TY - JOUR
T1 - Association Between Social Determinants of Health and Glycemic Control Among African American People with Type 2 diabetes
T2 - The Jackson Heart Study
AU - Hu, Jie
AU - Kline, David M.
AU - Tan, Alai
AU - Zhao, Songzhu
AU - Brock, Guy
AU - Mion, Lorraine C.
AU - Efird, Jimmy T.
AU - Wang, Danxin
AU - Sims, Mario
AU - Wu, Bei
AU - Mongraw-Chaffin, Morgana
AU - Joseph, Joshua J.
N1 - Publisher Copyright:
© 2022 Society of Behavioral Medicine. All rights reserved.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Background: Social determinants of health have a significant impact on health outcomes. However, the complexity and interaction of multiple factors influencing glycemic control remain understudied. Purpose: This study examined associations of socioeconomic position (income, education, and occupation), environmental (physical activity facilities, neighborhood social cohesion, neighborhood problem, and violence), behavioral (physical activity, nutrition, and smoking), and psychological factors (depressive symptoms, stress, and discrimination) with glycemic control (hemoglobin A1c [A1c]) using the World Health Organization Social Determinants of Health framework in African American adults with type 2 diabetes. Methods: A secondary data analysis was conducted using a longitudinal cohort of 1,240 African American adults with type 2 diabetes who participated in the community-based Jackson Heart Study. Socioeconomic position, environmental, behavioral, and psychological factors were measured using validated instruments in the Jackson Heart Study. Longitudinal structural equation modeling was used with glycemic control (A1c) collected over time (Exams 1-3) as the study outcome. Results: Our study presents the complex interplay of socioeconomic determinants of health and glycemic control over time. Higher socioeconomic position (higher income, higher level of education, and professional occupation) was directly associated with improvement in glycemic control over time. An association of socioeconomic position on glycemic control mediated through health behavior factors was also observed. Conclusions: In this analysis, socioeconomic position components were determinants of glycemic control in African American adults with type 2 diabetes. Future studies aimed at reducing health disparities and achieving equality of outcomes in this population will benefit from embedding socioeconomic position components into their design.
AB - Background: Social determinants of health have a significant impact on health outcomes. However, the complexity and interaction of multiple factors influencing glycemic control remain understudied. Purpose: This study examined associations of socioeconomic position (income, education, and occupation), environmental (physical activity facilities, neighborhood social cohesion, neighborhood problem, and violence), behavioral (physical activity, nutrition, and smoking), and psychological factors (depressive symptoms, stress, and discrimination) with glycemic control (hemoglobin A1c [A1c]) using the World Health Organization Social Determinants of Health framework in African American adults with type 2 diabetes. Methods: A secondary data analysis was conducted using a longitudinal cohort of 1,240 African American adults with type 2 diabetes who participated in the community-based Jackson Heart Study. Socioeconomic position, environmental, behavioral, and psychological factors were measured using validated instruments in the Jackson Heart Study. Longitudinal structural equation modeling was used with glycemic control (A1c) collected over time (Exams 1-3) as the study outcome. Results: Our study presents the complex interplay of socioeconomic determinants of health and glycemic control over time. Higher socioeconomic position (higher income, higher level of education, and professional occupation) was directly associated with improvement in glycemic control over time. An association of socioeconomic position on glycemic control mediated through health behavior factors was also observed. Conclusions: In this analysis, socioeconomic position components were determinants of glycemic control in African American adults with type 2 diabetes. Future studies aimed at reducing health disparities and achieving equality of outcomes in this population will benefit from embedding socioeconomic position components into their design.
KW - African Americans
KW - Glycemic control
KW - Jackson Heart Study
KW - Social determinants of health
KW - Type 2 diabetes
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U2 - 10.1093/abm/kaac026
DO - 10.1093/abm/kaac026
M3 - Article
C2 - 36197118
AN - SCOPUS:85142402861
SN - 0883-6612
VL - 56
SP - 1300
EP - 1311
JO - Annals of Behavioral Medicine
JF - Annals of Behavioral Medicine
IS - 12
ER -