Social Determinants of Health and Impact on Screening, Prevalence, and Management of Diabetic Retinopathy in Adults: A Narrative Review

Patel, Dhruva; Ananthakrishnan, Ajaykarthik; Lin, Tyger; Channa, Roomasa; Liu, T. Y. Alvin; Wolf, Risa M.

doi:10.3390/jcm11237120

Cited by 48Retinal Diseases and TreatmentsRetinal Imaging and AnalysisHealth disparities and outcomes

Social Determinants of Health and Impact on Screening, Prevalence, and Management of Diabetic Retinopathy in Adults: A Narrative Review

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Patel, Dhruva, Ananthakrishnan, Ajaykarthik, Lin, Tyger, Channa, Roomasa, Liu, T. Y. Alvin, Wolf, Risa M.·2022·Journal of Clinical Medicine

DOI 10.3390/jcm11237120PMC PMC9739502

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Abstract

Diabetic retinal disease (DRD) is the leading cause of blindness among working-aged individuals with diabetes. In the United States, underserved and minority populations are disproportionately affected by diabetic retinopathy and other diabetes-related health outcomes. In this narrative review, we describe racial disparities in the prevalence and screening of diabetic retinopathy, as well as the wide-range of disparities associated with social determinants of health (SDOH), which include socioeconomic status, geography, health-care access, and education.

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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 [9]
The Introduction and §3.5.2 report worse diabetes-related outcomes and reduced eye-care access among underserved and minority populations. Section 3 reports disproportionately higher prevalence of diabetic retinopathy in some ethnic minority groups. The paper addresses diabetic retinal disease, not DED, so it does not support the claimed higher prevalence of DED. Page numbers were not provided. (LLM, conf=0.88)
Experimental — accuracy not yet measured
The baseline data in this study confirmed racial, ethnic, and socioeconomic gap closure disparities, similar to other studies demonstrating the wide range of disparities associated with social determinants of health in diabetic retinopathy screening.
“The baseline data in this study confirmed these racial, ethnic, and socioeconomic gap closure disparities, similar to other studies demonstrating the wide range of disparities associated with social determinants of health in diabetic retinopathy screening9,41.”
From Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial (2024) · cites this paper as [9]

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Diabetic Retinopathy Screening and Monitoring of Early Stage Disease in Australian General Practice: Tackling Preventable Blindness within a Chronic Care Model
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The role of tele-ophthalmology in diabetic retinopathy screening
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Socioeconomic deprivation and development of diabetic retinopathy in patients with type 1 diabetes mellitus
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System-level and patient-level explanations for non-attendance at diabetic retinopathy screening in Sutton and Merton (London, UK): a qualitative analysis of a service evaluation
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Do Diabetic Patients Living in Racially Segregated Neighborhoods Experience Different Access and Quality of Care?
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Risk Factors for Proliferative Diabetic Retinopathy in African Americans with Type 2 Diabetes
Penman, A. D., Hancock, H., Papavasileiou, E., James, M., Idowu, O., Riche, D. M., Fernandez, M., Brauner, S. C., Smith, S. O., Hoadley, S., et al. (2016) · Ophthalmic Epidemiology · doi:10.3109/09286586.2015.1119287 · Cited by 37 · see citing works
Neighborhood Deprivation and Adherence to Initial Diabetic Retinopathy Screening
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Trends in the Care of Diabetic Macular Edema: Analysis of a National Cohort
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Does patient education improve compliance to routine diabetic retinopathy screening?
Moinul, P., Barbosa, J., Qian, J., Chen, M. L., Mohaghegh, M., Kaur, H., Holmes, J., Radman, H., Robinson, T., & Chaudhary, V. (2018) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x18804749 · Cited by 35 · see citing works
Geographic Access Disparities to Clinical Trials in Diabetic Eye Disease in the United States
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Social deprivation as a risk factor for late presentation of proliferative diabetic retinopathy
Lane, M., Mathewson, P. A., Sharma, H. E., Palmer, H., Nightingale, P., Shah, P., Tsaloumas, M. D., & Denniston, A. K. (2015) · Clinical ophthalmology · doi:10.2147/opth.s73272 · Cited by 30 · see citing works
Racial, Ethnic, and Gender Disparities in Diabetic Macular Edema Clinical Trials
Bowe, T., Salabati, M., Soares, R. R., Huang, C., Singh, R. P., Ma, K., Williams, B. K., Sridhar, J. S., Chiang, A., Cohen, M. N., et al. (2022) · Ophthalmology Retina · doi:10.1016/j.oret.2022.01.018 · Cited by 29 · see citing works
Disparities in Diabetic Retinopathy Screening Rates Within Minority Populations: Differences in Reported Screening Rates Among African American and Hispanic Patients
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Annual diabetic eye examinations in a managed care Medicaid population.
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The Impact of Race on Short-term Treatment Response to Bevacizumab in Diabetic Macular Edema
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Sanjiv, N., Osathanugrah, P., Harrell, M. F., Siegel, N. H., Ness, S. D., Chen, X., Cabral, H., & Subramanian, M. L. (2022) · Journal of the National Medical Association · doi:10.1016/j.jnma.2021.12.016 · Cited by 21 · see citing works
PATIENTS PRESENTING EMERGENTLY WITH PROLIFERATIVE DIABETIC RETINOPATHY
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Impact of Socioeconomic Disadvantage and Diabetic Retinopathy Severity on Poor Ophthalmic Follow-Up in a Rural Vermont and New York Population
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Visit adherence and visual acuity outcomes in patients with diabetic macular edema: a secondary analysis of DRCRnet Protocol T
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Race and Socioeconomic Status in Anti-VEGF Treatment of Diabetic Macular Edema
Malhotra, N. A., Muste, J. C., Hom, G. L., Conti, T. F., Greenlee, T. E., & Singh, R. P. (2021) · Ophthalmic surgery, lasers & imaging retina · doi:10.3928/23258160-20211018-01 · Cited by 19 · see citing works
Yearly Treatment Patterns for Patients with Recently Diagnosed Diabetic Macular Edema
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Payment Reform Needed to Address Health Disparities of Undiagnosed Diabetic Retinopathy in the City of Chicago
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Assessing the need for on-site eye care professionals in community health centers.
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Evaluating Adherence to Dilated Eye Examination Recommendations Among Patients with Diabetes, Combined with Patient and Provider Perspectives.
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Racial Differences in Anti-VEGF Intravitreal Injections Among Commercially Insured Beneficiaries
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Determinants in Initial Treatment Choice for Diabetic Macular Edema
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Teleophthalmology and Inequities in Diabetic Eye Disease at Safety Net Hospitals
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Anti‐ VEGF monotherapy versus anti‐ VEGF therapy combined with laser or intravitreal glucocorticoid therapy for diabetic macular edema: A Bayesian network meta‐analysis
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Diabetic retinopathy screening in Australian general practice: persistently low uptake despite national guidelines and equity initiatives
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The impact of sociodemographic factors on diabetic retinopathy screening and prevalence: a systematic review and meta-analysis
Tarazi, A., Ammar, O., AlSawaftah, Y., El-Hilo, K., & Yaghi, N. E. A. (2026) · Diabetology International · doi:10.1007/s13340-026-00905-6
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Coney, J. M., & Scott, A. W. (2022) · Journal of the National Medical Association · doi:10.1016/j.jnma.2021.12.011 · Cited by 53 · see citing works
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The association between social determinants of health and self-reported diabetic retinopathy: An exploratory analysis
Silverberg, E. L., Sterling, T. W., Williams, T. H., Castro, G., Rodriguez de la Vega, P., & Barengo, N. C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18020792 · Cited by 29 · see citing works
Racial and Socioeconomic Differences Correlate with Healthcare Disparities in Patients with Diabetic Retinopathy
Huang, D., Channamsetty, S., Verter, E. E., & Huang, J. (2024) · International Journal of Ophthalmology & Visual Science · doi:10.11648/j.ijovs.20240903.11 · Cited by 1 · see citing works

Authors: Patel, D., Ananthakrishnan, A., Lin, T., Channa, R., Liu, T. Y. A., & Wolf, R. M.
Affiliations: Johns Hopkins University (US)
University of Wisconsin–Madison (US)
Corresponding author: Wolf, Risa M.
ORCID: Ananthakrishnan, Ajaykarthik
Lin, Tyger
Channa, Roomasa
Liu, T. Y. Alvin
Wolf, Risa M.
Venue: Journal of Clinical Medicine
Publisher: MDPI AG
Published: 2022-11-30
Volume: 11
Issue: 23
Pages: 7120
ISSN: 2077-0383 (ISSN-L)
DOI: 10.3390/jcm11237120
PMC: PMC9739502
OpenAlex: W4311013854
Cited by: 43
References: 108
Citations by year: 2026: 12 · 2025: 16 · 2024: 11 · 2023: 4
FWCI: 1.66
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Journal of Clinical Medicine (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders: the National Eye Institute of the National Institutes of Health (R01EY033233)
Topics: Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
Social Sciences › Health › Health disparities and outcomes
Keywords: diabetic retinopathy, social determinants of health, racial disparities, diabetes screening, socioeconomic status, health care access, underserved populations, blindness, prevalence

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Social Determinants of Health and Impact on Screening, Prevalence, and Management of Diabetic Retinopathy in Adults: A Narrative Review

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