Association Between Social Determinants of Health and Glycemic Control Among African American People with Type 2 diabetes: The Jackson Heart Study-Reference-Cited by-同舟云学术

Association Between Social Determinants of Health and Glycemic Control Among African American People with Type 2 diabetes: The Jackson Heart Study

Published:2022-10-05 Issue:12 Volume:56 Page:1300-1311
ISSN:0883-6612
Container-title:Annals of Behavioral Medicine
language:en
Short-container-title:

Author:

Hu Jie¹^ORCID,Kline David M²³^ORCID,Tan Alai¹^ORCID,Zhao Songzhu³,Brock Guy³^ORCID,Mion Lorraine C¹^ORCID,Efird Jimmy T⁴⁵^ORCID,Wang Danxin⁶^ORCID,Sims Mario⁷^ORCID,Wu Bei⁸^ORCID,Mongraw-Chaffin Morgana⁹^ORCID,Joseph Joshua J¹⁰^ORCID

Affiliation:

1. College of Nursing, The Ohio State University , Columbus, OH , USA

2. Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine , Winston-Salem, NC , USA

3. Center for Biostatistics, College of Medicine Department of Biomedical Informatics, The Ohio State University , Columbus, OH , USA

4. Department of Radiation Oncology, School of Medicine, Case Western Reserve University , Cleveland, OH , USA

5. Boston VA Cooperative Studies Program Coordinating Center , Boston, MS , USA

6. Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida , Gainesville, FL , USA

7. University of Mississippi Medical Center , Jackson , MS , USA

8. Rory Meyers College of Nursing, New York University , New York, NY , USA

9. School of Medicine, Wake Forest University , Winston-Salem, NC , USA

10. College of Medicine, The Ohio State University , Columbus, OH , USA

Abstract

Abstract 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.

Funder

Jackson State University

Tougaloo College

Mississippi State Department of Health

University of Mississippi Medical Center

National Institute on Minority Health and Health Disparities

The Robert Wood Johnson Foundation

Harold Amos Medical Faculty Development Program

National Institute of Diabetes and Digestive and Kidney Diseases

Publisher

Oxford University Press (OUP)

Subject