High rate of depression found in African-American women at risk for type 2 diabetes

As the cases of type 2 diabetes in African-American women increase at an epidemic rate, researchers are examining risk factors involved with this disease in order to create programs that will hopefully slow this growing problem.

According to a recent study at the George Warren Brown (GWB) School of Social Work at Washington University in St. Louis, African-American women at risk for type 2 diabetes experience long periods of depression due, in part, to a lack of economic and social resources.

“At the beginning of our study, 40 percent of our sample of African-American women at risk for type 2 diabetes reported clinically significant depression,” says Wendy Auslander, Ph.D., professor at GWB and co-author of the study.

Wendy F. Auslander, Ph.D. (left), works with St. Louis-area peer counselors in the
Wendy F. Auslander, Ph.D. (left), works with St. Louis-area peer counselors in the “Eat Well, Live Well” program she pioneered with colleagues at the School of Medicine.

“Unlike their nondepressed peers, these women reported fewer economic assets and greater economic distress. Issues such as unemployment, low self-esteem and a low appraisal of their economic situation contributed to their depression.

“In addition to diet, depression and poverty represent significant risk factors for the development of type 2 diabetes in African-American women,” Auslander notes. “Programs need to be developed to address the social and economic factors associated with depression experienced by African-American women at risk for type 2 diabetes.”

Mary de Groot, Ph.D., assistant professor of psychology at Ohio University and former postdoctoral fellow at GWB, is the lead author of this study, which appeared in a recent issue of the journal Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine (Volume 25, Issue 3).

The National Institute of Diabetes & Digestive & Kidney Diseases, the Office of Research on Minority Health, and the National Heart, Lung and Blood Institute, all of the National Institutes of Health, funded the study.

Unlike other studies about type 2 diabetes and African-American women, this study, “Depression and Poverty Among African-American Women at Risk for Type 2 Diabetes,” documents the rate of depression among African-American women at risk for type 2 diabetes and the relationship between social and economic resources to depression.

“A better understanding of poverty as it relates to depression in African-American women at risk for type 2 diabetes will enable practitioners to adapt and formulate culturally sensitive and socioeconomically appropriate interventions,” says Auslander.

‘Eat Well, Live Well’

Researchers studied 181 African-American women aged 25 to 55 from a large Midwestern urban area. These women were at risk of diabetes due to obesity (≥ 20 percent of ideal body weight or body mass index of > 27), but did not have a current diabetes diagnosis.

The women were interviewed at three different times: at a baseline screening; immediately after completion of a three-month dietary intervention, the “Eat Well, Live Well Nutrition Program”; and three months following the intervention. The interviews gathered information about such issues as economic resources, economic distress, self-esteem, social support and life events.

“Eat Well, Live Well” consisted of six weekly group sessions focusing on dietary changes skills followed by six weekly individual sessions focusing on low-fat dietary patterns.

“Of the original 40 percent of the sample that reported depression, more than 50 percent continued to report significant levels of depression six months later, even after going through the dietary program,” notes Auslander. “The average duration of a major depressive episode is eight to 12 weeks. These women more than exceeded this average.”

An interesting finding from the interviews is that the absence of home ownership was associated with depression at the baseline interview and with persistent depression six months later.

“Many factors associated with home ownership may influence the development of depression, including transiency, quality of one’s environment, marital stability, health and general well-being,” says Auslander. “In addition, home ownership has been observed to be associated with increased life satisfaction.”

In addition to de Groot and Auslander, the other co-authors of this study are James Herbert Williams, Ph.D., the E. Desmond Lee Professor of Racial and Ethnic Diversity at GWB, Michael Sherraden, Ph.D., the Benjamin E. Youngdahl Professor of Social Development at GWB, and Debra Haire-Joshu, Ph.D., professor at the St. Louis University School of Public Health.