Family history of diabetes, awareness of risk factors, and health behaviors among African Americans

African-Americans who have family members with diabetes are more aware of the disease's risk factors - but that awareness may not lead to a healthier lifestyle.

The type 2 diabetes epidemic disproportionately affects African-Americans, so researchers wanted to see whether having a family member with the disease had any influence on a person's awareness or behavior. Their findings appear in the May issue of the American Journal of Public Health.

The study evaluated 1,122 African-American adults, living in Raleigh and Greensboro, N.C. None of the participants were diagnosed with diabetes; however, 36 percent reported that an immediate family member had the disease.

Participants where shown a seven-item list and asked whether any of the factors increase a person's risk of developing diabetes. All seven items on the list are risk factors for diabetes - minority race or ethnicity, overweight, family history of diabetes, sedentary lifestyle, older age, high-calorie diet and diabetes during pregnancy.

Among the participants with a family history of diabetes, nearly 60 percent had a better- than-average awareness of the diabetes risk factors. About 47 percent of the participants with no family history demonstrated such awareness. Yet, this awareness didn't necessarily translate into healthy behavior.

"We hypothesized that persons with a family history would be more aware of risk factors for diabetes, however, we were surprised that they were not more likely to engage in more of the healthy behaviors compared to persons without a family a history," said study co-author Tiffany Gary, Ph.D., of the Johns Hopkins Bloomberg School of Public Health.

More than 75 percent of the participants were aware that being overweight increases the risk of diabetes. But, of the 65 percent who were overweight, only 32 percent were trying to lose weight.

"Some reasons for this difference could be that people may not be aware of national standards used to define overweight and obesity," Gary said. "Furthermore, it has been shown in several studies that there may be a greater acceptance of a heavier body size among African-Americans." So, what more can be done to raise awareness that being overweight can lead to dangerous health consequences?

"One approach would be to improve awareness of health risks associated with being overweight or obese and accurate perceptions of defining overweight and obesity," Gary said. "This could be accomplished by national campaigns, community activism and policy approaches."

Kate Lorig, R.N., a professor at Stanford University's Patient Education Research Center said people who are overweight are "definitely aware that being overweight is unhealthy, but may not be able to name a specific risk."

"Education is part of the answer," Lorig said. "But what we really have to do is make it environmentally and educationally appealing to change behaviors, not just for diabetes, but for most chronic health conditions."

The authors did find two areas of significant behavior difference. African-Americans with a family history of diabetes were more likely (26.9 percent vs. 20.4 percent) to eat five or more servings of fruits and vegetables daily and to have had a diabetes screening test (74.6 percent vs. 61.2 percent).