Social determinants of health, cystic fibrosis-related diabetes, and mental health in adult patients with cystic fibrosis: a critical synthesis of narrative review.

The population of adults with cystic fibrosis (CF) exceeds that of the pediatric CF population, and life expectancy for people with CF (PwCF) continues to improve, resulting in an adult CF population with chronic extrapulmonary comorbid conditions, including CF-related diabetes (CFRD), a common complication affecting roughly 50% of PwCF, as well as mental health disorders, including depression and generalized anxiety. These comorbidities have been strongly associated with increased risk of progressive lung disease, impaired quality of life, and increased risk of acute exacerbations requiring healthcare utilization. These risks disproportionately affect PwCF who are from ethnic minorities and are often genetically ineligible for novel treatments. Social determinants of health (SDOH) are related to and contribute to health disparities in PwCF. To reduce the impact of SDOH on health-related disparities in this population, PwCF needs greater awareness of associated factors to develop interventions that can improve care. This narrative review critically synthesizes the available literature on the complex intersections of social determinants of health, mental health, and concomitant CFRD that affect health outcomes for PwCF.