a comprehensive analysis of social and environmental determinants of health and how they influence diabetes, how to empower the community, and increase health literacy and self-care strategies.
Social and Environmental Determinants of Health
Determinants of health are defined as circumstances or situations in which humans are born, live, grow, find work, and age. These conditions are usually shaped by economic, social, political, and political forces (Islam, 2019). For example, poor governance, policies, and unfair economic arrangement may cause unfavorable conditions. Social factors are those related to the stability of social connections, cohesion, neighborhood efficiency, education, work, and stability of households. Environmental factors may include health-related resources like transportation systems, recreational resources, and harmful substances. Below are examples of social and environmental determinants of health and an explanation of how they influence those with diabetes, taking the case of Rhonda in the second video covering diabetes.
Poverty and Deprivation
Deprivation is a lack of necessities to live in good health. Poverty is a broader term to explain deprivation. It is mainly understood as the inability to meet the minimum subsistence level critical for human survival (Rowley et al., 2021). Poverty and deprivation are critical factors when it comes to the issues of diabetes. For example, research shows that poverty is highly linked to the burden of non-communicable diseases like diabetes. Most patients living with diabetes come from low-income communities. This factor makes this population lack awareness and experience difficulties accessing health and medications; hence they do not achieve optimal diabetes prevention and management (Karachaliou et al., 2020). People living with diabetes are estimated to be 415 million, projected to rise to 624 million by 2040.
Education
The education factor is generally associated with good health. For example, even in countries like the US, which is highly developed, research shows that people with lower educational attainment experience poor health compared to other populations. There are also health inequalities related to education. Regarding diabetes recent research shows that diabetes incidents are highest in individuals with less than high school education attainment (10.4% out of 1000 people). Those with a terminal high school have a prevalence of 7.8 %/1000, while those with above high school are 5.3% per 1000 people (Hill-Briggs et al., 2020). Therefore, the lower the education level, the higher the odds of diabetes.
Food
Food as a health determinant is the absence or presence of food that impacts people’s diet. It covers areas like the distribution of food stores, locations’ proximity, and how people obtain food. It is a collection of sociocultural conditions, economic and physical opportunities, policies, and conditions that influence beverage and food choices and nutritional status. In marginalized areas, people are highly affected by inaccessibility to supermarkets and healthy foods. Instead, many fast restaurant outlets offer them energy-dense foods, which negatively affects their health. When associating the food environment and diabetes, research shows that higher food accessibility is associated with a lower prevalence of diabetes. Some people have access to grocery stores, fewer fast-food restaurants, and availability of direct supplies from farmers; hence have healthy food choices. However, those with less access to healthy food record a high prevalence of diabetes cases. For instance, 20% of the diabetic patient report having food insecurity (Hill-Briggs et al., 2020). Therefore, food insecurity, lack of affordability, poor access, and healthy choices highly impact those with diabetes.
Where You Live (Housing and Neighborhood)
The places where people, including the type of housing and the neighborhood, impact their health. First, some people experience housing instability. For example, some live in their cars, others stay with relatives or friends, and others are evicted and have trouble paying rent. Research done in the US in 2020 showed that 17 out of 10,00 are considered homeless. The more significant percentage of this population consists of African Americans (40%), followed by Latinos and Hispanics, representing 22% of the homeless people (Hill-Briggs et al., 2020). Housing instability is highly associated with the prevalence and outcomes of diabetes. For instance, housing instability makes it difficult to afford diabetes medications, eat healthy foods, self-manage, and engage in self-care. Also, the neighborhood is acritical is someone’s health. For example, some people live in neighborhoods with highly toxic environmental exposures and pollution. Research shows an increased risk of diabetes for people living in neighborhoods with toxic chemicals, pollution, and poor sanitation. See figure 1