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. 2023 Jan-Dec:14:21501319231192327.
doi: 10.1177/21501319231192327.

Social Determinants and Health Disparities Pertaining to Diabetes in Appalachia

Samuel Borgemenke  1 , Allyson S Hughes  1
Affiliations

Social Determinants and Health Disparities Pertaining to Diabetes in Appalachia

Samuel Borgemenke et al. J Prim Care Community Health. 2023 Jan-Dec.

Abstract

Context: Diabetes poses a significant threat to public health in the United States, with an estimated total prevalence of 37.3 million individuals in 2019, of which 28.7 million were diagnosed and 8.5 million remained undiagnosed. The high prevalence of diabetes imposes a considerable economic burden on the U.S. healthcare system. Appalachian Ohio is disproportionately impacted with southeastern Ohio exhibiting a diabetes prevalence that exceeds the national average by more than twofold and a critical shortage of healthcare providers.

Objective: To quantify the associations between diabetes prevalence and incidence in Ohio counties, considering various factors that impact health and quality-of-life outcomes.

Methods: The data used in this study were obtained from the United States Diabetes Surveillance System (USDSS) on the 88 counties in Ohio. Pearson correlation tests were employed to investigate the relationship between diabetes (prevalence and incidence) and social determinants of health. A t-test and multivariate analysis of variance (MANOVA) test were performed to analyze the disparities in diabetes and social determinants between Appalachian and non-Appalachian counties.

Results: The results of this study demonstrate notable disparities in diabetes prevalence between Appalachian and non-Appalachian counties (P < .001, α = .05). Furthermore, the MANOVA test revealed significant differences between these 2 groups regarding social determinants of health (P < .05).

Conclusion: These findings suggest that Appalachian counties may face a disproportionate impact from health-related factors and experience limited access to healthcare services. The data highlight the need for focused efforts to address the specific challenges faced by Appalachian counties. Improving access to healthcare services in the Appalachian region is paramount to ensure equitable healthcare and enhance the overall health outcomes of affected communities.

Keywords: Appalachia; Ohio; diabetes; social determinants of health.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Impact of social determinants of health on diabetes prevalence (percentage of people diagnosed with diabetes) for Ohio counties. Appalachian counties are indicated in red (non-Appalachian counties are blue).
Figure 2.
Figure 2.
Impact of social determinants of health on diabetes incidence (rate of newly diagnosed with diabetes per 1000 people) for Ohio counties. Appalachian counties are indicated in red (non-Appalachian counties are blue).
Figure 3.
Figure 3.
Comparison of diabetes prevalence between Appalachian and non-Appalachian counties in Ohio.
Figure 4.
Figure 4.
Comparison of diabetes incidence between Appalachian and non-Appalachian counties in Ohio.
See this image and copyright information in PMC

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