Understanding the Dynamics of Living with Diabetes Among African American Men

1
Understanding the Dynamics of Living with
Diabetes Among African American Men

• Apophia Namageyo-Funa
• May 6, 2008

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CDC Disclaimer

• The findings and conclusions in this presentation
  are those of the author(s) and do not necessarily
  represent the views of the Centers for Disease
  Control and Prevention/
• the Agency for Toxic Substances and Disease
  Registry.

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Background

• African American men compared to men and women in
  other racial/ethnic groups in the US1
• lowest life expectancy
• highest death rate
• African American men have higher rates than non
  Hispanic White/Asian/Pacific Islander men1
• hospital admissions for diabetes complications
• hypertension
• angina

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Background

• In 2003, 7.0 of African American men had
  diagnosed diabetes, compared with 5.1 of white
  men.2
• African American men experienced3
• poorer levels of glycemic control
• higher rates of diabetes-related complications

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Purpose

• To better understand the psychosocial
• perspectives and behaviors of African
• American men with diabetes

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Theory

• Illness narratives by Arthur Kleinman4
• Life History
• Symptom Symbols
• Culturally Marked Disorder
• Patient and Family Explanatory Model
• Personal and Interpersonal Significance

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Methods

• In-depth semi-structured interviews
• Purposive sampling used to recruit African
  American men in southeast Raleigh, NC
• Diagnosed diabetes for at least 2 years
• Asked questions about the impact of cultural
  context on diabetes management
• Analysis was conducted by 2 members of the
  research team

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Results

• Demographics
• Information for 16 participants is reported
• The mean age was 54 yrs (range 39-71yrs)
• Mean duration for having diabetes was10.6 yrs
• Time of diagnosis of diabetes
• 1 participant in their 20s,6 participants in
  their 30s, 4 participants in their 40s, 3
  participants in their 50s, and 2 participants in
  their 60s

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Results

• How did you develop diabetes?
• Diet
• Eating lots of foods high in starch and sugars
• Traditional family dietary habits
• Genetics
• Family members with diabetes
• Both diet and genetics

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Results

• How did you find out you had diabetes?
• Some experienced the symptoms
• Excessive thirst
• Frequent urination
• Weight loss
• Some did not experience symptoms
• Found out after visiting doctor for other issue
• Had to visit doctor because of a diabetes
  complication

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Results

• What motivates you to manage diabetes?
• Fear of complications
• Loss of independence
• Shortened lifespan
• Compromised quality of life
• Ability to perform sexually
• Relationships affected
• A desire to be healthy

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Results

• How have people treated you differently after
  learning you have diabetes?
• Accepting
• They knew of people who had diabetes
• Provided social support
• Cooked meals that were healthier
• Checked on them to frequently
• Rejection
• Inability to perform in sexual relationships

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Results

• How has knowing that you have diabetes affected
  the way you see yourself?
• Recognize physical limitation
• Less control in what they can do
• Anxious about effects of the disease
• Erectile dysfunction
• Weight loss
• No negative perceptions of self image
• No physical limitations or changes in lifestyle

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Limitations

• The results are not generalizable because
• Sample size
• Sampling method
• Geographic location of the study
• Cultural and social diversity of this population

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Conclusion

• This study highlights the need to develop and
  provide gender-sensitive interventions in "male
  spaces," and conduct research to expand the
  evidence-base for culturally sensitive
  interventions
• The findings underscore diabetes self-management
  challenges and impact of type 2 diagnosis on
  sense of self for African American men
• Health professionals can help address the impact
  of psychosocial factors on diabetes
  self-management

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References

• The Henry J. Kaiser Family Foundation (April
  2007) The Health Status of African American
  Men,. http//www.kff.org/minorityhealth/upload/76
  30.pdf
• Centers for Disease Control and Prevention.
  National diabetes fact sheet general information
  and national estimates on diabetes in the United
  States. Atlanta, GA US Dept. of Health and Human
  Services2005 www.cdc.gov/diabetes/statistics/prev
  /national/tableraceethsex.htm
• Harris MI, Eastman RC, Cowie CC, et al. Racial
  and ethnic differences in glycemic control of
  adults with type 2 diabetes. Diabetes Care 1999
  22(3)403-408
• Kleinman A The Illness Narratives Suffering,
  Healing the Human Condition. New York, Basic
  Books, 1988
• Literature on this study
• Liburd L, Namageyo-Funa A, Jack Jr. L, (2007)
  Understanding Masculinity and the
• Challenges of Managing Type 2 Diabetes Among
  African American Men. Journal of the
• National Medical Association, 995, 550-558
• Liburd, L., Namageyo-Funa, A., Jack, Jr. L.,
  Gregg, E. (2004) Views from Within and
• Beyond Illness Narratives of African American
  Men with Type 2 Diabetes. Diabetes
• Spectrum, 17219-224

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Acknowledgements

• Participants in the Project Direct Study
• Leandris Liburd, PhD, MPH of the CDC
• Leonard Jack, PhD formerly with CDC and now with
  the Louisiana State University

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Thank you

• Questions?