Addressing Social and Behavioral Determinants of Health

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Project Summary/Abstract – Addressing Social and Behavioral Determinants of Health Core Social determinants of health (SDOHs), defined as the conditions in the environments in which people are born, live, learn, work, play, worship, and age, are major drivers of diabetes-related morbidity, mortality, and disparities. Health behaviors such as care-seeking decisions, medication adherence, self management, diet, and physical activity are also key factors that influence diabetes-related outcomes. In addition, these behavioral factors can be important mediators of the deleterious effects of SDOHs on diabetes-related outcomes, limiting the real world impact of medical and public health advances in diabetes prevention and treatment and further contributing to population health disparities. Despite growing recognition of the importance of socio-ecological, economic, and behavioral influences on the prevention and treatment of diabetes, and their contribution to inequities in diabetes-related outcomes, much remains unknown about the most effective ways to address these influences to improve outcomes and eliminate disparities. Closing this gap in knowledge will require cross-disciplinary expertise in a broad range of social and behavioral determinants of health, experience with and access to strong cross-sector partnerships, and dissemination of novel research to key stakeholders who can implement, sustain, and disseminate findings. The Addressing Social and Behavioral Determinants of Health Core will catalyze state-of-the-art approaches to address socio- ecological, economic, and behavioral determinants of health in order to eliminate inequities in diabetes prevention and treatment. The Core will support Center investigators and trainees with measuring and intervening on social and behavioral determinants of health among diverse patient populations in a range of community and health care settings. This Core will have a particular focus on developing novel interventions that screen for and modify SDOHs, leverage insights from behavioral economics and other behavioral science frameworks, support culturally competent behavior change among diverse patient populations, and address the health consequences of individual, interpersonal, and structural racism. This Core has four Specific Aims: Aim 1. Support state-of-the-art translational research to address socio-ecological, economic, and behavioral determinants of health in order to eliminate inequities in diabetes prevention and treatment. Aim 2. Integrate rigorous measurement of socio-ecological, economic, and behavioral determinants of health into translational diabetes research. Aim 3. Catalyze new collaborations to address socio-ecological, economic, and behavioral determinants of health in translational diabetes research. Aim 4. Develop early career investigators who will measure and target socio-ecological, economic, and behavioral determinants of health in translational diabetes research. Our multidisciplinary focus, breadth, and depth of expertise in the social and behavioral determinants of health in this Core position us well to catalyze a pipeline of innovative diabetes translational research to improve outcomes and ameliorate the conditions that result in diabetes disparities.