Journal of general internal medicine · 2025
Associations Between Suboptimal Social Determinants of Health and Diabetes Distress in Low-Income Patients on Medicaid.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Williams Emily H, Juarez Lucia D, Presley Caroline A, Agne April, Cherrington Andrea L, Howell Carrie R
Аннотация
AIMS: To determine associations between suboptimal social determinants of health (SDoH) and diabetes distress in adults with diabetes on Medicaid.
METHODS: We surveyed adults with type 2 diabetes covered by Alabama Medicaid. Diabetes distress was assessed using the Diabetes Distress Scale. Suboptimal SDoH included food or housing insecurity; having < high school degree; being unemployed; and household income < $10,000/year. Unadjusted associations between individual SDoH and diabetes distress were examined using logistic regression. We also examined the association between the number of suboptimal SDoH and distress. Multivariable models controlled for age, sex, race, marital status, rurality, diabetes duration, social support, and insulin use.
RESULTS: In total, 433 patients participated (mean age, 50 years (SD 10.4); 80% female; 62% Black). Roughly 32% reported food insecurity, participants experienced a mean of 2 (SD, 0.9; range 0-5) suboptimal SDoH. There was increased odds of diabetes distress in participants who reported food insecurity (OR, 2.2; 95% CI, 1.36-3.65 and OR, 2.35; 95% CI, 1.40-3.93). For each additional suboptimal SDoH a patient experienced, they had increased odds of experiencing diabetes distress (OR, 1.50; CI, 1.15-2.01).
CONCLUSIONS: Participants with diabetes who reported food insecurity or experienced a higher number of suboptimal social determinants of health had an increased likelihood of experiencing diabetes distress.
METHODS: We surveyed adults with type 2 diabetes covered by Alabama Medicaid. Diabetes distress was assessed using the Diabetes Distress Scale. Suboptimal SDoH included food or housing insecurity; having < high school degree; being unemployed; and household income < $10,000/year. Unadjusted associations between individual SDoH and diabetes distress were examined using logistic regression. We also examined the association between the number of suboptimal SDoH and distress. Multivariable models controlled for age, sex, race, marital status, rurality, diabetes duration, social support, and insulin use.
RESULTS: In total, 433 patients participated (mean age, 50 years (SD 10.4); 80% female; 62% Black). Roughly 32% reported food insecurity, participants experienced a mean of 2 (SD, 0.9; range 0-5) suboptimal SDoH. There was increased odds of diabetes distress in participants who reported food insecurity (OR, 2.2; 95% CI, 1.36-3.65 and OR, 2.35; 95% CI, 1.40-3.93). For each additional suboptimal SDoH a patient experienced, they had increased odds of experiencing diabetes distress (OR, 1.50; CI, 1.15-2.01).
CONCLUSIONS: Participants with diabetes who reported food insecurity or experienced a higher number of suboptimal social determinants of health had an increased likelihood of experiencing diabetes distress.