Graduation Year

2009

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Anthropology

Major Professor

Lorena Madrigal, Ph.D.

Co-Major Professor

David Himmelgreen, Ph.D.

Committee Member

Elizabeth Barnett Pathak, Ph.D.

Committee Member

Fatimah Jackson, Ph.D.

Committee Member

Nancy Romero-Daza, Ph.D.

Keywords

Migrants, Cultural consensus analysis, Caribbean, Cross-Cultural, Florida

Abstract

In the U.S., individuals of Afro-Caribbean and Latino descent are two to three times more likely to develop type 2 diabetes than non-Hispanic whites. Caribbean and Latin America migrants, particularly minority women bear a disproportionate burden of type 2 diabetes and its risk factors. The purpose of this research is to investigate if Afro-Caribbean women share a cultural belief model about type 2 diabetes and how this belief model, along with structural barriers to health care, influence disease risk and management.

A sample of 40 women, primarily Jamaican and Trinidadian, 35 to 90 years of age previously diagnosed with type 2 diabetes were recruited in southwest Florida. Socio-demographic, medical history, and self-reported height and weight data were collected from women. A 53 item yes/no cultural beliefs questionnaire about type 2 diabetes' etiology, treatment, and symptoms was administered to 30 women. Semi-structured interviews about diet and lifestyle type 2 diabetes management were conducted with 38 women, 24 interviews were conducted over the telephone.

The cultural consensus analysis used to analyze the cultural beliefs questionnaire found that the women shared a single cultural belief model (.72 ±.081 SD) about type 2 diabetes. Body mass index was calculated from self-reported height and weight data, and correlated with socio-demographic and cultural belief variables. The age-adjusted prevalence of obesity was 40.39 percent. The spearman correlation found that women with higher BMI (rs = -0.42993, p = .0125) and individual cultural knowledge scores (rs = -0.41730, p = .0218) were significantly younger at age of type 2 diabetes diagnosis than women with lower BMI and individual cultural knowledge scores.

The women's cultural belief model about type 2 diabetes was similar to the biomedical model. Women struggled to modify their traditional Caribbean diet and failed to engage in regular leisure physical activity which may have contributed to their high BMI. Inadequate health insurance and transnational migration prevented women from accessing regular medical care and effectively managing the disease. Afro-Caribbean women face an ongoing struggle to control their glucose levels and BMI to prevent the onset of type 2 diabetes complications.

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