Public Health and Medicine, Brown School, Washington University in St. Louis, St. Louis, Missouri 63130, USA; email:
Departments of Medicine; Health, Behavior and Society; and Acute and Chronic Care; and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA; email:
Annu Rev Public Health. 2019 Apr 1;40:391-410. doi: 10.1146/annurev-publhealth-040218-044158. Epub 2019 Jan 2.
Disparities in diabetes burden exist in large part because of the social determinants of health (SDOH). Translation research and practice addressing health equity in diabetes have generally focused on changing individual behavior or providing supportive approaches to compensate for, rather than directly target, SDOH. The purpose of this article is to propose a pathway for addressing SDOH as root causes of diabetes disparities and as an essential target for the next generation of interventions needed to achieve health equity in diabetes prevention and treatment. This review describes ( a) the current burden of diabetes disparities, ( b) the influence of SDOH on diabetes disparities, ( c) gaps in and implications of current translation research, and ( d) approaches to achieving health equity in the next generation of diabetes translation.
糖尿病负担的差异在很大程度上是由于健康的社会决定因素(SDOH)造成的。针对糖尿病健康公平问题的翻译研究和实践通常侧重于改变个人行为或提供支持性方法来补偿,而不是直接针对 SDOH。本文的目的是提出一条解决 SDOH 作为糖尿病差异根本原因的途径,以及作为实现糖尿病预防和治疗健康公平所需的下一代干预措施的重要目标。本综述描述了:(a) 糖尿病差异的当前负担;(b) SDOH 对糖尿病差异的影响;(c) 当前翻译研究的差距和影响;以及 (d) 实现下一代糖尿病翻译健康公平的方法。