. L., Talavera, G. A., Aviles-Santa, M. L., Allison, M., Cai, J., Criqui, M. H., et al. (2012). Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. JAMA, 308, 1775–1784. doi:10.1001/jama.2012.14517
Elder, J. P., Ayala, G. X., Parra-Medina, D., & Talavera, G. A. (2009). Health communication in the Latino community: Issues and approaches. Annual Revivew of Public Health, 30, 227–251. doi:10.1146/annurev.publhealth.031308.100300
Ennis, S. R., Rios-Vargas, M., & Albert, N. (2011). The Hispanic population: 2010 Census Briefs. US Census Bureau. http://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf
Fortmann, A. L., & Gallo, L. C. (2013). Social support and nocturnal blood pressure dipping: A systematic review. American Journal of Hypertension, 26, 302–310. doi:10.1093/ajh/hps041f
Fortmann, A. L., Gallo, L. C., & Philis-Tsimikas, A. (2011). Glycemic control among Latinos with type 2 diabetes: The role of social-environmental support resources. Health Psychology, 30, 251–258. doi:10.1037/a0022850
Gallant, M. P. (2003). The influence of social support on chronic illness self-management: A review and directions for research. Health Education & Behavior, 30, 170–195. doi:10.1177/1090198102251030
Gallo, L. C., Penedo, F. J., Carnethon, M., Isasi, C., Sotrez-Alvarez, D., Malcarne, V. L., et al. (2014). The Hispanic community health study/study of Latinos sociocultural ancillary study: Sample, design, and procedures. Ethnicity and Disease, 24, 77–83.
Gallo, L. C., Penedo, F. J., Espinosa De Los Monteros, K., & Arguelles, W. (2009). Resiliency in the face of disadvantage: Do Hispanic cultural characteristics protect health outcomes? Journal of Personality, 77, 1707–1746. doi:10.1111/j.1467-6494.2009.00598.x
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., et al. (2013). Heart disease and stroke statistics—2014 update: A report from the American Heart Association. Circulation,. doi:10.1161/01.cir.0000441139.02102.80
Gorman, B. K., & Sivaganesan, A. (2007). The role of social support and integration for understanding socioeconomic disparities in self-rated health and hypertension. Social Science and Medicine, 65, 958–975. doi:10.1016/j.socscimed.2007.04.017
Harris, M. I. (2001). Racial and ethnic differences in health care access and health outcomes for adults with type 2 diabetes. Diabetes Care, 24, 454–459. doi:10.2337/diacare.24.3.454
Hogan, B. E., Linden, W., & Najarian, B. (2002). Social support interventions: Do they work? Clinical Psychology Review, 22, 383–442. doi:10.1016/S0272-7358(01)00102-7
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7, e1000316. doi:10.1371/journal.pmed.1000316
Isasi, C. R., Carnethon, M. R., Ayala, G. X., Arredondo, E., Bangdiwala, S. I., Daviglus, M. L., et al. (2014). The Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth): Design, objectives, and procedures. Annals of Epidemiology, 24, 29–35. doi:10.1016/j.annepidem.2013.08.008
Jasso, G., Massey, D. S., Rosenzweig, M. R., & Smith, J. P. (2004). Immigrant health-selectivity and acculturation. In N. B. Anderson, R. A. Bulatao, & B. Cohen (Eds.), Critical perspectives on racial and ethnic differences in health in late life (pp. 227–266). Washington, DC: National Academies Press.
Kershaw, E. F., & Flier, J. S. (2004). Adipose tissue as an endocrine organ. The Journal of Clinical Endocrinology & Metabolism, 89, 2548–2556. doi:10.1210/jc.2004-0395
Kumari, M., Head, J., & Marmot, M. (2004). Prospective study of social and other risk factors for incidence of type 2 diabetes in the Whitehall II study. Archives of Internal Medicine, 164, 1873–1880. doi:10.1001/archinte.164.17.1873
Kurian, A. K., & Cardarelli, K. M. (2007). Racial and ethnic differences in cardiovascular disease risk factors: A systematic review. Ethnicity and Disease, 17, 143–152.
Kyrou, I., & Tsigos, C. (2009). Stress hormones: Physiological stress and regulation of metabolism. Current Opinion in Pharmacology, 9, 787–793. doi:10.1016/j.coph.2009.08.007
Lakey, B., & Cohen, S. (2000). Social support theory and measurement. In S. Cohen, L. G. Underwood & B. H. Gottlieb (Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 29–52). Oxford: Oxford University Press.
Lanting, L. C., Joung, I. M., Mackenbach, J. P., Lamberts, S. W., & Bootsma, A. H. (2005). Ethnic differences in mortality, end-stage complications, and quality of care among diabetic patients: A review. Diabetes Care, 28, 2280–2288. doi:10.2337/diacare.28.9.2280
Lavange, L. M., Kalsbeek, W. D., Sorlie, P. D., Avilès-Santa, L. M., Kaplan, R. C., Barnhart, J., et al. (2010). Sample design and cohort selection in the Hispanic Community Health Study/Study of Latinos. Annals of Epidemiology, 20, 642–649. doi:10.1016/j.annepidem.2010.05.006
Markides, K. S., & Eschbach, K. (2011). Hispanic paradox in adult mortality in the United States. In R. G. Rogers & E. M. Crimmins (Eds.), International handbook of adult mortality (Vol. 2, pp. 227–240). Berlin: Springer.
Mcewen, B. S. (2012). Brain on stress: How the social environment gets under the skin. Proceedings of the National Academy of Science, 109, 17180–17185. doi:10.1073/pnas.1121254109
Merz, E. L., Roesch, S. C., Malcarne, V. L., Penedo, F. J., Llabre, M. M., Weitzman, O. B., et al. (2014). Validation of Interpersonal Support Evaluation List-12 (ISEL-12) scores among English- and Spanish-speaking Hispanics/Latinos from the HCHS/SOL Sociocultural Ancillary Study. Psychological Assessment, 26, 384–394. doi:10.1037/a0035248
Mookadam, F., & Arthur, H. M. (2004). Social support and its relationship to morbidity and mortality after acute myocardial infarction: Systematic overview. Archives of Internal Medicine, 164, 1514–1518. doi:10.1001/archinte.164.14.1514
Muthén, L. K., & Muthén, B. O. (2006). Mplus. Los Angeles: Muthén & Muthén.
Norberg, M., Stenlund, H., Lindahl, B., Andersson, C., Eriksson, J. W., & Weinehall, L. (2007). Work stress and low emotional support is associated with increased risk of future type 2 diabetes in women. Diabetes Research and Clinical Practice, 76, 368–377. doi:10.1016/j.diabres.2006.09.002
Olefsky, J. M., & Glass, C. K. (2010). Macrophages, inflammation, and insulin resistance. Annual Review of Physiology, 72, 219–246. doi:10.1146/annurev-physiol-021909-135846
Peckett, A. J., Wright, D. C., & Riddell, M. C. (2011). The effects of glucocorticoids on adipose tissue lipid metabolism. Metabolism, 60, 1500–1510. doi:10.1016/j.metabol.2011.06.012
Perez, G. K., & Cruess, D. (2011). The impact of familism on physical and mental health among Hispanics in the United States. Health Psychology Review, 1–33. doi: 10.1080/17437199.2011.569936
Pescosolido, B. A., & Levy, J. A. (2002). The role of social networks in health, illness, disease and healing: The accepting present, the forgotten past, and the dangerous potential for a complacent future. In J. A. Levy & B. A. Pescosolido (Eds.), Social networks and health (Advances in Medical Sociology) (Vol. 8, pp. 3–25). United Kingdom: Emerald Group Publishing Limited.
Pew Hispanic Center. (2011). Census 2010: 50 Million Latinos. Washington, DC: Pew Hispanic Center.
Pew Hispanic Center. (2014). Statistical portrait of Hispanics in the United States, 2012. Washington, DC: Pew Hispanic Center.
Pinquart, M., & Duberstein, P. R. (2010). Associations of social networks with cancer mortality: A meta-analysis. Critical Reviews in Oncology/Hematology, 75, 122–137. doi:10.1016/j.critrevonc.2009.06.003
Ruiz, J. M., Steffen, P., & Smith, T. B. (2013). Hispanic mortality paradox: A systematic review and meta-analysis of the longitudinal literature. American Journal of Public Health, 103, e52–e60. doi:10.2105/ajph.2012.301103
Schneiderman, N., Llabre, M., Cowie, C., Barnhart, J., Carnethon, M., Gallo, L. C., et al. (2014). Prevalence of diabetes among Hispanics/Latinos from Diverse Backgrounds: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Diabetes Care, 37, 2233–2239. doi:10.2337/dc13-2939
Schollgen, I., Huxhold, O., Schuz, B., & Tesch-Romer, C. (2011). Resources for health: Differential effects of optimistic self-beliefs and social support according to socioeconomic status. Health Psychology, 30, 326–335. doi:10.1037/a0022514
Singh, G. K., Rodriguez-Lainz, A., & Kogan, M. D. (2013). Immigrant health inequalities in the United States: Use of eight major national data systems. Scientific World Journal, 2013, 512313. doi:10.1155/2013/512313
Smith, S. M., & Vale, W. W. (2006). The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress. Dialogues in Clinical Neuroscience, 8, 383–395.
Sorlie, P. D., Avilès-Santa, L. M., Wassertheil-Smoller, S., Kaplan, R. C., Daviglus, M. L., Giachello, A. L., et al. (2010). Design and Implementation of the Hispanic Community Health Study/Study of Latinos. Annals of Epidemiology, 20, 629–641. doi:10.1016/j.annepidem.2010.03.015
Stopford, R., Winkley, K., & Ismail, K. (2013). Social support and glycemic control in type 2 diabetes: A systematic review of observational studies. Patient Education and Counseling, 93, 549–558. doi:10.1016/j.pec.2013.08.016
Teruya, S. A., & Bazargan-Hejazi, S. (2013). The immigrant and Hispanic paradoxes: A systematic review of their predictions and effects. Hispanic Journal of Behavioral Sciences, 35, 486–509. doi:10.1177/0739986313499004
Thoits, P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52, 145–161. doi:10.1177/0022146510395592
Tomaka, J., Thompson, S., & Palacios, R. (2006). The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. Journal of Aging and Health, 18, 359–384. doi:10.1177/0898264305280993
Tsatsoulis, A., Mantzaris, M. D., Bellou, S., & Andrikoula, M. (2013). Insulin resistance: An adaptive mechanism becomes maladaptive in the current environment—an evolutionary perspective. Metabolism, 62, 622–633. doi:10.1016/j.metabol.2012.11.004
Uchino, B. N. (2004). Social support and physical health: Understanding the health consequences of our relationships. New Haven, CT: Yale University Press.
Uchino, B. N. (2006). Social support and health: A review of physiological processes potentially underlying links to disease outcomes. Journal of Behavioral Medicine, 29, 377–387. doi:10.1007/s10865-006-9056-5
Uchino, B. N. (2009). Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support. Perspectives on Psychological Science, 4, 236–255. doi:10.1111/j.1745-6924.2009.01122.x
Uchino, B. N. (2013). Understanding the links between social ties and health: On building stronger bridges with relationship science. Journal of Social and Personal Relationships, 30, 155–162. doi:10.1177/0265407512458659
Uchino, B. N., Bowen, K., Carlisle, M., & Birmingham, W. (2012). Psychological pathways linking social support to health outcomes: A visit with the “ghosts” of research past, present, and future. Social Science and Medicine, 74, 949–957. doi:10.1016/j.socscimed.2011.11.023
Umberson, D., Crosnoe, R., & Reczek, C. (2010). Social relationships and health behavior across the life course. Annual Review of Sociology, 36, 139–157. doi:10.1146/annurev-soc-070308-120011
Van Dam, H. A., Van Der Horst, F. G., Knoops, L., Ryckman, R. M., Crebolder, H. F. J. M., & Van Den Borne, B. H. W. (2005). Social support in diabetes: A systematic review of controlled intervention studies. Patient Education and Counseling, 59, 1–12. doi:10.1016/j.pec.2004.11.001
Viruell-Fuentes, E. A., & Schulz, A. J. (2009). Toward a dynamic conceptualization of social ties and context: Implications for understanding immigrant and Latino health. American Journal of Public Health, 99, 2167–2175. doi:10.2105/ajph.2008.158956
Acknowledgments
The Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following Institutes/Centers/Offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Institute on Minority Health and Health Disparities, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, Office of Dietary Supplements. The HCHS/SOL Sociocultural Ancillary Study was supported by Grant 1 RC2 HL101649 from the NIH/NHLBI (Gallo/Penedo PIs). The authors thank the staff and participants of HCHS/SOL and the HCHS/SOL Sociocultural Ancillary Study for their important contributions.
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Authors Gallo, Fortmann, McCurley, Isasi, Penedo, Daviglus, Roesch, Talavera, Gouskova, Gonzalez, Schneiderman, and Carnethon declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
All procedures followed were in accordance with the 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 participants included in the study.
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Gallo, L.C., Fortmann, A.L., McCurley, J.L. et al. Associations of structural and functional social support with diabetes prevalence in U.S. Hispanics/Latinos: Results from the HCHS/SOL Sociocultural Ancillary Study. J Behav Med 38, 160–170 (2015). https://doi.org/10.1007/s10865-014-9588-z
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DOI: https://doi.org/10.1007/s10865-014-9588-z