Diabetes
Social Determinants of Health and Their Association with Self-Reported Diabetes and Prediabetes Among Adults Aged ≥18 Years Paul Eke* Guixiang Zhao Machell Town Yiling J. Cheng
Introduction: Diabetes remains a major health concern in the US. This study assessed the associations of social determinants of health (SDOH) measures with self-reported diabetes and prediabetes among US adults aged ≥18 years.
Methods: The 2022 Behavioral Risk Factor Surveillance System collected SDOH and diabetes data in 42 states (including DC and US territories), and prediabetes data in 26 states. Social risk factors assessed based on SDOH measures included life dissatisfaction, lack of social/emotional support, loneliness, employment instability, food insecurity, housing insecurity, utilities insecurity, lack of transportation access, mental stress, and cost barrier for needed care. For adjusted prevalence ratios, we conducted log-linear regression analyses adjusting for demographic characteristics and health-related behavioral risk factors.
Results: Overall, the prevalences of diabetes and prediabetes were 12.0% and 14.5% among US adults, respectively. After adjustment for study covariates, adults with 10 of the 11 social risk factors (except employment instability) were 10%-27% (P<0.05) more likely to report having diabetes, and adults with 8 social risk factors (except employment instability, food insecurity, and utilities insecurity) were 14%-38% (P<0.05) more likely to report having prediabetes compared with adults without corresponding social risk factors. Adults with increasing number of social risk factors were significantly more likely to report having diabetes and prediabetes compared to adults with none of the social risk factor.
Conclusions: Social risk factors are associated with higher risk of diabetes among US adults, independent of traditional diabetes risk factors. Diabetes prevention and intervention programs may be prioritized to individuals with social risk factors.