Interpersonal abuse and depression among mexican immigrant women with type 2 diabetes

Evidence for a bi-directional relationship of depression and type 2 diabetes suggests that social distress plays a role in depression among people with diabetes. In this study, we examine the relationship between subjective distress and depression in 121 first- and second-generation Mexican immigrant women seeking diabetes care at a safety-net hospital in Chicago. We used a mixed-methods approach including narrative interview, survey, and finger-stick blood HbA1c data. Using grounded theory analysis, we identified seven life stressors from narrative interviews: interpersonal abuse, stress related to health, family, neighborhood violence, immigration status, and work, and feeling socially detached. Women reported unusually high rates of interpersonal abuse (65%) and disaggregated physical abuse (54%) and sexual abuse (23%). We evaluated depression using CES-D cut-off points of 16 and 24 and assessed rates to be 49 and 34%, respectively. We found that interpersonal abuse was a significant predictor of depression (CESD ≥ 24) in bivariate (OR 3.97; 95% CI 1.58-10.0) and multivariate (OR 5.51; 95% CI 1.85, 16.4) logistic regression analyses. These findings suggest that interpersonal abuse functions as an important contributor to depression among low-income Mexican immigrant women and should be recognized and addressed in diabetes care.