Social determinants of health and diabetes: A scientific review
Open accessAbstract
Decades of research have demonstrated that diabetes affects racial and ethnic minority and low-income adult populations in the U.S. disproportionately, with relatively intractable patterns seen in these populations’ higher risk of diabetes and rates of diabetes complications and mortality (1). With a health care shift toward greater emphasis on population health outcomes and value-based care, social determinants of health (SDOH) have risen to the forefront as essential intervention targets to achieve health equity (2–4). Most recently, the COVID-19 pandemic has highlighted unequal vulnerabilities borne by racial and ethnic minority groups and by disadvantaged communities. In the wake of concurrent pandemic and racial injustice events in the U.S., the American College of Physicians, American Academy of Pediatrics, Society of General Internal Medicine, National Academy of Medicine, and other professional organizations have published statements on SDOH (5–8), and calls to action focus on amelioration of these determinants at individual, organizational, and policy levels (9–11). In diabetes, understanding and mitigating the impact of SDOH are priorities due to disease prevalence, economic costs, and disproportionate population burden (12–14). In 2013, the American Diabetes Association (ADA) published a scientific statement on socioecological determinants of prediabetes and type 2 diabetes (15). Toward the goal ofunderstanding and advancing opportunities for health improvement among the population with diabetes through addressing SDOH, ADA convened the current SDOH and diabetes writing committee, prepandemic, to review the literature on 1 ) associations of SDOH with diabetes risk and outcomes and 2 ) impact of interventions targeting amelioration of SDOH on diabetes outcomes. This article begins with an overview of key definitions and SDOH frameworks. The literature review focuses primarily on U.S.-based studies of adults with diabetes and on five SDOH: socioeconomic status (education, income, occupation); neighborhood and physical environment (housing, built environment, toxic environmental …
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This care gap is a major source of health disparity, with racial and ethnic minorities, and under-resourced communities, having worse outcomes, and a disproportionately higher prevalence of DED.
“This care gap is a major source of health disparity, with racial and ethnic minorities, and under-resourced communities, having worse outcomes, and a disproportionately higher prevalence of DED2,5–9.”
From Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial (2024) · cites this paper as [5]
The Introduction reports higher diabetes risk, complications, and mortality among racial and ethnic minority and low-income populations. The Health Care and Diabetes section documents disparities in care quality, including dilated eye examinations. Neither passage establishes that the care gap causes a higher prevalence of DED in those groups. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThese findings suggest that predictive modeling benefits from capturing both scales of SDoH, with area-level indices providing broad contextual signals and individual-level measures offering more actionable insights for tailoring case management interventions.
“These findings suggest that predictive modeling benefits from capturing both scales of SDoH, with area-level indices providing broad contextual signals and individual-level measures offering more actionable insights for tailoring case management interventions [33,36,37].”
From Machine learning-driven risk prediction for post-hospitalization diabetes case management: Integrating clinical and social determinants of health (2026) · cites this paper as [33]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredEvidence supports associations between social determinants of health and diabetes mellitus-related outcomes.
“Evidence also supports associations between SDOH and diabetes mellitus-related outcomes148.”
From A global view of hypertensive disorders and diabetes mellitus during pregnancy (2022) · cites this paper as [148]
The analysis also does not account for social determinants of health, which may impact the glycemic and weight outcomes in this population.
“The analysis also does not account for social determinants of health, which may impact the glycemic and weight outcomes in this population (25).”
From Tirzepatide Improved Markers of Islet Cell Function and Insulin Sensitivity in People With T2D (SURPASS-2) (2024) · cites this paper as [25]
Social determinants of health influence outcomes among patients with diabetes, particularly in vulnerable populations.
“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 [33]
The link between chronic antidepressant use and type 2 diabetes may reflect the association between diabetes and depression rather than an adverse effect of antidepressants.
“this may reflect the association of DM with depression rather than an adverse effect of these agents.1651,1652”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1652]
The Food Environment and Diabetes section discusses depressive symptoms and diabetes distress in relation to food insecurity, not antidepressant use. Searches for antidepressant use, adverse effects, and depression as an alternative explanation for diabetes found no passage addressing the claimed distinction. Page numbers were unavailable in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measuredChronic antidepressant use is associated with a modestly increased relative risk of type 2 diabetes.
“Although chronic use of antidepressant medication has been associated with a modestly increased relative risk of T2D”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1652]
The Food Environment and Diabetes section discusses depressive symptoms in relation to food insecurity, while the Health Care and Diabetes section discusses medication underuse among people who already have diabetes. Neither addresses whether chronic antidepressant use is associated with a modestly increased risk of developing type 2 diabetes. Searches for “antidepressant” and “antidepressants” found no relevant passage in our copy; page numbers were unavailable. (LLM, conf=0.75)
Experimental — accuracy not yet measuredAddressing elements of social determinants of health are necessary for people with diabetes to achieve optimal self-management and are deemed essential to achieving health equity.
“For DSMES services, SDOH must also be considered as process measures because addressing elements of SDOH are necessary for the PWD to achieve optimal self-management and are deemed essential to achieving health equity from the individual PWD, program, and population health perspectives (46).”
From 2022 National standards for diabetes self-management education and support (2022) · cites this paper as [46]
People with diabetes' concerns and needs change throughout their lifetime due to changes in physical and emotional health, cultural and religious practices, social determinants of health, ability to exercise, care support systems, and other factors.
“A PWD's concerns and needs change throughout their lifetime due to changes in physical and emotional health, cultural and religious practices, SDOH, the ability to exercise, care support systems, etc. (46,84,89,96).”
From 2022 National standards for diabetes self-management education and support (2022) · cites this paper as [46]
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A global view of hypertensive disorders and diabetes mellitus during pregnancy
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14. Children and Adolescents: Standards of Care in Diabetes—2025
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2022 National standards for diabetes self-management education and support
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“These disparities persist across healthcare settings and are influenced by intersecting factors, including provider prescribing bias, structural barriers to specialty care, medication costs, and restrictive insurance policies [4,5].”
Lee, S.-Y., Saleem, M., Land, A. M., DeLaney, E. W., Garretson, A. R., Patel, M., Hall, A. G., Westrick, S., Ovalle, F., Cherrington, A. L., et al. (2026) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2026.106604
- Authors
- Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., Thornton, P. L., & Haire-Joshu, D.
- Affiliations
- Department of Medicine, Johns Hopkins University, Baltimore, MD
- University of California, San Francisco (US)
- University of North Carolina at Chapel Hill (US)
- University of Chicago (US)
- Departments of Epidemiology and Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA
- Department of Environmental Health Sciences, Columbia University, New York, NY
- National Institutes of Health (US)
- Washington University in St. Louis (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2020-11-02
- Volume
- 44
- Issue
- 1
- Pages
- 258-279
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC7783927
- OpenAlex
- W3096909987
- Cited by
- 1,732
- References
- 294
- Citations by year
- 2026: 312 · 2025: 407 · 2024: 400 · 2023: 292 · 2022: 229 · 2021: 86 · 2020: 6
- FWCI
- 84.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5t32hl007180-45, UL1TR003098)
- National Heart, Lung, and Blood Institute (T32-HL-007180, R01HL131531)
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK109200, P30DK092949, P30DK092950, P30DK092926)
- National Institute of Environmental Health Sciences (P42ES010349, P30ES009089)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- social determinants of health, diabetes mellitus, health equity, racial and ethnic minorities, low-income populations, socioeconomic status, neighborhood environment, built environment, housing, prediabetes, type 2 diabetes, diabetes complications, diabetes mortality, COVID-19 pandemic
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