The forgotten - overcoming challenges in diabetes care for marginalized populations.

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM
Maria S Martinez-Cruz, Neesha Namasingh, Anastasia-Stefania Alexopoulos, Bryan C Batch, Matthew J Crowley, Hayden B Bosworth
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引用次数: 0

Abstract

Introduction: Diabetes disproportionately affects marginalized populations, leading to poorer glycemic control, higher complications, and reduced quality of life. Unequal access to care, mediated by multiple social determinants of health (SDoH), further exacerbates these risks. Addressing SDoH is crucial to mitigate health disparities and downstream impacts on the United States (U.S.) population and healthcare system.

Areas covered: This review explores SDoH that disproportionately affect marginalized communities, including socio-economic (SE), geographic, cultural and linguistic, health literacy-related, psychologic, and systemic barriers to equitable diabetes care. We also explore evidence-based care strategies such as telehealth, social media and internet-based education strategies, integration of community health workers (CHW), integrated care models and policy changes.

Expert opinion: While small-scale interventions have demonstrated success in overcoming challenges in diabetes care for marginalized populations, significant research gaps remain. Studies focusing on long-term outcomes and addressing the root causes of disparities tied to SDoH are urgently needed. Furthermore, rather than merely characterizing SDoH, researchers and clinicians must actively address them at the patient, provider, and system levels. Advancing diabetes care and reducing disparities requires equity-focused policies, inclusive research, and culturally tailored interventions. Without systemic reforms, however, these advancements risk perpetuating existing inequalities.

被遗忘者——克服边缘化人群糖尿病护理中的挑战。
糖尿病对边缘人群的影响不成比例,导致血糖控制较差,并发症较多,生活质量下降。在多种健康社会决定因素的影响下,获得医疗服务的机会不平等,进一步加剧了这些风险。解决SDoH问题对于减轻健康差距和对美国人口和医疗保健系统的下游影响至关重要。涵盖的领域:本综述探讨了严重影响边缘化社区的SDoH,包括社会经济(SE)、地理、文化和语言、健康素养相关、心理和系统性障碍,这些障碍阻碍了公平的糖尿病护理。我们还探讨了基于证据的护理策略,如远程医疗、社交媒体和基于互联网的教育策略、社区卫生工作者(CHW)的整合、综合护理模式和政策变化。专家意见:虽然小规模干预已证明在克服边缘化人群糖尿病护理挑战方面取得了成功,但仍存在重大的研究空白。迫切需要进行着眼于长期结果的研究,并解决与SDoH相关的差异的根本原因。此外,研究人员和临床医生必须在患者、提供者和系统层面积极解决这些问题,而不仅仅是描述SDoH的特征。推进糖尿病护理和缩小差距需要以公平为重点的政策、包容性研究和有文化针对性的干预措施。然而,如果不进行系统性改革,这些进步可能会使现有的不平等现象永久化。
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来源期刊
Expert Review of Endocrinology & Metabolism
Expert Review of Endocrinology & Metabolism ENDOCRINOLOGY & METABOLISM-
CiteScore
4.80
自引率
0.00%
发文量
44
期刊介绍: Implicated in a plethora of regulatory dysfunctions involving growth and development, metabolism, electrolyte balances and reproduction, endocrine disruption is one of the highest priority research topics in the world. As a result, we are now in a position to better detect, characterize and overcome the damage mediated by adverse interaction with the endocrine system. Expert Review of Endocrinology and Metabolism (ISSN 1744-6651), provides extensive coverage of state-of-the-art research and clinical advancements in the field of endocrine control and metabolism, with a focus on screening, prevention, diagnostics, existing and novel therapeutics, as well as related molecular genetics, pathophysiology and epidemiology.
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