Social Determinants of Health and Diabetes: A Scientific Review

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• Occupation is itself multidimensional.

• economic and socioeconomic determinants as foremost.

• multidimensional construct that includes educational, economic, and occupational status

• Socioeconomic status (SES) is a

• SES is a consistently strong predictor of disease onset and progression at all levels of SES for many diseases, including diabetes

• SES is linked to virtually all of the established SDOH. It is associated with the extent to which individuals and communities can access material resources including health care, housing, transportation, and nutritious food and social resources such as political power, social engagement, and control.

• economic status is often measured by determining a person’s own income.

• income of the household in which the person resides and by the income level of the community (e.g., mean household income of the census track in which a person resides

• Educational status can be quantified either in years of schooling or highest degree earned.

• the household (the highest grade completed by anyone in the household), or the community (e.g., percent of high school or college graduates in a census track).

• It may be assessed at the level of the individual (e.g., the person’s own educational attainment)

• Literacy has emerged as a measure of educational quality and as potentially more reflective of SES than years of schooling among African Americans and low-income Whites

• Health literacy, which is directly associated with literacy and is context specific (42–44), and literacy are included as SDOH in Healthy People 2020 (29).

• It has been measured as employment status

• (e.g., employed vs. unemployed

• stability (e.g., job insecurity)

• job type (e.g., manual vs. nonmanual

• , prestige of the occupation)

• and working conditions (e.g., shift work, number of hours worked

• job demands, and control)