Addressing Health-Related Social Needs in Diabetes Care: Increasing Our Stride Toward Health Equity?

Abstract

Diabetes-related disparities among U.S. racial and ethnic minority groups persist, despite decades of research on their causes and interventions in an attempt to reduce them. Research demonstrates a strong relationship between diabetes disparities and social determinants of health, the conditions where people are born, live, work, play, worship, and age. While these upstream factors strongly shape health outcomes, they are largely influenced by policy and community-level interventions with limited influence by clinicians or health systems. By contrast, health-related social needs (HRSN) are downstream consequences of adverse social and structural conditions that directly affect individuals and families. These immediate, actionable needs, such as food, housing, and transportation, can be addressed within health care settings. HRSN disproportionately affect racial and ethnic minority communities, with higher prevalence of diabetes, worse outcomes, and greater acute care use. These observations highlight the importance of addressing HRSN in diabetes care given the potential to improve outcomes and achieve diabetes equity. This narrative review summarizes current evidence on identifying and addressing HRSN in health care settings. Recently, significant progress has been made integrating medical and social care for adults with diabetes and HRSN. Specific examples of these efforts with reporting of diabetes outcomes are reviewed here. However, existing research has not yet demonstrated that HRSN interventions consistently reduce diabetes disparities. Additional infrastructure is needed to scale and sustain interventions, enhancing their feasibility, effectiveness, and long-term impact. We conclude with recommendations for research and practice to optimize social care integration for adults with diabetes and achieve diabetes equity.