Do acculturation and family cohesiveness influence severity of diabetes among Mexican Americans?

OBJECTIVE The goal of the study was to evaluate the effect of family cohesiveness, acculturation, socioeconomic position, and cardiovascular risk factors on severity of diabetes among Mexican Americans. DESIGN AND STUDY POPULATION The cross-sectional study involved a consecutive sample of 275 Mexican Americans under treatment for type 2 diabetes recruited from two medical clinics on the north side of Fort Worth, Texas. Recruitment and data collection took place during a span of 24 months from December 2001 to December 2003. MAIN OUTCOME MEASURES Hemoglobin A1C levels, available from medical charts, were used to indicate diabetes severity. Cases were defined as individuals with poorly controlled or severe diabetes based upon abnormally high hemoglobin A1C (> or = 7.0). Controls were defined as individuals with well-controlled or mild-moderate diabetes as reflected in a normal hemoglobin A1C (< 7.0). A face-to-face questionnaire was administered to study participants to collect data on protective factors related to family cohesiveness and acculturation, demographic and socioeconomic variables, and cardiovascular risk factors. RESULTS The results suggest that several variables were associated with severity of diabetes, including, receipt of food stamps, having spent childhood in Mexico, and current smoking status. Other variables representing acculturation and family cohesiveness, separately or combined, approached statistical significance. CONCLUSIONS Even though acculturation and family cohesiveness as schemas were not statistically significant because of small sample size, they highlight the importance of building more sophisticated models for testing their association with severity of diabetes.