Abstract
Purpose
Type 2 diabetes (T2D) is a chronic disease which leads to high morbidity, mortality and healthcare costs. Although relevant gains have been made towards evidence-based diabetes care, patients with T2D still experience diabetes complications and excess mortality risk, owing to multiple contributors, including non-clinical factors. The aim of this paper is to provide an overview of the main social determinants of vulnerabilities, which are known to have a relevant impact on T2D outcomes.
Results
As chronic diseases are under the influence of social inequalities, medicine and sociology are intertwined in the attempt to understand, explain and address them. There is robust evidence about a clear relationship between social determinants of health (SDOH), such as socio-economic status (occupation, education, income), and the likelihood of developing T2D and its complications. Furthermore, the uncontrolled widespread of T2D in urban areas, mainly among suburban communities, suggests that cities might act as amplifiers of SDOH, enhancing inequalities in health care and, therefore, life expectancy.
Conclusion
In light of the strong association between socio-cultural aspects and T2D outcomes, a global action is needed to raise awareness about disparities in diabetes prevention and treatment to reduce the burden of the disease.
Availability of data and materials
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References
Beck U (2009) World at Risk. Polity Press, Cambridge
Beck U, Ritter M (1992) Risk society : towards a new modernity. Sage, London
Elstad JI (2000) Social inequalities in health and their explanations. NOVA, Oslo
Iyen B, Vinogradova Y, Akyea RK, Weng S, Qureshi N, Kai J (2022) Ethnic disparities in mortality among overweight or obese adults with newly diagnosed type 2 diabetes: a population-based cohort study. J Endocrinol Invest 45(5):1011–1020. https://doi.org/10.1007/s40618-021-01736-9
Lenzi FR, Vaccaro K (2019) Il valore della multidimensionalità nell’approccio dell’urban health. Sicurezza e Scienze Sociali 1:192–206. https://doi.org/10.3280/SISS2019-001016
World Health Organization (2010) Equity, social determinants and public health programmes. https://www.who.int/publications/i/item/9789241563970. Accessed 13th October 2022
World Health Organization (2008) Closing the gap in a generation: health equity through action on the social determinants of health https://www.who.int/publications/i/item/WHO-IER-CSDH-08.1. Accessed 13th October 2022
World Health Organization (2011) Rio Political Declaration on Social Determinants of Health. https://www.who.int/publications/m/item/rio-political-declaration-on-social-determinants-of-health. Accessed 13th October 2022
Marmot M, Allen JJ (2014) Social determinants of health equity. Am J Public Health 104(4):S517-519. https://doi.org/10.2105/AJPH.2014.302200
Hill-Briggs F, Adler NE, Berkowitz SA, Chin MH, Gary-Webb TL, Navas-Acien A, Thornton PL, Haire-Joshu D (2020) Social determinants of health and diabetes: a scientific review. Diabetes Care. https://doi.org/10.2337/dci20-0053
Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A (2011) Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. Int J Epidemiol 40(3):804–818. https://doi.org/10.1093/ije/dyr029
Bijlsma-Rutte A, Rutters F, Elders PJM, Bot SDM, Nijpels G (2018) Socio-economic status and HbA1c in type 2 diabetes: a systematic review and meta-analysis. Diabetes Metab Res Rev 34(6):e3008. https://doi.org/10.1002/dmrr.3008
Jiang P, Babazono A, Fujita T (2020) Health inequalities among elderly type 2 diabetes mellitus patients in Japan. Popul Health Manag 23(3):264–270. https://doi.org/10.1089/pop.2019.0141
Nicolucci A, Rossi MC, Vaccaro K, Crialesi R, Rossetti S, Da Empoli S, Corsaro L, Morviducci L, Baroni MG, Frontoni S, Dotta F (2019) Urban diabetes: the case of the metropolitan area of rome. Acta Biomed 90(2):209–214. https://doi.org/10.23750/abm.v90i2.8345
Evans GW, Kantrowitz E (2002) Socioeconomic status and health: the potential role of environmental risk exposure. Annu Rev Public Health 23:303–331. https://doi.org/10.1146/annurev.publhealth.23.112001.112349
Bimonte VM, Besharat ZM, Antonioni A, Cella V, Lenzi A, Ferretti E, Migliaccio S (2021) The endocrine disruptor cadmium: a new player in the pathophysiology of metabolic diseases. J Endocrinol Invest 44(7):1363–1377. https://doi.org/10.1007/s40618-021-01502-x
Fine AM, Patrick L (2022) Environmental medicine: exploring the pollutome for solutions to chronic diseases. Phys Med Rehabil Clin N Am 33(3):719–732. https://doi.org/10.1016/j.pmr.2022.04.010
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Lenzi, F.R., Filardi, T. Social determinants of vulnerabilities in type 2 diabetes: a call to action. J Endocrinol Invest 46, 841–844 (2023). https://doi.org/10.1007/s40618-022-01952-x
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DOI: https://doi.org/10.1007/s40618-022-01952-x