Depressive symptomatology mediates the effect of socioeconomic disadvantage on HbA1c among rural African Americans with type 2 diabetes

Objective African Americans with diabetes mellitus type 2 (T2D) represent a disadvantaged and understudied group who experience difficulties with maintaining glycemic control. Although mounting evidence has linked socioeconomic disadvantage to chronic disease morbidity, few studies have examined the mediating mechanisms that account for this effect. We hypothesized that rural African Americansʹ financial distress, community disadvantage, and educational attainment would predict glycemic control, indirectly, via effects on depressive symptoms. s tions were tested using data from 192 rural African American adults with T2D and data from community support persons the participants nominated. Participants completed an in-home interview and provided a blood sample at a local laboratory. Levels of glycosylated hemoglobin (HbA1c) constituted the criterion variable. s ural equation modeling analyses confirmed our hypotheses: financial distress, community disadvantage, and educational attainment demonstrated significant indirect effects on HbA1c via their influence on depressive symptoms. sions ndings underscore the importance of targeting mental health in interventions to support glycemic control as well as tailoring interventions for individuals in difficult socioeconomic circumstances.