Overview of Social Determinants of Health in the Development of Diabetes

To guide effective planning and decision-making regarding strategies to address adverse social determinants of health (SDOH) in diabetes, an understanding of upstream drivers and root causes is imperative. The World Health Organization SDOH framework includes socioeconomic and political systems and racism as upstream drivers of SDOH. These factors are not currently included in the Healthy People 2030 or other commonly used U.S. SDOH frameworks. This summary of a special symposium gives an overview of the socioeconomic status SDOH and race and ethnicity in diabetes prevalence and incidence, discusses socioeconomic and political contexts and racism as upstream drivers and root causes of SDOH necessitating attention within the U.S., illustrates the role of these drivers in the entrenched nature of SDOH within racial and ethnic minoritized and marginalized populations, and examines current and emerging actions within and beyond the health care sector to mitigate adverse SDOH. Incorporating into U.S. SDOH frameworks socioeconomic and political systems and racism as root causes and current drivers of adverse SDOH enables an emphasis shift from primary individual and neighborhood level time-limited solutions to multisector and all-of-government initiatives that bring requisite policy change and permanent structural change.