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Impact of social determinants of health on outcomes for type 2 diabetes: a systematic review

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Abstract

Social determinants of health include the social and economic conditions that influence health status. Research into the impact of social determinants on individuals with type 2 diabetes has largely focused on the prevention of or risk of developing diabetes. No review exists summarizing the impact of social determinants of health outcomes in patients with type 2 diabetes. This systematic review examined whether social determinants of health have an impact on health outcomes in type 2 diabetes. Medline was searched for articles that (a) were published in English (b) targeted adults, ages 18 + years, (c) had a study population which was diagnosed with type 2 diabetes, (d) the study was done in the United States, and (e) the study measured at least one of the outcome measures—glycemic control, cholesterol (LDL), blood pressure, quality of life or cost. Using a reproducible strategy, 2,110 articles were identified, and 61 were reviewed based on inclusion criteria. Twelve were categorized as Economic Stability and Education, 17 were categorized as Social and Community Context, 28 were categorized as Health and Health Care, and three were categorized as Neighborhood and Built Environment. Based on the studies reviewed, social determinants have an impact on glycemic control, LDL, and blood pressure to varying degrees. The impact on cost and quality of life was not often measured, but when quality of life was investigated, it did show significance. More research is needed to better characterize the direct impact of social determinants of health on health outcomes in diabetes.

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Acknowledgment

This study was supported by grant 5K24DK093699-02 National Institute of Diabetes and Digestive Kidney Disease (NIDDK). The funding agency did not participate in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The manuscript represents the views of the authors and not those of the VA or HSR&D.

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Authors and Affiliations

  1. Health Equity and Rural Outreach Innovation Center (HEROIC), Charleston VA HSR&D COIN Ralph H. Johnson VAMC, Charleston, SC, USA

    Rebekah J. Walker & Leonard E. Egede

  2. Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, Room 280G, PO Box 250593, Charleston, SC, 29425, USA

    Rebekah J. Walker, Brittany L. Smalls, Jennifer A. Campbell, Joni L. Strom Williams & Leonard E. Egede

  3. Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Joni L. Strom Williams & Leonard E. Egede

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  1. Rebekah J. Walker
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Walker, R.J., Smalls, B.L., Campbell, J.A. et al. Impact of social determinants of health on outcomes for type 2 diabetes: a systematic review. Endocrine 47, 29–48 (2014). https://doi.org/10.1007/s12020-014-0195-0

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