Three Lessons About Diabetes and the Social Determinants of Health

Material needs security and mental health outcomes in adults with type 2 Diabetes in Lebanon: A cross-sectional study

Objectives

Despite their documented significance in type 2 diabetes (T2DM) management, social determinants of health (SDOHs) including material needs security and mental health outcomes are understudied in the Middle East and North Africa (MENA) region. This study aims to assess the relation between material needs security and mental health outcomes in Lebanese adults with T2DM.

Methods

Subjects with T2DM (N = 300) were recruited from primary health care centers in Lebanon. Sociodemographic, material need variables, depression measured by Patient Health Questionnaire (PHQ-9), and diabetes fatalism measured by Diabetes Fatalism Scale (DFS) were collected.

Results

Most of the participants were men, married and with lower educational levels. Multivariate analyses revealed that having material needs security was associated with diabetes fatalism (β = -0.63(-1.13; -0.12)), and depression (β = -0.46(-0.78; -0.13)). Also, higher age (β = 3.49(0.91; 6.06)) and education (β = 3.42(1.18; 5.66)), and lower income (β = 3.25(0.62; 5.88)) were independently associated with diabetes fatalism. Being male was the only independent variable associated with less depression (β = -1.56(-2.97; -0.14)).

Conclusion

Our study highlights the importance of material needs security on mental health outcomes for adults with T2DM in the MENA region. Clinicians are encouraged to assess the impact of material needs on mental health outcomes. Further research is needed to understand potential pathways/mechanisms and options for effective interventions and policymaking.

Social Determinants of Health Screening in Type 1 Diabetes Management

Type 1 diabetes management is intricately influenced by social determinants of health. Economic status impacts access to vital resources like insulin and diabetes technology. Racism, social injustice, and implicit biases affect equitable delivery of care. Education levels affect understanding of self-care, leading to disparities in glycemic outcomes. Geographic location can limit access to health care facilities. Stressors from discrimination or financial strain can disrupt disease management. Addressing these social factors is crucial for equitable diabetes care, emphasizing the need for comprehensive strategies that go beyond medical interventions to ensure optimal health outcomes for all individuals with type 1 diabetes.