Bringing Social Context into Diabetes Care: Intervening on Social Risks versus Providing Contextualized Care

Curr Diab Rep. 2019 Apr 29;19(6):30. doi: 10.1007/s11892-019-1149-y.

Abstract

Purpose of review: Patient social and economic risk information can guide diabetes care through social risk-targeted care (directly intervening on social risk factors) or social risk-informed care (modifying or tailoring care to accommodate social risks). We review evidence supporting these approaches and highlight critical gaps in the current evidence.

Recent findings: Literature is scarce on isolated social care interventions and the impact on glycemic control is unclear, while blended social-behavioral interventions more consistently point to reductions in HbA1c. Social risk-informed care naturally occurs at low rates, yet holds potential to improve care. Momentum is building around programs designed to intervene on social risk factors and/or to contextualize care based on social context. Future work will need to isolate the impacts of these programs, clarify the pathways through which social care programs can improve outcomes, and identify provider barriers and facilitators to using social risk information in care.

Keywords: Contextualized care; Social determinants of health; Social intervention; Social risk.

Publication types

  • Review

MeSH terms

  • Blood Glucose
  • Diabetes Mellitus*
  • Humans
  • Social Environment*

Substances

  • Blood Glucose