An updated literature review by the American Diabetes Association calls for interventions to address social determinants of health (SDOH), an important move toward the goal of achieving health equity in people with diabetes. It focuses on five key areas of SDOH: socioeconomic status, neighborhood and physical environment, food environment, health care, and social context.1
The review provides outcomes data about the impact of SDOH on patients with diabetes, as well as SDOH intervention recommendations from several national and international committees, some of which are directly relevant to primary care providers.2 The recommendations (Table 3) include, but are not limited to:
- Incorporate strategies for screening and assessing for social risk factors and needs.
- Incorporate social risk into care decisions using patient-centered care.
- Establish linkages between health care and social service providers.
- Include social workers in team care.
Though the review committee began their work pre-pandemic, the authors note that “the COVID-19 pandemic has highlighted unequal vulnerabilities borne by racial and ethnic minority groups and by disadvantaged communities."
In addition to providing an extensive list of clinician resources (Table 4), the authors call for an increased emphasis on non-medical interventions, including research and public policy, that impact root causes of disparities, such as literacy proficiency and zoning policies.
- Hill-Briggs F, Adler NE, Berkowitz SA, et al. Social determinants of health and diabetes: a scientific review. Diabetes Care. 2021;44(1):258-279.
- National Academies of Sciences, Engineering, and Medicine. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health. National Academies Press. 2019.