APHA 2024-Diabetes, SDoH, Low Income

This topic was presented in Minneapolis, MN as a presentation. This is the live presentation.
Abstract:
Social determinants of health inequalities (SDoH) are known to affect lower-income demographics, related economic minorities, and other vulnerable populations adversely and disproportionately. Therefore, chronic diseases like type-2 Diabetes Mellitus (T2DM), coupled with protracted exposure to upstream SDoH, exacerbate chronic diseases. This study evaluated the influence of SDoH on the incidence/prevalence of T2DM in the US. Using the 2018 and 2023 Health County Rankings datasets, we evaluated whether a statistically predictable relationship existed between T2DM prevalence and contextually found SDoH in the US. We performed geospatial and geostatistical analyses via ordinary least squared-based multiple linear, geographically weighted, and multiscale geographically weighted regression models. The results showed that contextually found SDoH adversely influenced the prevalence of T2DM in the US, especially in historically marginalized populations, with F(1,15)= 475.23, adj-R2=0.73, and p =.001 for the MLR model; AICc= 3,267 and adj-R2= 0.853 for the GWR model; and ACIc= 3,173 adj-R2= 0.857 for the MGWR model. These adverse effects was significant in females, Latinos, and African American populations in the US. They remain poor, underserved, and with higher odds of developing cognitive decline, a clinical manifestation of Alzheimer’s disease and related dementias (ADRD). Moreover, the geospatial and geostatistical evaluation depicts a disproportionately higher T2DM prevalence among the said population and in US areas historically identified with higher Latino and African American populations. These results should help contextualize public health interventions optimizing human and economic resources in the implementation of culturally sensitive strategies of health promotion through a sustainable approach to positive social change.