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. 2021 Jan 18;18(2):792.
doi: 10.3390/ijerph18020792.

The Association between Social Determinants of Health and Self-Reported Diabetic Retinopathy: An Exploratory Analysis

Emily L Silverberg  1 , Trevor W Sterling  1 , Tyler H Williams  1 , Grettel Castro  1 , Pura Rodriguez de la Vega  1 , Noël C Barengo  1   2   3
Affiliations

The Association between Social Determinants of Health and Self-Reported Diabetic Retinopathy: An Exploratory Analysis

Emily L Silverberg et al. Int J Environ Res Public Health. .

Abstract

One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person's environment that may impact health. The objective of this study was to determine whether there is an association between SDOHs and DR in patients with type II diabetes. This cross-section study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). This study included people with self-reported diabetes in the US in 2018 (n = 60,703). Exposure variables included homeownership, marital status, income, health care coverage, completed level of education, and urban vs. rural environment. The outcome variable was DR. Logistic regression analysis were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Alaskan Native/Native American (OR 2.11; 95% CI: 1.14-3.90), out of work (OR 2.82; 95% CI: 1.62-4.92), unable to work (OR 2.14; 95% CI: 1.57-2.91), did not graduate high school (OR 1.91; 95% CI: 1.30-2.79), only graduated high school (OR 1.43; 95% CI 1.08-1.97), or only attended college or technical school without graduating (OR 1.42; 95% CI: 1.09-1.86) were SDOHs associated with DR in patients with diabetes. Health care providers should identify these possible SDOHs affecting their diabetic patients.

Keywords: built environment; community; diabetes; diabetic retinopathy; economic stability; education; ethnicity; health care; race; social determinants of health.

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Conflict of interest statement

The authors declare no conflict of interest.

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