Purpose:The purpose of this qualitative descriptive study was to explore the socio-cultural influences and social context associated with living with type 2 diabetes among rural, migrant Latino adults. Methods:A qualitative descriptive study using grounded theory techniques was conducted. In-depth semistructured interviews were completed with ten participants (6 female and 4 male) ranging in age from 46-65 years and duration of diabetes diagnosis ranging from 1.5-40 years. Results:An over-arching meta-theme Self Management in a Social Environment emerged. Every aspect of the process of self-management, as described in the four major themes, (1) Family Cohesion, (2) Social Stigma of Disease, (3) Social Expectations/ Perception of "Illness," and (4) Disease Knowledge and Understanding, was influenced by the social context. Conclusions:The familist traditions, central to the Mexican culture, had both positive and negative consequences on diabetes management. Tailoring clinical care and developing novel education approaches, to include family and community, is central to improving the health of this population. Recognizing and acknowledging the social stigma associated with diabetes, for this population, will promote understanding and improve clinician/patient communication. The socio-cultural influences that impact diabetes management practices (e.g., include family, in particular the primary female caregiver, and establish community and home based education sessions) must be integrated into clinical practice. Future research focused on population defined health and disease self-management, novel educational interventions, and family and community interventions focusing on the concept of "social stigma of disease" is indicated to further impact the health disparities of this population. (2009) 2 The final, definitive version of this paper has been published in the Diabetes Educator, Vol. 35 (Iss 2), 2009. SAGE Publications, Inc., All rights reserved. doi: 10.1177/0145721708329545 D.WEILER & J. CRIST in DIABETES EDUCATORThe National Institutes of Health (NIH) define disparities in health as "differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States". 1 These disparities include shorter life expectancy, higher incidence and prevalence of disease states such as diabetes and cardiovascular disease, and higher infant mortality and mental disorder rates. Many factors can contribute to health disparities such as reduced access to health care, increased risk of morbidity and mortality due to occupation or hazard exposure; increased risk due to underlying biological, socioeconomic, ethnic and familial factors; influences of cultural values and level of education.1 The Latino population is one group with known health disparities, 2 especially in the area of diabetes. 3Diabetes poses a significant public health challenge in the United States. It is estimated that 1.5 million new cases are diagnosed ...

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Latinos are at elevated risk for metabolic syndrome (MetS), a cluster of metabolic factors predictive of cardiovascular disease and diabetes. This study summarizes the association of MetS risk factors with self-reported health behaviors for 225 low-income, Northwest Latino men and women according to age and gender. The Health-Promoting Lifestyle Profile II (HPLP II) in English and Spanish was used to measure the extent to which participants engaged in health-promoting behavior. Biophysical measures included body composition, blood pressure, and fasting venous blood analysis. Men had significantly higher triglycerides, blood glucose, and systolic and diastolic blood pressure readings. Both men and women had central obesity measurements above the recommended cutoffs. There were no statistically significant differences except for physical activity on the HPLP II scores according to level of risk for MetS.

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