The Impact of Social Determinants on Diabetes Self-Care Practices

There is not much information regarding the effects of self-care practices for minorities diagnosed with diabetes mellitus (DM). When it comes to medical conditions like diabetes, African Americans, Hispanics, and minorities face multiple disparities. Aware of this gap, Jacqueline Moody, Ph.D., RN, ACNS-BC, and an assistant professor of nursing at Lawrence Technological University, is looking into the numerous non-medical aspects that cause diabetes and impact self-care procedures amongst African Americans and Hispanics.

“I want to do a description and discover what the main problem is, whether there are any similarities or correlations between these two populations, and whether they have the same issues with the social determinants,” Moody explains. According to Moody, historically, African Americans have followed a generational diet consisting of carbohydrates and sugars similar to the diet of Hispanics. Moody focuses on external, non-medical aspects that affect African American and Hispanic self-care practices and their health outcomes. Before focusing on social determinants, the impact of spirituality, spiritual self-care practices, self-efficacy, and health literacy were investigated to track if such aspects impacted these individuals’ diabetic health. Focusing on social determinants, such as socioeconomic status, neighborhood, physical environment, the distance of the closest grocery store, health care access, and neighborhood environment, allows Moody to see if such factors impacted African American and Hispanic self-care practices—such as checking sugar levels, eating a healthy diet, annual foot examinations, and more—and if such social determinants act as a barrier amongst minorities with diabetes mellitus. “That's what I want to know: what are those barriers within those social determinants that affect them where they are unable to perform effective self-care? That's my goal,” Moody explains. By studying the causes of diabetes mellitus in this population, future generations will be able to overcome such obstacles.

“The problem is that with any population, you pass it down to your children, and with diabetes these days, you don't even have to have [it] run in your family,” Moody explains. Understanding the disparities and the factors that cause diabetes mellitus amongst African Americans and Hispanics will allow healthcare providers to intervene and teach patients how to better care for themselves. “If they don't have enough money, other things that they can do are interventions, such as healthier foods, healthy vitamins, and healthier things in the grocery store.” It is very important to disseminate the information learned and gained from this study to not only those surveyed but also to current nursing students and healthcare workers to navigate prevention, direct instruction, and raise awareness about such medical diagnoses and underserved populations. It's all about teaching the population how to better care for themselves, Moody emphasized. She will be teaching new nurses and LTU nursing students the findings from her research to ensure upcoming nurses properly educate and listen to their patients.

Jacqueline G Moody Ph.D, RN, ACNS-BC Assistant Professor of Nursing College of Health Sciences

A better understanding of the causes of diabetes mellitus among African Americans and Hispanics will contribute to healthcare inclusion and will help to end the negative treatment that such minority groups have experienced in the past. As Moody explains, “People may forgive and move on, but they don't forget, and that's still hindering us, which is why minorities are so behind in their research. Caucasians are so much further because they participate in research, but African Americans and other minorities don't.” A hesitancy to participate in research for many minority groups can be traced back to the Tuskegee Experiment and the fear of being treated inhumanely for the sake of science and answers. To adequately treat minorities and promote better health, it is imperative to close this gap and better understand the health and well-being of such groups.

“I just think it's important that we, as researchers, increase research to decrease the disparities and disproportionateness amongst the [minority] population,” Moody accentuated. Minorities are still treated differently, but there is hope that such differences will change by understanding the root causes of illnesses and disseminating information to help participants and patients alike learn how to better care for themselves.

The research to understand how social determinants impact self-care procedures amongst individuals who have diabetes mellitus and identify as African American and Hispanic will begin in 2024. Moody will first gain permission from places to collect data and then conduct qualitative research to understand the life experiences of such patients. From the pool of participants, 100 African American or Hispanic participants who have been diagnosed with diabetes mellitus will be asked to complete a few surveys. An original questionnaire will be developed to obtain information on the number and impact of social determinants on the population’s ability to perform self-care practices. This questionnaire will determine if both populations are affected by similar social determinants, followed by a second questionnaire that will collect personal, health-related, and diabetes self-care data. Participants will also complete a short questionnaire on diabetes knowledge.

Bringing inclusivity to the healthcare industry begins with researching minorities. Moody’s research focuses on the magnitude and correlation between the number of social determinants and the number of health complications among African Americans and Hispanics with diabetes mellitus. The results of this research will be published in refereed journal articles and in local, state, and national presentations, and they will provide healthcare workers with information concerning the impacts of social determinants.