63-OR: The Contribution of Social-Needs Factors to Racial Differences in Type 2 Diabetes

Abstract

Studies have attributed gaps in type 2 diabetes (T2D) between Black/African-American (BAA) and White adults to socioeconomic factors. We quantified the contribution of social risk factors to racial gaps in T2D in 6 Kaiser Permanente health systems across the U.S. We utilized data collected from the National KP Social Needs Survey conducted in 2020 among 10,226 health system members. We linked survey data to electronic health record data. Exposures included financial strain, food insecurity, and housing instability in the past year. The outcome, prevalent T2D, was defined as either a diagnosis of T2D or medication fills for antidiabetic medications. Self-reported BAA and White race were used to stratify data. Other covariates included demographics, insurance type, clinical measures, and comorbidities. Cross-sectional logistic regression models assessed the odds of T2D by race and the Oaxaca-Blinder decomposition method calculated the percent contribution of all variables to the racial difference in T2D. All statistical analysis were weighted to account for the complex survey design. Our final analysis included 1,223 BAA and 3,372 White survey participants. BAA participants were more likely to be younger, female, report more social risk factors, and have a greater burden of comorbidities. The prevalence of T2D was 22% in BAA patients and 11% in White patients. The covariates in the Oaxaca-Blinder analysis explained 43% of the 11% overall difference in T2D prevalence between BAA and White patients. Of this explained difference, the combined variable of financial strain, food insecurity, or housing instability significantly contributed to the racial gap in T2D by 11%. Our results demonstrated, that if social risk factors of BAA patients were equal to White patients, the racial difference in T2D would be reduced by 11% in our population with access to health care. However, the impact is relatively small and other social factors (e.g. discrimination) will be important to explore using this methodology. Disclosure S. Vupputuri: None. S. Kim: None. M. Clennin: None. L. Cromwell: None. S.L. Daugherty: None. Funding Kaiser Permanente Social Needs Network for Evaluation and Translation