Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Manoj Sharma


Type 2 diabetes disproportionately affects low-income African American women, age 50 years and older: 30% to 40% of this population has this chronic disease. Two significant factors affecting poor diabetes practice adherence are food insecurity and depression; another is obesity. The purpose of this quantitative correlational study was to determine if either food insecurity or depression significantly affect Type 2 diabetes self-management practices; and/or if food insecurity significantly influences practice adherence indirectly, through the mediator of depression, while controlling for obesity. The research questions were aligned with the theoretical pathways posited in Matthews's reserve capacity model (RCM) and used the most current national data from the 2015 BRFSS dataset. The results of the linear regression models indicated that as hypothesized, depression was significantly associated with poor practice adherence; contrary to hypotheses, food insecurity and obesity were not. The lack of significance between food insecurity and depression eliminated the need to test for mediation. While correlational analyses revealed a significant association between obesity and depression, this relationship was no longer detected in linear regression analyses. An unanticipated finding was the significant relationship between education and Type 2 depression self-management practices, a relationship that maintained significance even with the entry of depression.

These findings have implications for positive social change in the form of preventative interventions aimed at weight-loss and/or reducing depression among African American women at risk for developing Type 2 diabetes.