Relationship Between Social Risks and Diabetes Metrics in a US Health System

Area of Science:

• Primary care research
• Health services research
• Social determinants of health

Background:

• Quality metrics in diabetes care are essential for patient health.
• Social risk factors are increasingly recognized as significant barriers to achieving health goals.

Purpose of the Study:

• To assess the association between multiple social risk domains and a composite quality metric in type 2 diabetes patients.
• To identify specific social risks affecting diabetes care quality in a large US regional practice.

Main Methods:

• Cross-sectional analysis of 44,010 adult type 2 diabetes patients from the electronic health record.
• Defined a composite diabetes metric (D5) including HbA1c, blood pressure, statin use, tobacco avoidance, and aspirin use.
• Used multiple logistic regression to evaluate social risk domains (housing, finance, food, transportation) controlling for demographics.

Main Results:

• Patients with high-risk social factors in housing, finance, food insecurity, and transportation were less likely to meet the D5 quality metric.
• Younger, nonwhite, rural patients, and those with lower visit utilization or certain insurance types were also less likely to meet the metric.
• Demonstrated a significant association between social risk domains and diabetes quality metric attainment.

Conclusions:

• Social risk factors have a substantial clinical impact on primary care patients with diabetes.
• Highlights the need for interventions targeting social determinants of health to improve diabetes care.
• Emphasizes the importance of integrating social risk screening and management into routine primary care.