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Influence of race, ethnicity and social determinants of health on diabetes outcomes.
Open accessAbstract
Background There is strong evidence that race, ethnicity and social determinants of health significantly influence outcomes for patients with diabetes. A better understanding of the mechanisms of these relationships or associations would improve development of cost-effective, culturally tailored programs for patients with diabetes.Methods This article reviews the current state of the literature on the influence of race and ethnicity and social determinants of health on process of care, quality of care and outcomes for diabetes, with particular emphasis on the rural South to give an overview of the state of the literature.Results The literature review shows that racial or ethnic differences in the clinical outcomes for diabetes, including glycemic, blood pressure (BP) and lipid control, continue to persist. In addition, the literature review shows that the role of social determinants of health on outcomes, and the possible role these determinants play in disparities have largely been ignored. Psychosocial factors, such as self-efficacy, depression, social support and perceived stress, show consistent associations with self-care, quality of life and glycemic control. Neighborhood factors, such as food insecurity, social cohesion and neighborhood esthetics have been associated with glycemic control. Perceived discrimination has also been associated with self-care and the psychological component of quality of life.Conclusion Healthcare professionals need to be skilled in assessing social determinants of health and taking them into consideration in clinical care. In addition, more research is needed to identify the separate and combined influence of race and ethnicity and social determinants of health on process of care, quality of care and outcomes in diabetes, especially in the South, where the burden of disease is particularly high.
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“At the same time, there is growing recognition that social determinants of health (SDoH)—including socioeconomic status, food access, housing stability, and transportation—influence outcomes among patients with diabetes, particularly in vulnerable populations [31–34].”
From Machine learning-driven risk prediction for post-hospitalization diabetes case management: Integrating clinical and social determinants of health (2026) · cites this paper as [32]
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“Race was included not as a biological variable but as a structural equity proxy, reflecting disparities in healthcare access, treatment patterns, and social conditions that are associated with diabetes outcomes and health decline [32,42].”
From Machine learning-driven risk prediction for post-hospitalization diabetes case management: Integrating clinical and social determinants of health (2026) · cites this paper as [32]
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Metadata
- Authors
- Walker, R. J., Strom Williams, J., & Egede, L. E.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Egede, Leonard E.
- Venue
- The American Journal of the Medical Sciences
- Publisher
- Elsevier BV
- Published
- 2016-04
- Volume
- 351
- Issue
- 4
- Pages
- 366-373
- ISSN
- 0002-9629 (ISSN-L)
- PMC
- PMC4834895
- OpenAlex
- W2342360716
- Cited by
- 431
- References
- 71
- Citations by year
- 2026: 16 · 2025: 54 · 2024: 51 · 2023: 60 · 2022: 57 · 2021: 61 · 2020: 86 · 2019: 15 · 2018: 15 · 2017: 12 · 2016: 3
- FWCI
- 2.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of the Medical Sciences (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs (I50 HX001229)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK098529, K24DK093699)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- diabetes mellitus, race and ethnicity, social determinants of health, health disparities, glycemic control, blood pressure control, lipid control, psychosocial factors, self-efficacy, depression, social support, perceived stress, food insecurity, neighborhood factors, perceived discrimination, rural South, quality of care, process of care
- MeSH terms
- Diabetes Mellitus, Ethnicity, Humans, Health Knowledge, Attitudes, Practice, Treatment Outcome, Racial Groups, Healthcare Disparities, Social Determinants of Health
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