Discrimination and Depression among Urban Hispanics with Poorly Controlled Diabetes.

Objectives: We had three objectives for our study: 1) to describe the prevalence and burden of experiences of discrimination among Hispanics with poorly controlled diabetes; 2) to evaluate associations among discrimination experiences and their burden with comorbid depression among Hispanics with poorly controlled diabetes; and 3) to evaluate whether discrimination encountered in the health care context itself was associated with comorbid depression for Hispanic adults with diabetes. Design: We conducted a cross-sectional analysis of baseline data of a randomized controlled trial (RCT). Setting: We collected data in the context of an RCT in a clinical setting in New York City. Participants: Our sample comprised 221 urban-dwelling Hispanics, largely of Caribbean origin. Main Outcome Measures: The main outcome measure was major depression, measured by the Euro-D (score>3). Results: Of 221 participants, 58.8% reported at least one experience of everyday discrimination, and 42.5% reported at least one major experience of discrimination. Depression was associated significantly with counts of experiences of major discrimination (OR=1.46, 95%CI=1.09-1.94, P=.01), aggregate counts of everyday and major discrimination (OR=1.13, 95%CI=1.02-1.26, P=.02), and the experience of discrimination in getting care for physical health (OR=6.30, 95%CI=1.10-36.03). Conclusions: Discrimination may pose a barrier to getting health care and may be associated with depression among Hispanics with diabetes. Clinicians treating Caribbean-born Hispanics should be aware that disadvantage and discrimination likely complicate a presentation of diabetes.