Coping resources and acculturation as moderators of the relationships between self-care behaviors, depression, and disease complications for older Mexican Americans with diabetes

Health disparities involving chronic illnesses, such as diabetes, have historically impacted ethnic minorities in the U.S. The underlying mechanisms for the consistent associations between comorbid depression, poor disease management, and increased risks for diabetes complications are not well understood. This study evaluated coping resources and acculturation as potential moderators of the relationship between self-care behaviors and health outcomes, including depression and disease complications, for older Mexican Americans with diabetes. Hierarchical regression was conducted to examine data of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE; 1993-94). Data included interviews of 451 older Mexican Americans diagnosed with diabetes. The coping resources moderator model was not tested due to missing data. Significant moderating effect was not found for the acculturation moderator model. The prevalence of diabetes was 30.8%, and the prevalence of depression (CES-D ≥ 16) was 27.7%. Post hoc analyses were conducted to explore demographic covariates (sex, education, and marital status) as potential moderators for health outcomes. No significant moderating effects were found. Due to the large proportion of missing data from the H-EPESE and limited use of standardized measurements in the available data, further investigations are needed to test the moderator models. Critiques of the H-EPESE's data and recommended solutions for future research studies that plan to analyze public health data are provided.