Social Determinants of Health, Race, and Diabetes Population Health Improvement: Black/African Americans as a Population Exemplar

Curr Diab Rep. 2022 Mar;22(3):117-128. doi: 10.1007/s11892-022-01454-3. Epub 2022 Mar 3.

Abstract

Purpose of review: To summarize evidence of impact of social determinants of health (SDOH) on diabetes risk, morbidity, and mortality and to illustrate this impact in a population context.

Recent findings: Key findings from the American Diabetes Association's scientific review of five SDOH domains (socioeconomic status, neighborhood and physical environment, food environment, health care, social context) are highlighted. Population-based data on Black/African American adults illustrate persisting diabetes disparities and inequities in the SDOH conditions in which this population is born, grows, lives, and ages, with historical contributors. SDOH recommendations from US national committees largely address a health sector response, including health professional education, SDOH measurement, and patient referral to services for social needs. Fewer recommendations address solutions for systemic racism and socioeconomic discrimination as root causes. SDOH are systemic, population-based, cyclical, and intergenerational, requiring extension beyond health care solutions to multi-sector and multi-policy approaches to achieve future population health improvement.

Keywords: Diabetes; Health care disparities; Health care inequalities; Population health; Racial minorities; Social determinants of health.

Publication types

  • Review

MeSH terms

  • Adult
  • Black or African American
  • Diabetes Mellitus* / epidemiology
  • Health Status Disparities
  • Humans
  • Population Health*
  • Social Determinants of Health
  • United States / epidemiology