Purpose The purpose of the study was to explore and describe perceptions and experiences of young adults with type 1 diabetes mellitus (T1DM) living in Appalachia, Tennessee. Methods Qualitative descriptive analysis of in-depth interviews of 9 young adults (male = 3, female = 6) 18 to 30 years of age living in Appalachian counties in Tennessee provided the basis of identifying the salient concerns from the perspective of this diverse group related to living daily with T1DM. Data analysis was facilitated by using NVivo 11 Pro and consisted of iterative review of the accounts in 3 phases: immersion, reduction, and interpretation. Results Findings revealed that young Appalachian adults had some common, consistent experiences living with T1DM. Major themes included the struggle toward adulthood, the daily struggle of living with diabetes, the strong desire to live life, the supportive environment, the development of one's identity by diabetes, the disruptiveness of diabetes' demands, and the pros and cons of technological development in diabetes management. Conclusion Health vulnerabilities are multiplied for young adults living with T1DM in Appalachian Tennessee. Participants pointed to living in communities with social stigma, lack of T1DM knowledge, and lack of access to health care that compares with the quality of care they experienced when in pediatric care. They also expressed fear about pregnancy, diabetes complications, and the dangers of hypoglycemia. Individual and community-based empowerment programs focusing on T1DM accompanied by insurance reimbursement and T1DM policy reinforcement are necessary to reduce health disparities and improve quality of life in this underserved population of young adults in Appalachia.

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AimThis manuscript aims to describe stigmatizing features of diabetes.DesignThis article presents a narrative review of literature pertaining to stigma surrounding diabetes in different contexts.MethodsA literature search was conducted in CINAHL, PubMed and Web of Science for qualitative studies published between 2007–2017. The search was completed using various combinations of diabetes, T1DM, T2DM, stigma, social/public stigma, internalized/self‐stigma, stigmatization and diabetes‐related stigma in English. The reviewers then independently reviewed the eligible studies (N = 18) to extract data.ResultsFrom the 18 studies included in this narrative review, seven features related to stigma in diabetes were identified. People with diabetes were most notably considered and stigmatized as being “sick,” “death reminder,” “rejected marriage candidate,” “self‐inflicting,” “contagiousness,” “requiring a dietary modification” and “drunk or drug abuser.”

It is well established that Black women are at greater risk for preterm birth (PTB) and infant mortality than other race/ethnicities in the United States, particularly in the south. Evidence exists supporting the effects of adequate prenatal care to significantly reduce the risk of PTB among this vulnerable population (Debiec, Paul, Mitchell, & Hitti, 2010; Picklesimer, Billings, Hale, Blackhurst, & Covington-Kolb, 2012). However, Black mothers are 2.3 times more likely than White mothers to receive prenatal care late, or not at all (Office of Minority Health [OMH], 2015). Rationale for this trend remains unclear. The purpose of this article is to examine how current literature addresses Black women's experience of antenatal care, including the role that midwives may have in that care. A brief history of Black midwives and their role as the major health care providers for Black women, as well as the current trends in midwifery, will provide background and offer a point of reference. While much of the literature focuses on birth outcomes, provider qualities, and situational life factors in conjunction with the prenatal care received by Black women, very few investigate the effects that historical underpinnings may have played in Black women's current reception of prenatal care. The history of Black women's health care and the prominent role that midwifery played is all but forgotten. Throughout this review, the term Black is used rather than African American as birth certificate data and much of the early demographic data use the term Black as a racial indicator.