• Appalachia;
  • diabetes;
  • health belief model;
  • health disparities;
  • social stigma


Purpose: This study quantifies and describes perceptions of susceptibility and severity of diabetes; cultural beliefs, barriers, and knowledge about diabetes; and social stigma associated with diabetes in an Eastern Appalachian Kentucky population.

Methods: A 55-item intercept survey was administered in 2 large retail outlets in Eastern Kentucky. Individuals were screened to ensure an age range of 25-55 and an “at-risk” diabetes status (according to the American Diabetes Association's requirements). Descriptive statistics and t tests were used to describe the data. Differences across demographic variables were tested via an analysis of variance.

Findings: Most respondents agreed that diabetes is a growing problem in their community, yet the overall levels of perceived susceptibility and perceived severity were lower than expected (susceptibility = 3.88 on a 5-point scale and severity = 3.5). Women, however, perceived higher susceptibility than men. Social stigma did not emerge as a strong concern or worry. The only group differences noted focused on barriers to care and disease management. Specifically, men without a family history of diabetes were significantly less likely than men with a family history to agree that the community should help persons living with diabetes manage their disease (P= .034).

Conclusions: There appears to be a gap between actual and perceived risk levels for developing diabetes. Additionally, it seems that diabetes is viewed as an intrapersonal issue rather than a community-level problem. Yet, for men, a personal experience with the disease may be enough to change the belief that diabetes is an individual problem.