Identifying individual social needs during intake for diabetes Self-Management education and support services in the Detroit, Michigan area

Denise White Perkins; Pamela Milan; Kimberly Miazek; Ashley Francis; Suzanne Havstadb; Andrew S Bossick; Ganesa Wegienka

doi:10.1016/j.pmedr.2024.102671

Identifying individual social needs during intake for diabetes Self-Management education and support services in the Detroit, Michigan area

Prev Med Rep. 2024 Feb 27:40:102671. doi: 10.1016/j.pmedr.2024.102671. eCollection 2024 Apr.

Authors

Denise White Perkins^{1

2

3

4}, Pamela Milan⁵, Kimberly Miazek⁵, Ashley Francis⁴, Suzanne Havstadb², Andrew S Bossick^{2

6}, Ganesa Wegienka^{2

6}

Affiliations

¹ Department of Family Medicine, Henry Ford Health, One Ford Place, Detroit, MI 48202, USA.
² Department of Public Health Sciences, Henry Ford Health, One Ford Place, Detroit, MI 48202, USA.
³ Center for Bioethics and Social Justice & Department of Family Medicine, College of Human Medicine, Michigan State University, East Fee Hall 965 Wilson Road Rm A-126, Lansing MI, USA.
⁴ School of Medicine, Wayne State University, 540 E Canfield St, Ste 9374, Detroit MI 48201, USA.
⁵ Department of Population Health, Henry Ford Health, One Ford Place, Detroit, MI 48202, USA.
⁶ Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, 965 Wilson Rd, 48224 East Lansing, MI, USA.

Abstract

The American Diabetes Association has recommended that diabetes self-management education and support (DSMES) teams improve diabetes outcomes by identifying and responding to patients' social needs. This study examines demographic patterns in how hemoglobin A1c (A1c) is related to individual social needs, reported urgency of those needs, and interest in obtaining assistance. A total of 1125 unique persons who had been referred for DSMES and had completed a social needs screener via our electronic medical record were included. The majority (51.9 %) had an A1c < 8 % at their most recent assessment and most respondents (52.5 %) reported having at least 1 unmet social need (n = 591), Those who reported having at least 1 social need, tended to have higher A1c levels compared with those who reported no social needs (median of 8.0 % versus 7.7 %; p < 0.05). Among Black individuals the associations were stronger (median A1c of 8.2 % among those with versus 7.2 % among those without a reported social need; p < 0.05). However, among White individuals, there was no difference in A1c between these two groups. Among those who reported a social need, those who also reported they needed assistance (35.7 %) tended to have higher A1c levels than those who did not (median 8.3 % versus 7.8 %; p < 0.10). This relationship did not vary by race. Ongoing study of the relationship between unmet social needs and glycemic control is warranted to help identify effective clinical workflows to help providers incorporate consideration of social needs into their medical decision making.

Keywords: Diabetes education; Diabetes mellitus; Healthcare disparities; Healthcare utilization; Self-management; Social risk screening; Unmet basic needs.