Black men who report bias at the doctor's office talk less about their diabetes, A&M public health studies find

Black men with Type 2 diabetes who say they have faced discrimination in medical settings tend to talk less about their diabetes with the people around them, even while they stay in close contact with those same people, according to two studies from the Texas A&M University School of Public Health.

Tyler Prochnow, an associate professor in the school, and colleagues used responses from 1,225 Black and African American men nationwide who live with the disease. The work appears in the Journal of Racial and Ethnic Health Disparities and in Social Science & Medicine, the university said in an Oct. 28 announcement.

Two kinds of discrimination

The researchers measured discrimination with the Everyday Discrimination Scale, which asks about things like being treated with less respect, getting poorer service or being treated as less intelligent, and used a version adapted to doctor's offices.

The two kinds pointed in different directions. Everyday discrimination went along with more conversation of every type, diabetes included. Discrimination in healthcare settings went along with more general conversation but less talk about diabetes. That matters for care because diabetes-specific conversations were strongly tied to self-care in the data.

"They are still connected, still reaching out. What goes quiet is the health conversation specifically," Prochnow said in the university's release.

More contact is not always better

The studies also found that frequent communication, including frequent talk about diabetes, was linked to worse mental health. Where a man's circle was made up largely of people he considered truly supportive, he tended to report stronger mental health and better self-management.

Prochnow said the findings point health providers toward culturally responsive support rather than simply more frequent contact. "Even one person who is genuinely in it with a patient appears to be worth more than a large circle of people," he said.

The university notes that Type 2 diabetes is diagnosed more often among Black adults than among non-Hispanic white adults, and that serious complications are also more common. Co-authors include Ledric Sherman and Meg Patterson, also of A&M's public health school, and Matthew Lee Smith of Indiana University's public health school.

Sources

stories.tamu.edu