The Influence of Stress, Gender, and Culture on Type 2 Diabetes Prevention and Management Among Black Men

Abstract

This study used focus-group methodology to seek understanding about the unique influence of stress, gender, and culture on type 2 diabetes mellitus (t2dm) prevention and management among Black men. Twenty men from Iowa were recruited from a larger longitudinal study on Black families; each of these men participated in one of three focus groups. Ninety-five percent of the men in the sample were Black and all were either diagnosed with t2dm ( n = 10), were prediabetic ( n = 1), or had experience with t2dm through family and friends ( n = 9). Our results revealed the existence of significant stress and some pessimism with respect to perceived ability to prevent and manage t2dm. The participants made it clear that, while their families are primary sources of support for managing stress, including t2dm, they can also be a source of stress, particularly with respect to parenting. Black men had mixed opinions on their relationships with respect to their health care providers; some had positive, long-standing relationships while others reported little or no relationship with their providers. In response to life stress, Black men reported experiencing inadequate and disrupted sleep as well as consuming too much alcohol at times. Some of the participants reported engaging in physical activity to manage their stress. The study concluded that, as researchers develop t2dm prevention and management programs, they should continue to consider the unique role that stress in its various forms, plays in the lives of Black men.

Older African American Men’s Perspectives on Factors That Influence Type 2 Diabetes Self-Management and Peer-Led Interventions

“…Gender-related norms among Black men also include “superman syndrome” or the ability to maintain their health without the assistance of doctors [13]. In another study, Black men with T2D reported waiting until symptoms became severe before seeking medical attention [10]. These findings are consistent with prior work, which examined the role of male gender norms in diabetes self-management for a sample of Black men diagnosed with T2D [5].…”

“…In the context of this discussion, sex refers to biological differences such as chromosomes, and sex organs while gender describes the characteristics that a society or culture delineates as masculine or feminine [9]. Studies show that traditional male gender norms can discourage healthy behaviors, with significant implications for the health trajectories of older Black men [10,11]. For instance, cultural expectations for male self-reliance can deter help-seeking from health professionals, and societal beliefs that men should display autonomy and dominance, and cope independently with pain or discomfort, can pose barriers to asking for help from family members to support health behavior change, or following health advice given by medical professionals [11].…”

“…Results from that study aligned with the broader literature in showing that the need to maintain a strong image to the outside world by not acknowledging symptoms of illness, and to maintain control of one’s own health served as barriers to engaging in healthy behaviors—particularly seeking help from family members and attending doctor appointments [5]. These studies suggest that tailoring T2D self-management interventions to address the unique intersectional needs of age, gender, and race for men may be critical to helping them to achieve optimal health outcomes [5,10,11]. Such findings also suggest the need to tailor messaging for diabetes management for men to emphasize ways that caring for one’s own health and health care addresses values and goals particular to Black men (e.g., staying healthy allows one to continue to provide for one’s family).…”

Family behaviours that have an impact on the self‐management activities of adults living with Type 2 diabetes: a systematic review and meta‐synthesis

“…). More than half the studies were conducted in high‐income countries ( n =25; Table ). Half of the studies ( n =22) focused on culturally and linguistically diverse or disadvantaged populations.…”

Perceptions of Heart-Healthy Behaviors among African American Adults: A Mixed Methods Study

“…These discussions frequently centered on economic limitations, rather than racial discrimination. It is important to note the complex interactions between socioeconomic status, race, gender, and age in CVD risk [ 30 , 32 , 35 ]. Healthcare access was expressed as an urgent African American health issue.…”