Moving Diabetes Upstream: the Social Determinants of Diabetes Management and Control Among Immigrants in the US
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ECONOMICS AND POLICY IN DIABETES (AA BAIG AND N LAITEERAPONG, SECTION EDITORS)
Moving Diabetes Upstream: the Social Determinants of Diabetes Management and Control Among Immigrants in the US Aresha Martinez-Cardoso 1
&
Woorin Jang 2 & Arshiya A. Baig 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Relative to the US-born population, immigrants are less likely to successfully manage and control their diabetes, leading to a host of diabetes-related complications. This review draws on the social determinants of health framework (SDoH) to summarize the multilevel factors that shape diabetes care and management among immigrants in the USA. Recent Findings While the diabetes literature is replete with research on individual-level risk factors and health behaviors, empirical literature linking the SDoH to diabetes management among immigrants is limited. However, housing precarity, food insecurity, poverty, uninsurance and underinsurance, and limited support for immigrants in healthcare systems are consistently shown to deter diabetes management and care. Summary Immigrants with diabetes face a multitude of structural constraints to managing their diabetes. More research that theorizes the role of SDoH in diabetes management along with empirical qualitative and quantitative studies are needed. Interventions to address diabetes also require a more upstream approach in order to mitigate the drivers of diabetes disparities among immigrants. Keywords Immigrants . Diabetes management and control . Social determinants of health (SDoH)
Introduction Diabetes has emerged as a pressing national concern in the USA, yet limited attention has been paid to diabetes disparities among immigrants. Many immigrant groups face a high risk of developing diabetes in the USA [1–3]. Asian, African, and Latinx immigrants are especially vulnerable, as they often experience persistent social disadvantages and the double burden of being racialized immigrants [1, 4]. Moreover, relative to the US-born, immigrants with diabetes are less likely to meet targets for diabetes management, leading to disparities This article is part of the Topical Collection on Economics and Policy in Diabetes * Aresha Martinez-Cardoso [email protected] 1
Department of Public Health Sciences, University of Chicago, 5841 South Maryland Ave, MC 2000, Chicago, IL 60637, USA
2
The College, University of Chicago, Chicago, IL, USA
3
Department of Medicine, University of Chicago, Chicago, IL, USA
in diabetes-related complications [5–9]. These trends pose numerous challenges for our healthcare system and the future health of our nation. Immigrants in the USA are a growing demographic group whose health will increasingly shape the healthcare landscape. In order to effectively battle the diabetes epidemic in the USA, understanding the health and healthcare experiences of immigrants with diabetes is paramount [10]. Diabetes management and the prevention of diabetesrelated complications for immigrants is complex and shaped
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