OBJECTIVE Social determinants of health (SDoHs) account for more than half of the variance in racial and ethnic disparities in health. However, few studies have examined how SDoHs may cluster in ways that affect health. We aimed to identify patterns of social adversity and their differential associations with both diabetes status at baseline and change in diabetes status across ∼12 years among Hispanic/Latino adults. RESEARCH DESIGN AND METHODS Participants were from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; N = 16,415; aged 18–74 years). Diabetes status (defined as normoglycemia, prediabetes, or diabetes per American Diabetes Association criteria) was measured by clinical assessment and self-reported medications at baseline (2008–2011) and two follow-up visits (2014–2017 and 2020–2024). SDoHs were assessed at baseline and as part of the HCHS/SOL Sociocultural Ancillary Study (2010–2012). RESULTS Latent class analyses of nine SDoHs (income, education, employment status, home ownership, language and social acculturation, chronic stressors, family cohesion, and social support) revealed four distinct patterns of social adversity: 1) low adversity, 2) social/educational strengths, 3) acculturated and underresourced, and 4) high adversity. Compared with the low-adversity group, the high-adversity group had the highest odds of worse diabetes status at baseline and had greater odds of worsening diabetes status over time. CONCLUSIONS SDoHs cluster in distinct ways that affect diabetes outcomes; social adversities must be addressed to mitigate diabetes burden among Hispanic/Latino adults.
Brown et al. (Tue,) studied this question.
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