Chapter 67
Social Determinants of Diabetes
Keri F. Kirk,
Gerald McKinley,
Briana Mezuk,
Erica Spears,
Keri F. Kirk
Department of Family Medicine and Psychiatry, Georgetown University School of Medicine, MedStar-Georgetown University Hospital, Washington, DC, USA
Search for more papers by this authorGerald McKinley
Department of Pathology and Laboratory Medicine, Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
Search for more papers by this authorBriana Mezuk
Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
Search for more papers by this authorErica Spears
Louisiana Public Health Institute, New Orleans, LA, USA
Search for more papers by this authorKeri F. Kirk,
Gerald McKinley,
Briana Mezuk,
Erica Spears,
Keri F. Kirk
Department of Family Medicine and Psychiatry, Georgetown University School of Medicine, MedStar-Georgetown University Hospital, Washington, DC, USA
Search for more papers by this authorGerald McKinley
Department of Pathology and Laboratory Medicine, Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
Search for more papers by this authorBriana Mezuk
Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
Search for more papers by this authorErica Spears
Louisiana Public Health Institute, New Orleans, LA, USA
Search for more papers by this authorBook Editor(s):Richard I.G. Holt MA, MB BChir, PhD, FRCP, FHEA,
Allan Flyvbjerg MD, DMSc,
Richard I.G. Holt MA, MB BChir, PhD, FRCP, FHEA
Professor in Diabetes & Endocrinology Faculty of Medicine Honorary Consultant Physician
Human Development and Health
University of Southampton, Southampton, UK
Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
Search for more papers by this authorAllan Flyvbjerg MD, DMSc
Former CEO at Steno Diabetes Center Copenhagen (SDCC) Professor of Clinical Endocrinology
The Capital Region of Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Search for more papers by this authorFirst published: 12 January 2024
Summary
While social determinants of health have been examined as determinants of various aspects of diabetes care (i.e. medication taking, glycaemic management), there also is a growing body of literature on how social determinants shape the risk of developing type 2 diabetes. Using illustrative examples from the USA and Canada, this chapter describes how social determinants of health drive racial inequities in type 2 diabetes. It describes how macro- and meso-level factors influence the risk of type 2 diabetes by structuring the dimensions on which individuals can make choices about health behaviours. Social inequities in type 2 diabetes exist across all dimensions of this disease, including incidence, prevalence, complications, and mortality. Social determinants of health systematically shape the options individuals have for engaging in type 2 diabetes prevention behaviours, and therefore have direct impacts on the choices that individuals make. The chapter concludes with key takeaway messages for clinicians and public health practitioners.
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