Early Life Structural Racism Experiences & Diabetes Self-Management in Older Age

Purposes/Aims:  To develop a framework for understanding the ways in which  the self-management behaviors of  African American older adults with uncontrolled type 2 diabetes mellitus are influenced by the structural racism-related experiences that  they have encountered throughout their lives.

Conceptual Basis: This study was sensitized by four concepts: symbolic interactionism, social determinants of health, life course perspective, and structural racism.

Methods: This study is using a constructivist ground theory (CGT) methodology. Through the use of focus groups and individual interviews,  CGT provides a systematic means for data collection, analysis and theory generation, and acknowledges that the participant and researcher are co-constructing the data. In addition, photo elicitation is being used to generate recall of events experienced from the participants’ early years through older age. Photos from events that affected African Americans in several regions of the country were selected. 

Results: In-progress

Implications: Mullings described an “emancipator knowing nursing perspective”, which provides guidance on how to critically examine hidden ideologies and assumptions in social structures, and to challenge what is known. Emancipatory knowing seeks to discern underlying, more invisible problems that are fundamental to the more obvious and visible problems. This study will lay the groundwork for the development of deep structural, community-based, nurse-led, culturally-tailored interventions. It will deepen our understanding of the underlying factors that contribute to health disparities among African American seniors with type 2 diabetes.