Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes
Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes
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DOI：
10.1016/j.amjms.2016.01.008
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发表时间：
2016-04-01
影响因子：
3.1
通讯作者：
Egede, Leonard E.
中科院分区：
文献类型：
--
作者：
Walker, Rebekah J.;Williams, Joni Strom;Egede, Leonard E.
背景资料：有强有力的证据表明，种族、民族和健康的社会决定因素显着影响糖尿病患者的结果。更好地理解这些关系或关联的机制将有助于为糖尿病患者制定具有成本效益的文化定制计划。方法：本文综述了种族和民族以及健康的社会决定因素对糖尿病护理过程、护理质量和结局的影响的文献现状，特别强调在农村南部给一个概述的状态的literation.Results：文献综述显示，种族或民族的差异，在糖尿病的临床结果，包括血糖，血压（BP）和血脂控制，继续坚持。此外，文献综述表明，健康的社会决定因素对结果的作用，以及这些决定因素在差异中可能发挥的作用在很大程度上被忽视了。社会心理因素，如自我效能、抑郁、社会支持和感知压力，与自我护理、生活质量和血糖控制一致。邻里因素，如食物不安全，社会凝聚力和邻里美学已与血糖控制。感知歧视也与自我保健和心理组成部分的quality of life.Conclusion：医疗保健专业人员需要熟练评估健康的社会决定因素，并考虑到他们在临床护理。此外，需要开展更多的研究，以确定种族和族裔以及健康的社会决定因素对糖尿病护理过程、护理质量和结果的单独和综合影响，特别是在疾病负担特别高的南方。
Background: There is strong evidence that race, ethnicity and social determinants of health significantly influence outcomes for patients with diabetes. A better understanding of the mechanisms of these relationships or associations would improve development of cost-effective, culturally tailored programs for patients with diabetes.Methods: This article reviews the current state of the literature on the influence of race and ethnicity and social determinants of health on process of care, quality of care and outcomes for diabetes, with particular emphasis on the rural South to give an overview of the state of the literature.Results: The literature review shows that racial or ethnic differences in the clinical outcomes for diabetes, including glycemic, blood pressure (BP) and lipid control, continue to persist. In addition, the literature review shows that the role of social determinants of health on outcomes, and the possible role these determinants play in disparities have largely been ignored. Psychosocial factors, such as self-efficacy, depression, social support and perceived stress, show consistent associations with self-care, quality of life and glycemic control. Neighborhood factors, such as food insecurity, social cohesion and neighborhood esthetics have been associated with glycemic control. Perceived discrimination has also been associated with self-care and the psychological component of quality of life.Conclusion: Healthcare professionals need to be skilled in assessing social determinants of health and taking them into consideration in clinical care. In addition, more research is needed to identify the separate and combined influence of race and ethnicity and social determinants of health on process of care, quality of care and outcomes in diabetes, especially in the South, where the burden of disease is particularly high.