Race/ethnicity moderates the relationship between chronic life stress and quality of life in type 2 diabetes

Aims: To determine whether chronic life stress is differentially associated with quality of life (QoL) for Blacks vs. Hispanics with type 2 diabetes. Methods: We assessed self-reported chronic stress and QoL in 125 patients with type 2 diabetes who self-identified as either non-Hispanic Black or Hispanic. Separate cross-sectional two-way interaction models (stress × race/ethnicity) with physical and mental health as outcomes were examined. Results: The two-way interaction predicted mental (b = 3.12, P = .04) but not physical health. Simple slopes analyses indicated that under conditions of high stress, Blacks (b = -4.4, P < .001), but not Hispanics, experienced significantly lower levels of mental health. In exploratory analyses, we examined a three-way interaction (stress × race/ethnicity × social support) with physical and mental health as outcomes. Results indicated the three-way interaction predicted mental (b = .62, P = .01) but not physical health. Simple slopes analyses indicated that under conditions of high stress, high levels of social support improved mental health for Hispanics (b = 1.2, P < .001), but not for Blacks. Conclusions: Black patients with type 2 diabetes may be particularly vulnerable to the deleterious effects of high chronic stress. Social support buffers effects of stress on mental health in Hispanics but not Blacks, which suggests differences in the use and/or quality of social support between Hispanics and Blacks. Longitudinal investigations that examine race/ethnicity, stress, social support, and QoL should help clarify the processes that underlie these observed relations.