Abstract
Type 2 diabetes (T2DM) is increasing in global prevalence. It is more common among people with poor social determinants of health (SDoH). Social determinants of health are typically considered at a population and community level; however, identifying and addressing the barriers related to SDoH at an individual and clinical level, could improve the self‐management of T2DM. This literature review aimed to explore the methods and strategies used in clinical settings to identify and address the SDoH in individuals with T2DM. A systematic search of peer‐reviewed literature using the electronic databases MEDLINE, CINAHL, Scopus and Informit was conducted between April and May 2017. Literature published between 2002 and 2017 was considered. Search results (n = 1,119) were screened by title and abstract against the inclusion and exclusion criteria and n = 56 were retained for full text screening. Nine studies met the inclusion criteria. Review and synthesis of the literature revealed written and phone surveys were the most commonly used strategy to identify social determinant‐related barriers to self‐management. Commonly known SDoH such as; income, employment, education, housing and social support were incorporated into the SDoH assessments. Limited strategies to address the identified social needs were revealed, however community health workers within the clinical team were the primary providers of social support. The review highlights the importance of identifying current and individually relevant social determinant‐related issues, and whether they are perceived as barriers to T2DM self‐management. Identifying self‐management barriers related to SDoH, and addressing these issues in clinical settings, could enable a more targeted intervention based on individually identified social need. Future research should investigate more specific ways to incorporate SDoH into the clinical management of T2DM.
Highlights
Diabetes prevalence has increased globally over the past three decades, with type 2 diabetes (T2DM) accounting for 85%–90% of all diagnoses (Diabetes Australia, 2015; World Health Organisation [WHO], 2016)
To the contrary, when a person's lifespan is permeated with poor education, low economic status, unemployment, inadequate housing and limited access to quality healthcare, it is probable that their health status will be of poor quality, and they will have a shorter life expectancy (WHO, 2003)
This literature review aimed to explore methods and strategies used in clinical settings to identify and address the social determinants of health (SDoH) of individuals with T2DM
Summary
Diabetes prevalence has increased globally over the past three decades, with type 2 diabetes (T2DM) accounting for 85%–90% of all diagnoses (Diabetes Australia, 2015; World Health Organisation [WHO], 2016). Including strategies that identify and account for SDoH-related barriers may augment usual care by allowing additional interventions to be instigated as part of standard clinical practice This may be an additional step towards improving health outcomes for people with T2DM. Incorporating SDoH into T2DM clinical care; by identifying, considering and subsequently addressing the related self-management barriers could improve T2DM outcomes by enabling the ability to make the positive lifestyle choices required for effective T2DM self-management. This in turn, could help reduce the personal suffering that often accompanies the burden of living with diabetes
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