Identification of risk factors mediating the associations of socioeconomic, cultural, and demographic factors with type 2 diabetes across ethnic groups

We identified the associations of distal (socioeconomic status (SES), cultural and demographic characteristics), intermediate (diet, physical activity), and proximal (obesity) factors with type 2 diabetes (T2D) across ethnicities. ^ Our secondary analysis of the Acculturation and Nutrition Needs Assessment Study among 200 low-income Puerto Rican women indicated that acculturation, SES, marital status, and access to social networks were related to cigarette smoking, consuming alcohol, obesity, and physical activity. Based on these results, we conducted a case-control study to compare the nutrition and diabetes-related knowledge and behaviors, and to examine the diabetes management and healthcare access characteristics among 201 Latino (85% Puerto Rican) women (100 with self-reported T2D, 101 controls) aged 35–61y. There were significant associations between acculturation, SES, demographic factors, and nutrition knowledge and T2D risk factors. Being highly acculturated was related to greater likelihood of having a high (\u3e35 in) waist circumference (WC) (odds ratio = 1.26, 95% confidence interval = 1.02–1.56). WC was positively related to having T2D (1.11, 1.05–1.19). ^ Our last study examined the variables associated with T2D and its risk factors in a nationally representative sample (n = 3992 adults, aged 20–84 y) from the 1999–2000 NHANES. The analytical sample included 1096 Mexican Americans, 781 non-Hispanic Blacks, 1734 non-Hispanic Whites, and 381 people with other ethnicities; 460 individuals had T2D. Low education level