Family History of Diabetes: Neighborhood and Familial Risks in African American Youth Living in Public Housing

Background/Objectives: Recent data shows increasing diabetes prevalence among African Americans. Youth with a family history of diabetes are at high risk for diabetes. This study explores the multilevel risk factors associated with a family history of diabetes among African American youth in public housing. Methods: This study used a cross-sectional, quantitative, and community-based participatory research (CBPR) approach. The research team, comprising community stakeholders and academic researchers, employed respondent-driven sampling (RDS) for data collection (survey) and used univariate and bivariate analyses to examine variable relationships. A sequential logistic regression highlighted factors influencing the likelihood of having a family history of diabetes. Results: The final sample (n = 190, mean age 18.5 years, 58% female) included 35% of youth with a family history of diabetes. Forty-six percent reported medium to severe household hardships. Results suggest that reporting a family history of diabetes is correlated with maternal substance use (tau-b = 0.27 **) and alcohol problems (tau-b = 0.16 ***), paternal substance use (tau-b = 0.17 *), and eating fewer fruits (tau-b = 0.17 *). With an odds ratio (OR) of 1.70 [0.68, 4.13] and attributable fraction among the exposed at 41.3%, the final model (3) was not significant [χ2 = 11.19(8)]. Thus, we fail to reject the null hypothesis that the model fits the data well. Fewer vegetable consumption (OR = 15.08, p < 0.001), higher soda consumption (OR = 0.06, p < 0.001), severe household hardships (OR = 5.82, p < 0.01), and maternal substance use problems (OR = 6.81, p < 0.05) predicted a higher likelihood of a history of diabetes. Conclusions: Our study calls attention to the need to reevaluate interventions for hardships and substance use in diabetes management, particularly in poor neighborhoods and among minority families.