Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA.
Department of Public Health, Faculty of Medicine, University of Helsinki, 00100 Helsinki, Finland.
Int J Environ Res Public Health. 2021 Jan 18;18(2):792. doi: 10.3390/ijerph18020792.
One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person's environment that may impact health. The objective of this study was to determine whether there is an association between SDOHs and DR in patients with type II diabetes. This cross-section study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). This study included people with self-reported diabetes in the US in 2018 (n = 60,703). Exposure variables included homeownership, marital status, income, health care coverage, completed level of education, and urban vs. rural environment. The outcome variable was DR. Logistic regression analysis were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Alaskan Native/Native American (OR 2.11; 95% CI: 1.14-3.90), out of work (OR 2.82; 95% CI: 1.62-4.92), unable to work (OR 2.14; 95% CI: 1.57-2.91), did not graduate high school (OR 1.91; 95% CI: 1.30-2.79), only graduated high school (OR 1.43; 95% CI 1.08-1.97), or only attended college or technical school without graduating (OR 1.42; 95% CI: 1.09-1.86) were SDOHs associated with DR in patients with diabetes. Health care providers should identify these possible SDOHs affecting their diabetic patients.
三分之一的美国糖尿病患者会患上糖尿病视网膜病变（DR），这是导致美国工作年龄段人群失明的主要原因。健康的社会决定因素（SDOHs）是一个人所处环境中可能影响健康的条件。本研究的目的是确定 SDOH 与 2 型糖尿病患者 DR 是否存在关联。本横断面研究使用了 2018 年行为风险因素监测系统（BRFSS）的数据。本研究包括 2018 年美国自我报告患有糖尿病的人群（n = 60703）。暴露变量包括自有住房、婚姻状况、收入、医疗保险覆盖范围、完成的教育程度以及城市与农村环境。结局变量是 DR。应用逻辑回归分析计算比值比（OR）和 95%置信区间（CI）。阿拉斯加原住民/美洲原住民（OR 2.11；95%CI：1.14-3.90）、失业（OR 2.82；95%CI：1.62-4.92）、无法工作（OR 2.14；95%CI：1.57-2.91）、未高中毕业（OR 1.91；95%CI：1.30-2.79）、仅高中毕业（OR 1.43；95%CI 1.08-1.97）或仅上大学或技术学校但未毕业（OR 1.42；95%CI：1.09-1.86）与糖尿病患者的 DR 相关。医疗保健提供者应识别这些可能影响其糖尿病患者的 SDOH。
