Unfavorable social determinants of health and risk of mortality in adults with diabetes: findings from the National Health Interview Survey
Authors' conclusion
Cumulative social disadvantage in individuals with diabetes is associated with over twofold higher risk of mortality, independent of established risk factors. Our findings call for action to screen for unfavorable social determinants and design novel interventions to mitigate the risk of mortality in this high-risk population.
Study context
- Population
- Adults with DM, 2013–2018 National Health Interview Survey linked to the National Death Index through 2019; 47 social determinants of health used to form quartileswith DM
- Participants
- 20,079 adults
- Exposure
- Increasing quartiles of cumulative social disadvantage
- Outcome
- All-cause mortality
Methodological detailspopulation-based, multivariable Cox proportional hazards models
- Population-based
- Multivariable Cox proportional hazards models
Main finding
As reported in the abstract
All-cause mortality in adults with DM
Q1
1052.7 per 100 000 person-years
Q4
2073.1
per 100 000 person-years
Observational data: associations, not effects.
Further findings
Mortality by gender and racial/ethnic subgroups
- Effect similar across gender and racial/ethnic subgroups; relatively stronger association in non-Hispanic white vs non-Hispanic black and Hispanic participants
Original publication
Unfavorable social determinants of health and risk of mortality in adults with diabetes: findings from the National Health Interview Survey. BMJ Open Diabetes Res Care. Published 30 January 2024. doi:10.
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