Financial security determines diabetes care in Detroit-area women

A study recently published by a University of Michigan Social Work researcher has confirmed a social determinant influencing the health status of many Americans: financial security. If you have it, you’re more likely to be well or manage your health problems. Without it, you’re more likely to be ill and be less able to care for your illness.

Emily Nicklett, in the current issue of Qualitative Social Work (, notes that changes imposed by a diabetes regimen are considered unmanageable by financially insecure women. Study participants who were raised with fewer resources were more likely to have family members who were diabetic and have fewer treatment options available to them. However, more affluent women were more capable of managing the disease. Financially secure women have greater access to self-treatment options and a more optimistic outlook than women who don’t have the same financial security, the study found.

Research participants recalled experiencing fear, depression or denial after being diagnosed with the disease. Those with a more favorable financial situation tended to be more optimistic about their diagnosis. Knowledge and experience about diabetes prior to diagnosis could be partially responsible for this difference, according to the study.

Nicklett published the research with Sara Kuzminski Damiano, of the University of Southern California. “It became apparent that having previous knowledge about diabetes and the regimen, as well as having previous experiences viewing complications unfold among loved ones, shaped the experience of diagnosis and attitudes toward diabetes,” according to Nicklett, a U-M assistant professor of Social Work. The authors interviewed women with Type 2 diabetes in the Detroit area.

Emily Nicklett can be reached at