Research Shows Improvement in Social Determinants of Metabolic Health Can Improve Diabetes, Other Disease Risks

Social determinants of health have been linked with metabolic diseases and other conditions, and researchers have found that improvements in these areas can have an equal effect on disease risks, according to a presentation at the American Diabetes Association’s 81st Scientific Sessions.

Countries’ social and economic development is highly correlated with a healthy life expectancy and other health outcomes, according to presenter Mika Kivimaki, FMedSci, a professor of social epidemiology at University College London. Studies show that an increased life expectancy is attributable to growth in gross domestic product, increases in the average years of school, and other social factors, according to Kivimaki.

He discussed 4 research questions around the social determinants of metabolic health: causation, disease specificity, disease modifiability, and socially patterned disease trajectories.

When explaining the issue of causation, Kivimaki discussed a study of children who were followed through 48 years of age. The participants were studied by postal code, and although the researchers said there were no differences in the beginning of the study, higher body mass indexes (BMIs) and other risk factors emerged after young adulthood. The researchers also noted differences in diet, physical activity levels, and the likelihood to smoke.

Among individuals with lower socioeconomic status, the researchers saw higher insulin concentrations and a higher fasting glucose from 25 years of age onward. They also confirmed that individuals with lower socioeconomic status were at increased risk of type 2 diabetes at 48 years of age when their follow-up period ended.

Next, Kivimaki said research has shown that socioeconomic status is not only associated with metabolic diseases. Although he said this issue has not been studied in great detail, studies have shown that moving to neighborhoods with higher socioeconomic status resulted in lower risks for a variety of disease states, including vascular diseases and behavioral disorders.

“It seems not to be disease-specific, and definitely seems to be more general,” Kivimaki said.

The Moving to Opportunity trial examined disease modifiability by giving a variable group a voucher to move into a better neighborhood, while a control group remained in their current neighborhoods. According to the presentation, researchers found that a high BMI was slightly less common in the variable group than in the control group, as well as slightly lower rates of diabetes in the variable group. Kivimaki called this “very strong evidence.”

Based on these various studies and their findings, Kivimaki said it is vital to consider social determinants of health and patients’ likelihood of developing metabolic diseases. Furthermore, because 1 diagnosis is a strong predictor of developing other diseases, Kivimaki said addressing social determinants should be carefully studied as potential ways to address these diseases.

REFERENCE

Kivimaki, M. Social Determinants of Metabolic Health in Human Populations. Presented at: American Diabetes Association 81st Scientific Sessions. June 25, 2021. Accessed June 25, 2021.