Patient, system and clinician level interventions to address disparities in diabetes care

Type 2 diabetes disproportionately affects socially disadvantaged groups, including racial and ethnic minority groups and low income and less educated persons [1-7]. Although effective therapies are available for managing diabetes and preventing or treating its complications, these therapies are underutilized, particularly among these socially disadvantaged groups [8-10]. Social disadvantage may affect diabetes outcomes through a number of different pathways, including access to care, the quality of care received, psychosocial characteristics, and neighborhood or community factors [11]. Because of the high prevalence of diabetes in socially disadvantaged persons, interventions to reduce racial/ethnic and social disparities in health may have a profound impact on the morbidity and mortality associated with diabetes. In this review, we will discuss evidence on interventions at the individual, provider, health care system, and community levels that have the potential to reduce diabetes disparities and highlight gaps in our understanding of social disparities and health for persons with diabetes.