Experiences of Discrimination and Incident Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA)

Kara M Whitaker; Susan A Everson-Rose; James S Pankow; Carlos J Rodriguez; Tené T Lewis; Kiarri N Kershaw; Ana V Diez Roux; Pamela L Lutsey

doi:10.1093/aje/kwx047

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Experiences of Discrimination and Incident Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA)

Journal article

Open access

Peer reviewed

Experiences of Discrimination and Incident Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA)

Kara M Whitaker, Susan A Everson-Rose, James S Pankow, Carlos J Rodriguez, Tené T Lewis, Kiarri N Kershaw, Ana V Diez Roux and Pamela L Lutsey

American journal of epidemiology, Vol.186(4), pp.445-455

08/15/2017

DOI: 10.1093/aje/kwx047

PMCID: PMC5860562

PMID: 28407040

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Abstract

Experiences of discrimination are associated with increased risk of adverse health outcomes; however, it is unknown whether discrimination is related to incident type 2 diabetes mellitus (diabetes). We investigated the associations of major experiences of discrimination (unfair treatment in 6 situations) and everyday discrimination (frequency of day-to-day experiences of unfair treatment) with incident diabetes among 5,310 participants from the Multi-Ethnic Study of Atherosclerosis, enrolled in 2000-2002. Using Cox proportional hazards models, we estimated hazard ratios and confidence intervals, adjusting for demographic factors, depressive symptoms, stress, smoking, alcohol, physical activity, diet, waist circumference, and body mass index. Over a median follow-up of 9.4 years, 654 diabetes cases were accrued. Major experiences of discrimination were associated with greater risk of incident diabetes when modeled continuously (for each additional experience of discrimination, hazard ratio = 1.09, 95% confidence interval: 1.01, 1.17) or categorically (for ≥2 experiences vs. 0, hazard ratio = 1.34, 95% confidence interval: 1.08, 1.66). Similar patterns were observed when evaluating discrimination attributed to race/ethnicity or to a combination of other sources. Everyday discrimination was not associated with incident diabetes. In conclusion, major experiences of discrimination were associated with increased risk of incident diabetes, independent of obesity or behavioral and psychosocial factors. Future research is needed to explore the mechanisms of the discrimination-diabetes relationship.

United States - epidemiology

Asian Americans - statistics & numerical data

Humans

Middle Aged

Hispanic Americans - statistics & numerical data

Male

Educational Status

Hispanic Americans - psychology

Incidence

European Continental Ancestry Group - psychology

Diabetes Mellitus, Type 2 - ethnology

Exercise

Social Discrimination - psychology

Aged, 80 and over

Asian Americans - psychology

Diabetes Mellitus, Type 2 - etiology

Female

Body Mass Index

Diabetes Mellitus, Type 2 - psychology

Proportional Hazards Models

Stress, Psychological - ethnology

European Continental Ancestry Group - statistics & numerical data

Atherosclerosis - ethnology

Marital Status

African Americans - statistics & numerical data

Aged

Longitudinal Studies

Stress, Psychological - complications

Stress, Psychological - etiology

African Americans - psychology

Stress, Psychological - physiopathology

Details

Title: Subtitle: Experiences of Discrimination and Incident Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA)
Creators: Kara M Whitaker
Susan A Everson-Rose
James S Pankow
Carlos J Rodriguez
Tené T Lewis
Kiarri N Kershaw
Ana V Diez Roux
Pamela L Lutsey
Resource Type: Journal article
Publication Details: American journal of epidemiology, Vol.186(4), pp.445-455
Publisher: United States
DOI: 10.1093/aje/kwx047
PMID: 28407040
PMCID: PMC5860562
ISSN: 0002-9262
eISSN: 1476-6256
Grant note: N01HC95169 / NHLBI NIH HHS N01HC95161 / NHLBI NIH HHS T32 HL007779 / NHLBI NIH HHS N01HC95164 / NHLBI NIH HHS N01HC95160 / NHLBI NIH HHS N01HC95167 / NHLBI NIH HHS N01HC95159 / NHLBI NIH HHS N01HC95163 / NHLBI NIH HHS N01HC95166 / NHLBI NIH HHS P60 MD002249 / NIMHD NIH HHS N01HC95168 / NHLBI NIH HHS UL1 TR000040 / NCATS NIH HHS UL1 TR001079 / NCATS NIH HHS N01HC95165 / NHLBI NIH HHS N01HC95162 / NHLBI NIH HHS
Language: English
Date published: 08/15/2017
Academic Unit: Epidemiology; Health and Human Physiology
Record Identifier: 9984002359502771

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