Diabetes knowledge and sources of information among African American and white older women.

African American women have a disproportionate risk of diabetes-related morbidity and mortality. Despite this risk, evidence indicates that educational interventions are not aimed at this population. We also currently lack basic information about the source of diabetes information for African American women and how such sources might affect their knowledge of the disease. We interviewed 51 women with diabetes to address such deficits in our understanding and, conceivably, to contribute culturally sensitive recommendations to enhance glucose control. To detect ethnic variations in knowledge and information source, half of our selected sample was African American and half was white. Results indicate that African American respondents achieved lower scores on the Diabetes Knowledge Test than their white counterparts. However, few differences were noted in the source of diabetes information, with both groups receiving their information from a wide variety of sources. Implications for health providers and educators are discussed.

Stories of meaning: lay perspectives on the origin and management of noninsulin dependent diabetes mellitus among older women in the United States.

Researchers have sought to explain nonadherence to standard medical regimens by investigating a variety of sociodemographic variables, and, less often, by exploring variations between the health perspectives and life circumstances of the individual. While divergence between lay and professional perspectives on the etiology and treatment of chronic diseases, such as noninsulin dependent diabetes mellitus, may possibly account for the documented low rates of adherence to biomedical recommendations, health beliefs and activities are best understood as connected to an individual's personal history and circumstances. In order to evaluate the relationship between causal explanation of NIDDM and adherence, ethnographic interviews were conducted among 51 older (65+) women with diabetes and their physicians. We chose to investigate adherence to dietary recommendations because it represents one of the most challenging lifestyle modifications and is particularly important to maintaining glycemic control. The interviews involved ethnomedical and food frequency intake questionnaires and semi-structured interviews. Results reveal a stronger association between dietary adherence and etiological perspectives on diabetes than any sociodemographic factors, including ethnicity, education and income or other health belief factors. Informants suggested five categories that they believed were responsible for the onset of their NIDDM; poor past dietary practices (n = 22); familial tendency to have diabetes (n = 10); improper bodily functioning (n = 10); personal risk factors (n = 6); and currently being overweight (n = 3). Analyses indicated that those who implicate former dietary practices, currently being overweight, or having improper bodily functions were more likely to follow a standard recommended diet for individuals with diabetes. These findings also highlight the attempt by individuals with NIDDM to create 'stories' of meaning of their diabetes by linking their current management strategies for NIDDM with past practices and history. In addition, our results question the utility of the 'biomedical/alternative' labels.

The role of race and residence in determining stage at diagnosis of breast cancer.

Breast cancer kills more than 46,000 women each year. Previous research has found that minorities and those who reside in geographically remote settings are particularly vulnerable. However, virtually no research has been done on the potential "double jeopardy" faced by rural minority women. This research examines (1) the extent to which racial and residential differences contribute to differences in stage at diagnosis; (2) the existence of an interaction between race and residence, which may place black rural women at greater risk; and (3) the influence of both individual and structural characteristics on racial and residential differences. The findings indicate that rural black women are diagnosed with breast cancer much later than are black urban women or whites of either residence. A number of individual and structural variables were influential in predicting stage at diagnosis, yet none of these accounted entirely for racial differences.

Racial differences in adolescent drug use: the impact of religion.

Contrary to popular stereotypes, current studies of adolescent populations suggest that Black teens are less likely to use illicit drugs than are White teens. This study investigates the extent to which differences in religiosity are responsible for racial differences in drug use. Using data from a national survey of United States high school seniors, our results indicate that religion does provide some protection from drug use by adolescents. However, religiosity has less of an impact on the drug use of Black adolescents, perhaps as a result of the diverse roles of the Black church.