Social Determinants of Health in Minority Populations: A Call for Multidisciplinary Approaches to Eliminate Diabetes-Related Health Disparities

Abstract

In Brief This article explores current discourse regarding the limitations of linear approaches to addressing diabetes prevention and control typically reported in efficacy investigations. The authors discuss the need for health professionals to understand the link between social determinants of health and health outcomes. They define social determinants of health, provide examples, and discuss how these social determinants affect minority health. This information can lead to the adoption of nontraditional strategies that involve the use of nontraditional partners and the identification of opportunities for improving or preventing negative health outcomes in communities affected by inequitable conditions.

Are There Clinical Implications of Racial Differences in HbA1c? A Difference, to Be a Difference, Must Make a Difference

“…Society-level factors such as social position, residence, material conditions (including wealth), social connections, environment, and food and physical insecurity are particularly important factors influencing risk of obesity and diabetes (6,7). There are well-documented racial disparities in the risk of diabetes, with African Americans approximately twice as likely to develop diabetes as compared with their white counterparts (8).…”

1. Promoting Health and Reducing Disparities in Populations

“…Social determinants of health can be defined as the economic, environmental, political, and social conditions in which people live, and are responsible for a major part of health inequality worldwide (40). Given the tremendous burden that obesity, unhealthy eating, physical inactivity, and smoking place on the health of patients with diabetes, efforts are needed to address and change the societal determinants of these problems (41). The ADA recognizes the association between social and environmental factors and the development of obesity and type 2 diabetes and has issued a call for research that seeks to better understand how these social determinants influence behaviors and how the relationships between these variables might be modified for the prevention and management of diabetes (42).…”

Having Their Say: Patients’ Perspectives and the Clinical Management of Diabetes**The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

“…Furthermore, the role of the environment, both physical (eg, access to healthy foods, options for physical activity, neighborhood safety) and social (eg, family and social support, resources at the workplace to facilitate diabetes management), contributes to cultural norms, views, and perspectives of individuals. 11 …”

“…10,14 Similarities and differences between and among ethnic groups are manifested in life experiences, family backgrounds, individual beliefs, attitudes, practices, socioeconomic status, environmental surroundings, and perceptions and experiences of racism. 10,11,14 These similarities and differences must be understood and considered when designing, delivering, and evaluating primary or secondary prevention lifestyle interventions. This is particularly the case given that culturally appropriate interventions (clinical and community) greatly affect adoption and maintenance of healthy behaviors over time.…”