Hollingsworth 1

Jada Hollingsworth
April 11, 2016
African American Health

Psychosocial/Behavioral Theories
According to the CDC, Diabetes is the condition in which the body does not properly
process food for use as energy. Most of the food we eat is turned into glucose, or sugar, for our
bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone
called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body
either doesn't make enough insulin or can't use its own insulin as well as it should. This causes
sugars to build up in your blood. This is why many people refer to diabetes as sugar (CDC).
According to the U.S. National Library of Medicine, Type 1 diabetes is a lifelong (chronic)
disease in which there is a high level of sugar (glucose) in the blood (NLM). The risk of getting
diabetes could be dependent on what you eat, genetics, or your quality of life.
Psychosocial refers to involving both psychological and social aspects; for example,
age, education, marital and related aspects of a person's history (Medical Dictionary).
Behavioral, on the other hand, pertains to how a person acts. Chamberlain states that
Psychosocial factors are implicated in all aspects of the disease and its treatment. Factors such
as patient understandings and attitudes, stress, coping and social support impact, directly and
indirectly, on successful adherence to treatment and the control of blood glucose levels. Diabetic
individuals can suffer impaired quality of life, affective and dietary disorders, and sexual
dysfunction as a consequence of the disease, and psychosocial factors are utilized in
interventions to prevent these (Chamberlain, 2011). There has been many research on the

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psychosocial factors of diabetes, for example Glasgow and associates stated in one of their
research statements that we begin by defining what we mean by psychosocial barriers.
Websters dictionary defines a barrier as something immaterial that impedes or separates. In
our case, we are concerned with psychological and interpersonal factors that impede diabetes
management or diabetes-related quality of life (Glasgow, 2001). The American Diabetes
Association states that a substantial amount of behavioral science research has demonstrated
that psychosocial factors play an integral role in the management of diabetes in both children and
adults. Research has also shown the efficacy of a number of psychosocial therapies that can
improve regimen adherence, glycemic control, psychosocial functioning, and quality of life
(Delamater). Psychosocial or behavioral aspects play a large role in the attainment or treatment
of diabetes.
According to Diabetic Gourmet, like other chronic illnesses, diabetes mellitus poses a
wide range of problems for patients and their family members. These problems include pain,
hospitalization, changes in lifestyle and vocation, physical disabilities, and threatened survival.
Direct psychological consequences can arise from any one of these factors, making it harder for
patients to treat their diabetes and live productive, enjoyable lives. This excerpt in general,
could be related to the weathering theory. Basically, the effects of Diabetes on your body,
eventually begins to wear you down. Whether that be physically, which is to be expected, or even
mentally. It is possible that youth diagnosed with diabetes can sometimes eventually lead to
eating disorders, and other psychological issues. The CDC stated that Diabetes can cause
serious health complications including heart disease, blindness, kidney failure, and lowerextremity amputations. Diabetes is the seventh leading cause of death in the United States

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(CDC). By weather, the mind and body wears down, causing much more harm than the initial
intent.
John Henryism is another theory that can be used to describe the resilience of the African
American community, including those faced with diseases such as diabetes. John Henry, the
figure from American folklore who worked himself to death to beat a steam engine, is a key to
understanding the medical reality of African Americans in the 21st century. John Henryism, is a
coping style that has a clear genetic basis in African Americans and reflects clear personality
traits. The effects of John Henryism are apparent in clinical and non-clinical settings, can
influence emotional reactions and may impact how African Americans function in their everyday
lives. Psychologists have formally recognized John Henryism as a style of strong coping
behaviors used by many African Americans to deal with psychosocial and environmental
stressors such as career issues, health problems and even racism (Duke, 2006). John Henryism
is a sign of resilience in the terms of diabetes, but really for any disease because if you give up,
youll lose the battle. Diabetes is incurable, but it is treatable, so you have to be mentally strong
to survive or you arent going to make it. You have to be resilient to survive.

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Biogenetic and Environmental Interactions

Risk exposure, or the high prevalence of risk threats of social or environmental threats in
predominantly minority communities, as well as resource deprivation where minorities are more
likely to live that dont have the appropriate infrastructure to support life, are environmental
factors that relate to the health status of minorities. Diabetes is related to sugar intake. Nutrition
has been suggested as an important environmental factor other than viruses and chemicals in the
pathogenesis of type 1 diabetes (Kagohashi, 2015). Diabetes, in terms of diet, is based off of
artificial sugars and sweeteners such as cane sugar or things like Splenda. Natural sugars such as
the ones in fruits, do not lead to Diabetes. If the area is low income or does not have the
resources it needs such as transportation or proper places to shop to get their food choices, then
natural sugars may not be available to them. Diabetes can be linked to other unhealthy food
choices as well, which all relate back to what is available within their community.
According to the CDC, Diabetes is very prevalent among blacks. Blacks are 1.7 times as
likely to develop diabetes as whites; The prevalence of diabetes among blacks has quadrupled
during the past 30 years; Among blacks age 20 and older, about 2.3 million have diabetes 10.8
percent of that age group; Blacks with diabetes are more likely than non-Hispanic whites to
develop diabetes and to experience greater disability from diabetes-related complications such as
amputations, adult blindness, kidney failure, and increased risk of heart disease and stroke; Death
rates for blacks with diabetes are 27 percent higher than for whites (CDC). This could be due to
Biological, Behavioral, or Socioenvironmental factors.
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Socio-Environmental Theories
Quality of life can lead to the acquisition of different diseases, or even the prolonging of
them. It can make your experience easier, or much more difficult. Socio factors refer to where
you live, income, age, crime rate and things of that nature whereas environmental refers to the air
land and water quality of the area. If these things are not up to par, it can have a negative effect
on your health and your body. Research in South Korea has proven that Diabetes mellitus is the
result of complex interactions involving many genes and environmental factors, and rapid socioenvironmental changes which have been strongly associated with the development of diabetes.
Along with increasing diabetes-related mortality, many socio-economic, proxies for physical
activity and diet indices showed remarkable changes (Choi, 2006). Although this research was
done on Koreans, as a minority, it can still relate to African Americans.
Other studies such as the one that is about to be shown have looked into the fact that
socioenvironmental factors play a role in your health status. Type 1 Diabetes occurs when the
body's immune system turns against itself so that, in a very specific and targeted way, it destroys
the pancreatic -cells. Type 1 Diabetes results from poorly defined interactions between
susceptibility genes and environmental determinants. In contrast to the rapid progress in finding
Type 1 Diabetes genes, identification and confirmation of environmental determinants remain a
formidable challenge (Rnningen, 2015). So many African Americans are more likely to get
certain diseases due to racial ethnic segregation, where they are subject to worse outcomes
simply because of their environment.

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References
Psychosocial. Medical Dictionary. http://medical-dictionary.thefreedictionary.com/psychosocial
Diabetes and Psychosocial Problems http://diabeticgourmet.com/articles/9.shtml
Chamberlain, K. (2011) Diabetes: Psychological Aspects
http://www.sciencedirect.com/science/article/pii/B0080430767037876
Glasgow, Russell et al (2001). Psychosocial Barriers to Diabetes Self-Management and Quality
of Life http://spectrum.diabetesjournals.org/content/14/1/33.full
Psychosocial Aspects of Diabetes in Adult Populations http://www.niddk.nih.gov/aboutniddk/strategic-plans-reports/Documents/Diabetes%20in%20America %202nd
%20Edition/chapter24.pdf
Delamater, Alan et al (2001). Psychosocial Therapies in Diabetes. American Diabetes
Association http://care.diabetesjournals.org/content/24/7/1286.long
10.2337/diacare.24.7.1286 Diabetes Care July 2001 vol. 24 no. 7 1286-1292
Duke Medicine (2006). http://corporate.dukemedicine.org/news_and_publications
/news_office/news/9546
Choi, YJ et al (2006). Rapidly increasing diabetes-related mortality with socio-environmental changes in
South Korea during the last two decades http://www.ncbi.nlm.nih.gov/pubmed /
16707191
Rnningen, KS (2015). Environmental Triggers of Type 1 Diabetes
http://www.ncbi.nlm.nih.gov/pubmed/25883954 ?dopt=Abstract Tidsskr Nor Laegeforen.
2007 Sep 20;127(18):2405-8.

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Eringsmark, Regnll (2013). The environment and the origins of islet autoimmunity and Type 1
diabetes http://www.ncbi.nlm.nih.gov/pubmed/23252770 Diabet Med. 2013
Feb;30(2):155-60. doi: 10.1111/dme.12099.
Kagohashi, Y (2015). Nutritional Factors In Early Life Leading To Type 1 Diabetes
http://www.ncbi.nlm.nih.gov/pubmed/25883958?dopt=Abstract Biomed Res Int.
2015;2015:382165. doi: 10.1155/2015/382165. Epub
Tamayo, T (2010) Impact of Early Psychosocial Factors (Childhood Socioeconomic Factors and
Adversities) on Future Risk of Type 2 Diabetes, Metabolic Disturbances and Obesity: A
Systematic Review http://www.medscape.com/viewarticle/730030 BMC Public Health.
2010 Sep 1; 10:525. doi: 10.1186/1471-2458-10-525.
The Psychological and Social Impact of Type 2 Diabetes http://www.health.am/db/more/thepsychological-and-social-impact-of-type-2-diabetes/
CDC. What Is Diabetes? http://www.cdc.gov/media/presskits/aahd/diabetes.pdf
NLM. U.S. National Library of Medicine. What Is Type 1 Diabetes?
https://www.nlm.nih.gov/medlineplus/ency/article/000305.htm