Stigma impacts the way that communities, families, and partners interact with people living with diabetes, and undermines efforts to curtail the disease. We explored stigma and its associated attributes in 21 African American churches in 4 metropolitan areas. All churches are actively taking part in a 33-month, cluster randomized controlled trial focused on self-management support efforts to improve diabetes outcomes. Baseline data for participants (n=309) [(mean age: 65.3±11.1 years, 100% African American, 25.6% male, 50.8% obese (BMI>=30 kg/m2), mean diabetes distress scale score: 2.0±0.98] were examined to determine levels of stigma using the Type 2 Diabetes Stigma Assessment Scale (DSAS-2). DSAS-2 is a validated, 19-item scale with 3 subscales (Treated Differently, Blame and Judgement, and Self-Stigma). Average overall stigma scores were not significantly different by gender; however, there was a strong correlation between younger age and overall stigma (r=-0.19, p=0.001), feelings of being treated differently (r=-0.1, p=0.09), blame and judgement (r=-0.18, p=0.001), and self-stigma (r=-0.21, p<0.0001). The same pattern was apparent for participants who were obese. Obese participants were significantly more likely to feel overall stigmatization (p=0.03), blame and judgement (p=0.003) and self-stigma about their diabetes (p=0.04) compared to non-obese participants. After controlling for age, gender, obesity, and diabetes distress, younger male participants who experienced more diabetes distress were 1.4x more likely to feel stigmatized about their diabetes compared to their counterparts. The addition of distress to the models attenuated the association between stigma and obesity, suggesting that participants with higher distress levels often feel stigmatized about their diabetes. Future efforts aimed at ways to decrease distress levels, particularly in younger African American men, who oftentimes do not understand “why this happened to them" are paramount.
G. Piatt: None.
National Institutes of Health