SDOH Play Role in Surge in Youth Diabetes Cases, Health Disparities

According to a new study, Black and Hispanic children and teens are seeing increasing rates of type 1 and type 2 diabetes, highlighting the role social determinants of health (SDOH) play in perpetuating health disparities.

“These increases in type 2 diabetes in youth are sobering,” professor at Johns Hopkins Bloomberg School of Public Health Elizabeth Selvin told the Detroit Free Press.

“It used to be thought that type 2 diabetes was a disease of adults. And now, we’re seeing major increases in kids. And this is a disease they’re likely to have their whole lives.”

Youth-onset type 1 and 2 diabetes are serious chronic health conditions. Those with youth-onset diabetes are at increased risk for early complications, comorbidities, and excess mortality.

In addition to studying the rates at which type 1 and type 2 diabetes increased in children over the years, researchers also examined the race and ethnicity of the children to search for health disparities.

“Race and ethnicity were based primarily on self-reported information collected on a short survey administered to parents or guardians of children younger than 18 years and adults 18 years or older using the 2000 US census race and ethnicity categories, with medical records serving as the secondary source,” the research authors wrote.

According to an article published by the Centers for Disease Control and Prevention (CDC) featuring data from the SEARCH for Diabetes in Youth Study, while populations of non-Hispanic White individuals have the highest rate of type 1 diabetes incidences, Hispanic and Black youths have seen larger increases of cases in the last 20 years.

The study analyzed records of 3.47 million youth between 2001 to 2017 from six clinical centers in seven states: California, Colorado, Ohio, South Carolina, Washington and Arizona, and New Mexico. While the study only focused on those specific areas, Selvin indicated that they were comparable to national databases.

“It’s significant. These are important findings,” said Dr. Dayna McGill, a pediatric endocrinologist at Massachusetts General Hospital. “It highlights the hard work we all have ahead. It shows just how much we need to do to improve the care of and reduce the disparities for youth who are minorities.”

McGill explained that social determinants of health could play a large role in the increased cases of type 2 diabetes in underrepresented communities. If children do not have access to safe places to play outdoors, healthy food, or team sports participation, their overall health will be impacted.

Children with less access to healthcare are less likely to receive a timely diagnosis, impacting chronic disease management.

“Their diabetes can be a more severe diagnosis,” McGill said. “We need to treat them pretty aggressively right out of the gate with all the options that we have to make their glucose controlled as quickly as possible.”