Social Determinants of Health and Diabetes Outcomes

Throughout this textbook, the disease burden of diabetes is taken as a major threat to global health (Bommer et al., Lancet Diabetes Endocrinol 5:423–430, 2017; http://apps.who.int/iris/bitstream/handle/10665/204871/9789241565257_eng.pdf?sequence=1). Understanding of the biomedical mechanisms of diabetes, such as insulin resistance and beta cell dysfunction, has dramatically deepened in the past few decades (Kahn et al., Lancet 383:1068–1083, 2014), and new pharmaceutical strategies (e.g., DPP-4 inhibitors) have been developed to better counter the disease. Despite all of the advancements in technology and science, however, diabetes remains a social challenge because the process and consequences of the disease’s development are rooted in the very context of human behavior and life experiences. Indeed, accumulated evidence has confirmed that the burden of the disease is distributed unequally across populations and countries (http://www.who.int/iris/handle/10665/44289), as this chapter will review. This chapter aims to introduce readers to the concept of “social determinants of diabetes” and articulate the significance of this concept for policy discussions about confronting the social challenge of diabetes.