TY - JOUR
T1 - The role of structural racism and geographical inequity in diabetes outcomes
AU - Agarwal, Shivani
AU - Wade, Alisha N.
AU - Mbanya, Jean Claude
AU - Yajnik, Chittaranjan
AU - Thomas, Nihal
AU - Egede, Leonard E.
AU - Campbell, Jennifer A.
AU - Walker, Rebekah J.
AU - Maple-Brown, Louise
AU - Graham, Sian
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/7/15
Y1 - 2023/7/15
N2 - Diabetes is pervasive, exponentially growing in prevalence, and outpacing most diseases globally. In this Series paper, we use new theoretical frameworks and a narrative review of existing literature to show how structural inequity (structural racism and geographical inequity) has accelerated rates of diabetes disease, morbidity, and mortality globally. We discuss how structural inequity leads to large, fixed differences in key, upstream social determinants of health, which influence downstream social determinants of health and resultant diabetes outcomes in a cascade of widening inequity. We review categories of social determinants of health with known effects on diabetes outcomes, including public awareness and policy, economic development, access to high-quality care, innovations in diabetes management, and sociocultural norms. We also provide regional perspectives, grounded in our theoretical framework, to highlight prominent, real-world challenges.
AB - Diabetes is pervasive, exponentially growing in prevalence, and outpacing most diseases globally. In this Series paper, we use new theoretical frameworks and a narrative review of existing literature to show how structural inequity (structural racism and geographical inequity) has accelerated rates of diabetes disease, morbidity, and mortality globally. We discuss how structural inequity leads to large, fixed differences in key, upstream social determinants of health, which influence downstream social determinants of health and resultant diabetes outcomes in a cascade of widening inequity. We review categories of social determinants of health with known effects on diabetes outcomes, including public awareness and policy, economic development, access to high-quality care, innovations in diabetes management, and sociocultural norms. We also provide regional perspectives, grounded in our theoretical framework, to highlight prominent, real-world challenges.
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U2 - 10.1016/S0140-6736(23)00909-1
DO - 10.1016/S0140-6736(23)00909-1
M3 - Review article
C2 - 37356447
AN - SCOPUS:85163478033
SN - 0140-6736
VL - 402
SP - 235
EP - 249
JO - The Lancet
JF - The Lancet
IS - 10397
ER -