"That wasn't really a place to worry about diabetes": Housing access and diabetes self-management among low-income adults
"That wasn't really a place to worry about diabetes": Housing access and diabetes self-management among low-income adults
复制标题
DOI：
10.1016/j.socscimed.2017.11.051
复制
发表时间：
2018-01-01
影响因子：
5.4
通讯作者：
Murillo, Sascha
中科院分区：
文献类型：
--
作者：
Keene, Danya E.;Guo, Monica;Murillo, Sascha
缺乏负担得起的住房是美国低收入家庭面临的一个重大且日益严重的问题，这些住房挑战可能会对2型糖尿病等慢性病的管理构成障碍。在这项定性研究中，我们研究了住房挑战和住房资源如何塑造糖尿病自我管理行为。我们对美国康涅狄格州纽黑文市的40名低收入居民进行了半结构化访谈，他们被诊断为2型糖尿病，居住在或有资格获得补贴住房。我们有目的地构建我们的样本，包括一系列的住房经验（补贴，无补贴，无家可归）和治疗制度。我们使用归纳编码和备忘录写作的扎根理论技术分析数据。我们的研究结果表明，住房访问可以影响糖尿病自我管理的多种方式，对血糖水平和未来并发症的影响。具体来说，我们描述了住房访问影响参与者能力的方式：1）优先考虑他们的糖尿病护理，2）建立和维持糖尿病常规，3）负担糖尿病相关费用。总之，我们的研究结果表明，住房挑战如何增加了遵守糖尿病管理制度的成本，使得住房不足的个人不得不为同样的结果投资和牺牲更多。我们的研究结果表明，改善经济适用房的获得可能是改善2型糖尿病患者结局和减少社会经济差距的机会。
Lack of affordable housing access represents a significant and growing problem for low-income households in the United States and these housing challenges may present barriers to the management of chronic diseases such as type 2 diabetes. In this qualitative study, we examined how both housing challenges and housing resources shaped diabetes self-management behaviors. We conducted semi-structured interviews with 40 low-income residents of one US city, New Haven, Connecticut, who had a diagnosis of type 2 diabetes and either resided in or qualified for subsidized housing. We purposively constructed our sample to include a range of housing experiences (subsidized, unsubsidized, homeless) and treatment regimes. We analyzed the data using grounded theory techniques of inductive coding and memo writing. Our findings suggest multiple ways that housing access can affect diabetes self-management with implications for blood glucose levels and future complications. Specifically, we describe the ways that housing access affected participants' ability to: 1) prioritize their diabetes care, 2) establish and maintain diabetes routines, and 3) afford diabetes-related expenses. Together, our findings show how housing challenges increased the cost of adherence to diabetes management regimes such that inadequately housed individuals had to both invest and sacrifice more for the same outcomes. Our findings suggest that improved affordable housing access may represent an opportunity to improve outcomes and reduce socioeconomic disparities among those living with type 2 diabetes.