Social Determinants of Health and Racial/Ethnic Disparities in Type 2 Diabetes in Youth

Butler, Ashley M.

doi:10.1007/s11892-017-0885-0

Cited by 69 publications

(70 citation statements)

References 26 publications

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“…As in our study, others showed substantial proportions (≥40%) of subjects come from the most deprived families . The conceptual model for SDOH in youth with T2D proposes social determinants such as low family income, low parental education and higher levels of stress (in parents/caregivers and youth) are more prevalent in some ethnic minorities leading to both onset of T2D and poorer glycemic control acting via mediators like poorer lifestyle choices, healthcare access, family knowledge and coping skills and management of chronic diseases . Attitudes of healthcare providers when treating CYP from diverse ethnic and socioeconomic backgrounds could be another explanatory factor though not as significant as those above and harder to assess in observational studies like ours.…”

Section: Discussionsupporting

confidence: 53%

Inequalities in glycemic control in childhood onset type 2 diabetes in England and Wales—A national population‐based longitudinal study

et al. 2019

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Background Not much is known about glycaemic‐control trajectories in childhood‐onset type 2 diabetes (T2D). We investigated characteristics of children and young people (CYP) with T2D and inequalities in glycemic control. Methods We studied 747 CYP with T2D, <19 years of age in 2009‐2016 (from the total population‐based National Pediatric Diabetes Audit [>95% diabetes cases in England/Wales]). Linear mixed‐effects modeling was used to assess socioeconomic and ethnic differences in longitudinal glycated hemoglobin (HbA1c) trajectories during 4 years post‐diagnosis (3326 HbA1c data points, mean 4.5 data points/subject). Self‐identified ethnicity was grouped into six categories. Index of Multiple Deprivation (a small geographical area‐level deprivation measure) was grouped into SES quintiles for analysis. Results Fifty‐eight percent were non‐White, 66% were female, and 41% were in the most disadvantaged SES quintile. Mean age and HbA1c at diagnosis were 13.4 years and 68 mmol/mol, respectively. Following an initial decrease between diagnosis and end of year 1 (−15.2 mmol/mol 95%CI, −19.2, −11.2), HbA1c trajectories increased between years 1 and 3 (10 mmol/mol, 7.6, 12.4), followed by slight gradual decrease subsequently (−1.6 mmol/mol, −2, −1.1). Compared to White CYP, Pakistani children had higher HbA1c at diagnosis (13.2 mmol/mol, 5.6‐20.9). During follow‐up, mixed‐ethnicity and Pakistani CYP had poorer glycemic control. Compared to children in the most disadvantaged quintile, those in the most advantaged had lower HbA1c at diagnosis (−6.3 mmol, −12.6, −0.1). Differences by SES remained during follow‐up. Mutual adjustment for SES and ethnicity did not substantially alter the above estimates. Conclusions About two‐thirds of children with childhood‐onset T2D were non‐White, female adolescents, just under half of whom live in the most disadvantaged areas of England and Wales. Additionally, there are substantial socioeconomic and ethnic inequalities in diabetes control.

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Section: Discussionsupporting

confidence: 53%

Inequalities in glycemic control in childhood onset type 2 diabetes in England and Wales—A national population‐based longitudinal study

et al. 2019

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“…Research clearly demonstrates the relationship between SES and diabetes. Studies have found that low family income, parental education, and high youth stress are common among families of minority youth with T2DM, noting their influence on disparities in diabetes onset, quality of life, and family burden (26,71). Walker and colleagues (138) focus on income and stress as key determinants of poor glycemic control.…”

Section: Socioeconomic Statusmentioning

confidence: 99%

The Next Generation of Diabetes Translation: A Path to Health Equity

Haire‐Joshu

Hill-Briggs²

2019

Annu. Rev. Public Health

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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.

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“…As ethnicity overlaps with SES indicators (e.g., parental educational attainment) [30,31] and as parental educational attainment has a strong protective influence on academic achievement of youth, researchers have been interested in decomposing the contribution of ethnicity from SES (e.g., parental educational attainment) in explaining ethnic differences in academic achievement [32][33][34]. The results of this line of research are, however, conflicting.…”

Section: Introductionmentioning

confidence: 99%

Mathematical Performance of American Youth: Diminished Returns of Educational Attainment of Asian-American Parents

et al. 2020

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The Marginalization-related Diminished Returns (MDR) phenomenon refers to the weaker effects of parental educational attainment for marginalized groups, particularly ethnic minorities. This literature, however, is limited to Blacks and Hispanics; thus, it is not clear if the MDR phenomenon also applies to the educational performance of Asian Americans or not. To explore ethnic differences in the association between parental educational attainment and youth mathematical performance among 10th-grade American high schoolers, this cross-sectional study used baseline data from the Education Longitudinal Study, a national survey of 10th-grade American youth. The analytical sample included a total number of 10,142 youth composed of 1460 (14.4%) Asian-American and 8682 (85.6%) non-Hispanic youth. The dependent variable was youth math performance (standard test score). The independent variable was parental education. Gender, both parents living in the same household, and school characteristics (% students receiving free lunch, urban school, and public school) were the covariates. Ethnicity was the moderating variable. Linear regression was used for data analysis. Overall, parental educational attainment was positively associated with math ability (test score). We observed a statistically significant interaction between ethnicity (Asian American) and parental education attainment on the results of math test scores, indicating that the boosting effect of high parental educational attainment on youth math function is smaller for Asian-American youth than for Non-Hispanic White youth. While high parental educational attainment contributes to youth educational outcomes, this association is weaker for Asian-American youth than non-Hispanic White youth. Diminished returns (weaker effects of parental education in generating outcomes for ethnic minorities) that are previously shown for Hispanics and Blacks also apply to Asian Americans.

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Social Determinants of Health and Racial/Ethnic Disparities in Type 2 Diabetes in Youth

Cited by 69 publications

References 26 publications

Inequalities in glycemic control in childhood onset type 2 diabetes in England and Wales—A national population‐based longitudinal study

Inequalities in glycemic control in childhood onset type 2 diabetes in England and Wales—A national population‐based longitudinal study

The Next Generation of Diabetes Translation: A Path to Health Equity

Mathematical Performance of American Youth: Diminished Returns of Educational Attainment of Asian-American Parents

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