The influence of neighbourhood formality status and socio-economic position on self-rated health among adult men and women: a multilevel, cross sectional, population study from Aleppo, Syria

Background There is substantial evidence from high income countries that neighbourhoods have an influence on health independent of individual characteristics. However, neighbourhood characteristics are rarely taken into account in the analysis of urban health studies from developing countries. Informal urban neighbourhoods are home to about half of the population in Aleppo, the second largest city in Syria (population>2.5 million). This study aimed to examine the influence of neighbourhood socioeconomic status (SES) and formality status on self-rated health (SRH) of adult men and women residing in formal and informal urban neighbourhoods in Aleppo. Methods The study used data from 2038 survey respondents to the Aleppo Household Survey, 2004 (age 18–65 years, 54.8% women, response rate 86%). Respondents were nested in 45 neighbourhoods. Five individual-level SES measures, namely education, employment, car ownership, item ownership and household density, were aggregated to the level of neighbourhood. Multilevel regression models were used to investigate associations. Results We did not find evidence of important SRH variation between neighbourhoods. Neighbourhood average of household item ownership was associated with a greater likelihood of reporting excellent SRH in women; odds ratio (OR) for an increase of one item on average was 2.3 (95% CI 1.3-4.4 (versus poor SRH)) and 1.7 (95% CI 1.1-2.5 (versus normal SRH)), adjusted for individual characteristics and neighbourhood formality. After controlling for individual and neighbourhood SES measures, women living in informal neighbourhoods were less likely to report poor SRH than women living in formal neighbourhoods (OR= 0.4; 95% CI (0.2- 0.8) (versus poor SRH) and OR=0.5; 95%; CI (0.3-0.9) (versus normal SRH). Conclusions Findings support evidence from high income countries that certain characteristic of neighbourhoods affect men and women in different ways. Further research from similar urban settings in developing countries is needed to understand the mechanisms by which informal neighbourhoods influence women’s health.

Differential effects of single -sex versus coed education on the mathematical reasoning ability, verbal reasoning ability, and self-concept of high school girls

This study explored the differential effects of single-sex versus coed education on the cognitive and affective development of young women in senior year of high school. The basic research question was: What are the differential effects of single-sex versus coed education on the development of mathematical reasoning ability, verbal reasoning ability, or self-concept of high school girls?^ This study was composed of two parts. In the first part, the SAT verbal and mathematical ability scores were recorded for those subjects in the two schools from which the sample populations were drawn. The second part of the study required the application of the Piers-Harris Children's Self-Concept Scale to subjects in each of the two sample populations. The sample schools were deliberately selected to minimize between group differences in the populations. One was an all girls school, the other coeducational.^ The research design employed in this study was the causal-comparative method, used to explore causal relationships between variables that already exist. Based on a comprehensive analysis of the data produced by this research, no significant difference was found to exist between the mean scores of the senior girls in the single-sex school and the coed school on the SAT 1 verbal reasoning section. Nor was any significant difference found to exist between the mean scores of the senior girls in the single-sex school and the coed school on the SAT 1 mathematical reasoning section. Finally, no significant difference between the mean total scores of the senior girls in the single-sex school and the coed school on the Piers-Harris Children's Self-Concept Scale was found to exist.^ Contrary to what many other studies have found in the past about single-sex schools and their advantages for girls, this study found no support for such advantages in the cognitive areas of verbal and mathematical reasoning as measured by the SAT or in the affective area of self-concept as measured by the Piers-Harris Children's Self-Concept Scale. ^

Hispanic -serving land -grant colleges: Analysis and plan for an educational policy initiative

Hispanics and other minority Americans are denied access to higher education by a system that needs structural reform. The purpose of the research was to determine whether creating Hispanic-serving land-grant colleges, similar to the Morrill land-grant colleges serving Black and Native Americans, might be an effective strategy to increase the access of Hispanic students to quality higher education. In addition to published materials, data was collected from a survey of Hispanic-serving institutions and extensive interviews with college presidents, government representatives, educational association leaders, and educational historians. ^ The research examined how existing land-grant college systems came into being and how they have evolved. A look at the functions of the land-grant systems serving Blacks and Native Americans revealed promising possibilities for a system that would include more Hispanics. Legal, fiscal, curricular, and organizational criteria were inferred from the existing systems. While none of the existing land-grant systems can be adapted to serve Hispanics or most other minorities outside their limited regions, each has elements that could be adapted by a new minority-serving system. A number of colleges already have features that could make them candidates for state designation as land-grant colleges. ^ The research suggests that a new federally funded system of Morrill land-grant colleges dedicated to serving all urban Americans, not just Hispanics, would do much to increase the numbers of Hispanic students and other racially and ethnically minority Americans in good quality higher educational institutions. An inclusive urban land-grant system would be politically feasible, whereas one meant to serve Hispanics alone would not. Because of their urban locations, these universities would serve large concentrations of minority citizens of all ethnic groups. ^ Finally, the basic elements of a strategic plan are presented for an educational organization to use for organizing leaders of minority educational associations, financing an initiative to lobby Congress, eliciting legislative and federal agency support, and securing the assistance of other educational, industrial, and special interest groups. The plan includes a suggested timetable for action. Recommendations are made for innovations that would make such a higher education system distinctive and would help meet important national needs. ^

Compensatory effects of parent and peer support on well -being and achievement during pre- and early adolescence

The current study was designed to explore the salience of parent and peer support in middle childhood and early adolescence across two time periods as indicated by measures of achievement (grade point average (GPA), Stanford Achievement Test (SAT) scores and teacher rated school adaptation) and well-being (loneliness, depression, self-concept and teacher-rated internalizing behaviors). ^ Participants were part of an initial study on social network relations and school adaptation in middle childhood and early adolescence. Participants at Time 1 (in the spring of 1997) included 782 children in grades 4 and 6 of eight lower and middle income public elementary schools. Participants (N = 694) were reinterviewed two years later in the spring of 1999 (Time 2). ^ Multivariate analyses of variance (MANOVA) were used to investigate the change in salience of parent and peer support from Time 1 to Time 2. In addition, Tukey-HSD (Honestly Significant Difference) post hoc tests were used to test the significance of the differences among the means of four support categories: (1) low parent-low friend, (2) low parent-high friend, (3) high parent-low friend, and (4) high parent-high friend. ^ Compensatory effects were observed for loneliness and self-concept at Time 1, as well as for SAT scores, self-concept and overall achievement at Time 2. Results were consistent with existing findings that suggest a competitive model of parent/peer influence on achievement during adolescence. This study affirms the need for a more contextual approach to research examining competing and compensatory effects on adolescent development. ^

Academic orientations of African -American adolescents in Miami-Dade County

The purpose of this research was to answer the following research questions: (a) how high-achieving African-Americans maintain a “racefull” Black identity; (b) how African-American identity affects academic orientation and achievement; (c) how the school's ethnic composition affects African-American students' identity; and (d) how family structure, specifically living in female single-parent households, affects academic orientation and achievement. ^ The data were gathered in an inner-city high school in Miami, Florida. Participants were African-American adolescents, males and females, who started their first-year of high school in the fall of 1995 until their graduation in June 1999. The number of students in the sample varied from 27 students at the beginning of the project to 24 students at the time of graduation. ^ Data were gathered through intensive ethnographic field work, which involved direct participant observation of students in natural contexts; in-depth interviewing of students, peers, teachers, and families; open-ended classroom discussions on matters about the research; and focus groups. Data on demographics, levels of self-esteem and depression, hours spent doing homework, family help with school work, aspirations, and other factors were gained through a survey. ^ African-Americans in this high school developed a racefull persona and still embraced education. They did not need to be raceless to succeed. The ethnic composition of the school where these students were a minority within a minority school resulted in their developing reactive ethnicity formation. Family structure did not affect academic orientation. What made a difference in these students lives were parental support and family ties, which affected their academic orientation. ^

Quality of life and application of the transtheoretical model to diabetes self -management behaviors in older adults with type 2 diabetes

One in five adults 65 years and older has diabetes. Coping with diabetes is a lifelong task, and much of the responsibility for managing the disease falls upon the individual. Reports of non-adherence to recommended treatments are high. Understanding the additive impact of diabetes on quality of life issues is important. The purpose of this study was to investigate the quality of life and diabetes self-management behaviors in ethnically diverse older adults with type 2 diabetes. The SF-12v2 was used to measure physical and mental health quality of life. Scores were compared to general, age sub-groups, and diabetes-specific norms. The Transtheoretical Model (TTM) was applied to assess perceived versus actual behavior for three diabetes self-management tasks: dietary management, medication management, and blood glucose self-monitoring. Dietary intake and hemoglobin A1c values were measured as outcome variables. Utilizing a cross-sectional research design, participants were recruited from Elderly Nutrition Program congregate meal sites (n = 148, mean age 75). ^ Results showed that mean scores of the SF-12v2 were significantly lower in the study sample than the general norms for physical health (p < .001), mental health (p < .01), age sub-group norms (p < .05), and diabetes-specific norms for physical health (p < .001). A multiple regression analysis found that adherence to an exercise plan was significantly associated with better physical health (p < .001). Transtheoretical Model multiple regression analyses explained 68% of the variance for % Kcal from fat, 41% for fiber, 70% for % Kcal from carbohydrate, and 7% for hemoglobin A 1c values. Significant associations were found between TTM stage of change and dietary fiber intake (p < .01). Other significant associations related to diet included gender (p < .01), ethnicity (p < .05), employment (p < .05), type of insurance (p < .05), adherence to an exercise plan (p < .05), number of doctor visits/year ( p < .01), and physical health (p < .05). Significant associations were found between hemoglobin A1c values and age ( p < .05), being non-Hispanic Black (p < .01), income (p < .01), and eye problems (p < .05). ^ The study highlights the importance of the beneficial effects of exercise on quality of life issues. Furthermore, application of the Transtheoretical Model in conjunction with an assessment of dietary intake may be valuable in helping individuals make lifestyle changes. ^

Psychosocial barriers to self -care among Hispanic women with type 2 diabetes mellitus

This cross-sectional survey-designed study investigated the presence and influence of psychosocial barriers to diabetes self-management practices among Hispanic women with type 2 diabetes mellitus. Women (n = 128) who were diagnosed and being treated for type 2 diabetes were recruited from the Miami-Dade area in South Florida. A Beck Depression Inventory-II, Diabetes Care Profile, Diabetes Knowledge Test, Diabetes Empowerment, Multidimensional Health Locus of Control, and Perceived Stress Scales were administered, along with assessment of diet through a 24-hour recall and anthropometric evaluation by body composition analysis and body mass index computation. ^ Mean (± SD) age for subjects was 50.15 ± 15.93 and age at diagnosis was 42.46 ± 14.69. Mean glycosylated hemoglobin (A 1C) was 8.55 ± 1.39. Diabetes education had not been received by 46.9% of subjects. Psychosocial status had previously been evaluated in only 4 participants. Forty percent of participants were assessed as depressed and 17% moderately to severely so. Depression correlated significantly (p < 0.01) with A1C (r = 0.242), perceived stress (r = 0.566), and self-rated health (r = −0.523). Perceived stress correlated significantly (p < 0.01) with A1C (r = 0.388), understanding of diabetes (r = 0.282), self-rated health (r = −0.372) and diabetes empowerment (r = −0.366). For Cuban women, perceived stress (β = 0.418, p = 0.033) was the only significant predictor of A1C, while among non-Cuban Hispanic women, self-reported health (β = −0.418, p = 0.003) and empowerment (β = 0.432, p = 0.004) were better predictors. The most desirable DM status among the women surveyed (high diet adherence, low exercise barriers, and A1C ≤ 7) was associated with superior self-rated health, more support from family and friends, and greater empowerment. ^ This study revealed the error in considering Hispanics a homogenous entity in treating disease, as their cultural backgrounds and concentration in a community can greatly influence management of a chronic disease like diabetes. The strong correlations found between diabetes-related health indicators and psychosocial factors such as depression and perceived stress suggest that psychosocial assessment of patients must be more strongly advocated in diabetes care. Psychosocial assessment of ethnically diverse diabetic populations is especially vital if greater knowledge is to be gained about their barriers to self-care so that diabetes treatment and thus outcomes are enhanced. ^

Personal autonomy in discharge planning decision -making in mentally alert hospitalized elderly individuals: The social workers' perspective

This study was conducted to understand (a) hospital social workers' perspectives about patients' personal autonomy and self-determination, (b) their experiences, and (c) their beliefs and behaviors. The study used the maximum variation sampling strategy to select hospitals and hospital social work respondents. Individual interviews were conducted with 31 medical/surgical and mental health hospital social workers who worked in 13 hospitals. The data suggest the following four points. First, the hospital setting as an outside influence as it relates to illness and safety, and its four categories, mentally alert patients, family members, health care professionals, and social work respondents, seems to enhance or diminish patients' autonomy in discharge planning decision making. Second, respondents report they believe patients must be safe both inside and outside the hospital. In theory, respondents support autonomy and self-determination, respect patients' wishes, and believe patients are the decision makers. However, in practice, respondents respect autonomy and self-determination to a point. Third, a model, The Patient's Decision in Discharge Planning: A Continuum, is presented where a safe discharge plan is at one end of a continuum, while an unsafe discharge plan is at the other end. Respondents respect personal autonomy and the patient's self-determination to a point. This point is likely to be located in a gray area where the patient's decision crosses from one end of the continuum to the other. When patients decide on an unsafe discharge plan, workers' interventions range from autonomy to paternalism. And fourth, the hospital setting as an outside influence may not offer the best opportunity for patients to make decisions (a) because of beliefs family members and health care professionals hold about the value of patient self-determination, and (b) because patients may not feel free to make decisions in an environment where they are surrounded by family members, health care professionals, and social work respondents who have power and who think they know best. Workers need to continue to educate elderly patients about their right to self-determination in the hospital setting. ^

The relationship of managers' self -reported leadership practices and their spirituality

The role of spirituality in leadership in business and other organizations has gained growing recognition. The purpose of this study was to explore the relationship between spirituality and nine selected transformational leadership practices. Community leaders (N = 138) in business, education, and other professions who were graduates of a 10-week leadership program, Leadership Fort Lauderdale, from 1994 to 2004 completed the Spirituality Assessment Scale (SAS), the Leadership Practices Inventory (LPI), and four transformational leadership items of the Multifactor Leadership Questionnaire (MLQ). ^ The predictor variables were participants' scores on the LPI and MLQ. The criterion variable was their score on the SAS. Stepwise multiple regression analysis was used to test the hypothesis: Is there a combination of nine selected transformational leadership practices that would account for a significant portion of the variance of each of two spirituality measures? The Definitive and Correlated dimensions and Total spirituality score of the SAS were used in the analysis. ^ Results showed that two of the LPI leadership practices were significantly related to spirituality. The variable Inspiring a Shared Vision accounted for 10% of the variance of the SAS Definitive dimension. The variable Encouraging the Heart accounted for 30% of the variance of the Correlated dimension. For the Total spirituality score, two models were revealed. In the first model, Encouraging the Heart accounted for 28% of the variance of the total spirituality score. In the second model, Encouraging the Heart and Inspiring a Shared Vision together accounted for 31% of the total spirituality score. None of the transformational leadership practices from the MLQ were significantly related to spirituality. ^ The data partially support the hypothesis: two of the nine leadership variables did in combination correlate with leaders' spirituality. The results also support at least a partial relationship between spirituality and certain transformational leadership practices among leaders in various spheres, such as education, business, and other professions. ^

Evaluation of a mentored self -help intervention for the management of psychotic symptoms

Cognitive behavioral therapy has been shown to be promising for the treatment of individuals experiencing psychotic symptoms, who are often diagnosed with schizophrenia. Using a non-random non-equivalent comparison group design (n = 26), this study explores whether an individually mentored self-help and self-paced intervention based upon cognitive behavioral approaches to auditory hallucinations or "hearing voices" makes a significant positive difference for individuals with major mental disorder diagnoses and psychotic symptoms who are residing in the community and receiving community mental health services. The mentored self-help intervention uses a workbook (Coleman & Smith, 1997) that stemmed from the British psychiatric survivor and "voice hearers"' movements and from cognitive behavioral approaches to treating psychotic symptoms. Thirty individuals entered the study. Pre- and post-intervention assessments of 15 participants in the intervention group and 11 participants in the comparison group were carried out using standardized instruments, including the Rosenberg Self-Esteem Scale, the Brief Psychiatric Rating Scale, and the Hoosier Assurance Plan Inventory - Adult. Four specific research questions address whether levels of self-esteem, overall psychotic symptoms, depression-anxiety, and disruption in life improved in the intervention group, relative to the comparison group. Pre- and post-assessment scores were analyzed using repeated measures analysis of variance. Results showed no significant difference on any measure, with the exception of the Brief Psychiatric Rating subscale for Anxious Depression, which showed a statistically significant pre-post difference with a strong effect size. A conservative interpretation of this single positive result is that it is due to chance. An alternative interpretation is that the mentored self-help intervention made an actual improvement in the level of depression-anxiety experienced by participants. If so, this is particularly important given high levels of depression and suicide among individuals diagnosed with schizophrenia. This alternative interpretation supports further research on the intervention utilized in this study. ^

Self -management factors, influences, and conditions for type 2 diabetes among Black ethnic groups in Miami, Florida and Abidjan, Cote d'Ivoire

The Dahlgren and Whitehead ecological theory provides the framework for a cross-sectional design to compare socio-demographic characteristics, living and working conditions, and lifestyle daily habits as well as cultural and ecological factors among six diabetic multiethnic Black groups in Miami and Abidjan. Approximately 180 Black Americans (African-, Caribbean-, and Haitian-) and 180 Black Africans (Akan, Malinke, and Krou) aged 20 years and older were surveyed. During the preliminary of this study participants' attitudes and behaviors were qualitatively assessed (N=60) and a tool was developed to describe, in the main study (N=360), differences in participants' strength of commitment to diabetes lifestyle self-management. Despite similarities found in terms of age and gender, statistically significant differences were also found within and among groups in terms of living and working conditions, education level, and religion. African American groups were more likely to participate in more diabetes classes than Haitian Americans and Caribbean Americans. However, African Americans were less likely to adhere to daily dietary and weight control regimens. Although, Black African groups reported limited access to equipment, facilities, and financial support they were more likely to follow dietary and weight control recommendations than Black American groups. Overall, African American participants showed the poorest attitudes towards recommended foods, Caribbean American respondents reported the best attitudes and behaviors towards weight control regimens, and the Malinke group had significantly more strength of commitment to successful weight control. Furthermore, Black African groups had significantly more strength of commitment to successful dietary adherence and significantly less support for weight control than Black American groups. ^ Significant differences found within Black groups suggest that understanding each patient's conditions may help healthcare professionals in initiating individualized appropriate counseling before goal setting, and in developing culturally relevant type 2 diabetes management programs. Moreover, significant differences exist in strength of commitment to lifestyle adherence among Black groups in Miami and Abidjan. Cultural, socio-demographic factors and self-management habits may explain differences in participants' outcomes. At the policy level, Black groups should not be approached as a homogenous group and assessment of the vulnerability of each ethnic group may be necessary in the decision-making process.^

Examining moderators of the hindsight bias in the context of civil legal decision -making: Counterfactuals, causal proximity, and self -referencing

The current research sought to clarify the diverging relationships between counterfactual thinking and hindsight bias observed in the literature thus far. In a non-legal context, Roese and Olson (1996) found a positive relationship between counterfactuals and hindsight bias, such that counterfactual mutations that undid the outcome also increased participants’ ratings of the outcome’s a priori likelihood. Further, they determined that this relationship is mediated by causal attributions about the counterfactually mutated antecedent event. Conversely, in the context of a civil lawsuit, Robbennolt and Sobus (1997) found that the relationship between counterfactual thinking and hindsight bias is negative. The current research sought to resolve the conflicting findings in the literature within a legal context. ^ In Experiment One, the manipulation of the normality of the defendant’s target behavior, designed to manipulate participants’ counterfactual thoughts about said behavior, did moderate the hindsight effect of outcome knowledge on mock jurors’ judgments of the foreseeability of that outcome as well as their negligence verdicts. Although I predicted that counterfactual thinking would increase, or exacerbate, the hindsight bias, as found by Roese and Olson (1996), my results provided some support for Robbenolt and Sobus’s (1997) finding that counterfactual thinking decreases the hindsight bias. Behavior normality did not moderate the hindsight effect of outcome knowledge in Experiment Two, nor did causal proximity in Experiment Three. ^ Additionally, my hypothesis that self-referencing may be an effective hindsight debiasing technique received little support across the three experiments. Although both the self-referencing instructions and self-report measure consistently decreased mock jurors’ likelihood of finding the defendant negligent, and self-referencing instructions decreased their foreseeability ratings in studies two and three, the self-referencing manipulation did not interact with outcome knowledge to moderate a hindsight bias effect on either foreseeability or negligence judgments. The consistent pattern of results across the three experiments, however, suggests that self-referencing may be an effective technique in reducing the likelihood of negligence verdicts.^

Energy-efficient self -organization of wireless acoustic sensor networks for ground target tracking

With the developments in computing and communication technologies, wireless sensor networks have become popular in wide range of application areas such as health, military, environment and habitant monitoring. Moreover, wireless acoustic sensor networks have been widely used for target tracking applications due to their passive nature, reliability and low cost. Traditionally, acoustic sensor arrays built in linear, circular or other regular shapes are used for tracking acoustic sources. The maintaining of relative geometry of the acoustic sensors in the array is vital for accurate target tracking, which greatly reduces the flexibility of the sensor network. To overcome this limitation, we propose using only a single acoustic sensor at each sensor node. This design greatly improves the flexibility of the sensor network and makes it possible to deploy the sensor network in remote or hostile regions through air-drop or other stealth approaches. Acoustic arrays are capable of performing the target localization or generating the bearing estimations on their own. However, with only a single acoustic sensor, the sensor nodes will not be able to generate such measurements. Thus, self-organization of sensor nodes into virtual arrays to perform the target localization is essential. We developed an energy-efficient and distributed self-organization algorithm for target tracking using wireless acoustic sensor networks. The major error sources of the localization process were studied, and an energy-aware node selection criterion was developed to minimize the target localization errors. Using this node selection criterion, the self-organization algorithm selects a near-optimal localization sensor group to minimize the target tracking errors. In addition, a message passing protocol was developed to implement the self-organization algorithm in a distributed manner. In order to achieve extended sensor network lifetime, energy conservation was incorporated into the self-organization algorithm by incorporating a sleep-wakeup management mechanism with a novel cross layer adaptive wakeup probability adjustment scheme. The simulation results confirm that the developed self-organization algorithm provides satisfactory target tracking performance. Moreover, the energy saving analysis confirms the effectiveness of the cross layer power management scheme in achieving extended sensor network lifetime without degrading the target tracking performance.

A decision support framework for infrastructure maintenance investment decision-making

Infrastructure management agencies are facing multiple challenges, including aging infrastructure, reduction in capacity of existing infrastructure, and availability of limited funds. Therefore, decision makers are required to think innovatively and develop inventive ways of using available funds. Maintenance investment decisions are generally made based on physical condition only. It is important to understand that spending money on public infrastructure is synonymous with spending money on people themselves. This also requires consideration of decision parameters, in addition to physical condition, such as strategic importance, socioeconomic contribution and infrastructure utilization. Consideration of multiple decision parameters for infrastructure maintenance investments can be beneficial in case of limited funding. Given this motivation, this dissertation presents a prototype decision support framework to evaluate trade-off, among competing infrastructures, that are candidates for infrastructure maintenance, repair and rehabilitation investments. Decision parameters' performances measured through various factors are combined to determine the integrated state of an infrastructure using Multi-Attribute Utility Theory (MAUT). The integrated state, cost and benefit estimates of probable maintenance actions are utilized alongside expert opinion to develop transition probability and reward matrices for each probable maintenance action for a particular candidate infrastructure. These matrices are then used as an input to the Markov Decision Process (MDP) for the finite-stage dynamic programming model to perform project (candidate)-level analysis to determine optimized maintenance strategies based on reward maximization. The outcomes of project (candidate)-level analysis are then utilized to perform network-level analysis taking the portfolio management approach to determine a suitable portfolio under budgetary constraints. The major decision support outcomes of the prototype framework include performance trend curves, decision logic maps, and a network-level maintenance investment plan for the upcoming years. The framework has been implemented with a set of bridges considered as a network with the assistance of the Pima County DOT, AZ. It is expected that the concept of this prototype framework can help infrastructure management agencies better manage their available funds for maintenance.

Perceived Stress and Self‑rated Health of Haitian and African Americans with and without Type 2 Diabetes

Background: Blacks have a higher incidence of diabetes and its related complications. Self-rated health (SRH) and perceived stress indicators are associated with chronic diseases. The aim of this study was to examine the associations between SRH, perceived stress and diabetes status among two Black ethnicities. Materials and Methods: The cross-sectional study included 258 Haitian Americans and 249 African Americans with (n = 240) and without type 2 diabetes (n = 267) (N = 507). Recruitment was performed by community outreach. Results: Haitian-Americans were less likely to report ‘fair to poor’ health as compared to African Americans [OR=0.58 (95% CI: 0.35, 0.95), P = 0.032]; yet, Haitian Americans had greater perceived stress than African Americans (P = 0.002). Having diabetes was associated with ‘fair to poor’ SRH [OR=3.14 (95% CI: 2.09, 4.72),P < 0.001] but not perceived stress (P = 0.072). Haitian-Americans (P = 0.023), females (P = 0.003) and those participants having ‘poor or fair’ SRH (P < 0.001) were positively associated with perceived stress (Nagelkerke R2=0.151). Conclusion: Perceived stress associated with ‘poor or fair’ SRH suggests that screening for perceived stress should be considered part of routine medical care; albeit, further studies are required to confirm our results. The findings support the need for treatment plans that are patient-centered and culturally relevant and that address psychosocial issues.