Influences of Demographic, Social Determinants, Clinical, Knowledge, and Self-Care Factors on Quality of Life in Adults With Type 2 Diabetes: Black-White Differences

Background: This study evaluated racial differences in the contribution of demographic, social determinants, clinical, and self-care factors on quality of life (QOL) in adults with type 2 diabetes mellitus (T2DM). Methods: A total of 615 adults with T2DM in Southeastern United States were recruited. Linear regression models were used to assess the contribution of demographic, social determinants, clinical, and self-care factors on the mental (MCS) and physical components (PCS) of QOL, after stratifying by race. Results: For the entire sample, there were significant relationships between PCS and psychological distress (β = 0.02, p < 0.01), neighborhood aesthetics (β = 0.05, p < 0.01), neighborhood walking environment (β = −0.02, p < 0.05), access to healthy food (β = 0.01, p < 0.05), neighborhood crime (β = −0.15, p < 0.05), and neighborhood comparison (β = 0.13, p < 0.05); and MCS and depression (β = −0.06, p < 0.05), psychological distress (β = −0.09, p < 0.001), perceived stress (β = −0.12, p < 0.01), and perceived health status (β = −0.33, p < 0.01). In the regression models stratified by race, notable differences existed in the association between PCS, MCS, and demographic, psychosocial, built environment, and clinical factors among Whites and Blacks, respectively. Conclusion: In this sample, there were racial differences in demographic, social determinants, built environment, and clinical factors associated with PCS and MCS components of QOL. Interventions may need to be tailored by race or ethnicity to improve quality of life in adults with T2DM.