Association Between Social Determinants of Health and Glycemic Control Among African American People with Type 2 diabetes: The Jackson Heart Study.
Association Between Social Determinants of Health and Glycemic Control Among African American People with Type 2 diabetes: The Jackson Heart Study.
复制标题
患有 2 型糖尿病的非洲裔美国人中健康的社会决定因素与血糖控制之间的关联：杰克逊心脏研究。
DOI：
10.1093/abm/kaac026
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Joseph,JoshuaJ
中科院分区：
文献类型：
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作者：
Hu,Jie;Kline,DavidM;Tan,Alai;Zhao,Songzhu;Brock,Guy;Mion,LorraineC;Efird,JimmyT;Wang,Danxin;Sims,Mario;Wu,Bei;Mongraw-Chaffin,Morgana;Joseph,JoshuaJ
背景健康的社会决定因素对健康结果有重要影响。然而，影响血糖控制的多个因素的复杂性和相互作用仍然没有得到充分的研究。（收入，教育和职业），环境（体育活动设施，邻里社会凝聚力，邻里问题和暴力），行为（体力活动、营养和吸烟），以及心理因素（抑郁症状，压力，和辨别力）与血糖控制（血红蛋白A1 c [A1 c]）使用世界卫生组织健康的社会决定因素框架，在非裔美国成年2型糖尿病患者中。这项研究使用了1,240名参与社区杰克逊心脏研究的患有2型糖尿病的非洲裔美国成年人的纵向队列。在杰克逊心脏研究中，社会经济地位、环境、行为和心理因素均采用经验证的仪器进行测量。纵向结构方程模型与血糖控制（A1 C）收集随着时间的推移（考试1-3）作为studyoutcome.ResultsOur研究提出了复杂的相互作用的社会经济因素的健康和血糖控制随着时间的推移。较高的社会经济地位（较高的收入、较高的教育水平和专业职业）与血糖控制的改善直接相关。还观察到社会经济地位与通过健康行为因素介导的血糖控制之间的关联。结论在这项分析中，社会经济地位因素是非裔美国成年2型糖尿病患者血糖控制的决定因素。未来的研究，旨在减少健康差距和实现平等的结果，在这一人群将受益于嵌入社会经济地位的组成部分，他们的设计。
BackgroundSocial determinants of health have a significant impact on health outcomes. However, the complexity and interaction of multiple factors influencing glycemic control remain understudied.PurposeThis study examined associations of socioeconomic position (income, education, and occupation), environmental (physical activity facilities, neighborhood social cohesion, neighborhood problem, and violence), behavioral (physical activity, nutrition, and smoking), and psychological factors (depressive symptoms, stress, and discrimination) with glycemic control (hemoglobin A1c [A1c]) using the World Health Organization Social Determinants of Health framework in African American adults with type 2 diabetes.MethodsA secondary data analysis was conducted using a longitudinal cohort of 1,240 African American adults with type 2 diabetes who participated in the community-based Jackson Heart Study. Socioeconomic position, environmental, behavioral, and psychological factors were measured using validated instruments in the Jackson Heart Study. Longitudinal structural equation modeling was used with glycemic control (A1c) collected over time (Exams 1–3) as the study outcome.ResultsOur study presents the complex interplay of socioeconomic determinants of health and glycemic control over time. Higher socioeconomic position (higher income, higher level of education, and professional occupation) was directly associated with improvement in glycemic control over time. An association of socioeconomic position on glycemic control mediated through health behavior factors was also observed.ConclusionsIn this analysis, socioeconomic position components were determinants of glycemic control in African American adults with type 2 diabetes. Future studies aimed at reducing health disparities and achieving equality of outcomes in this population will benefit from embedding socioeconomic position components into their design.