The Relationship Between Postrelease Social Determinants of Health and Glycemic Control in African Americans With Criminal Legal Involvement and Type 2 Diabetes

BACKGROUND: Limited literature exists on the relationship between postrelease social determinants of health and glycemic control among African Americans with a history of criminal legal involvement and Type 2 diabetes mellitus (T2DM). METHODS: Participants were recruited from clinics, community centers, and places of worship in the midwestern United States. Stepwise regression with forward selection was used to evaluate the relationship between postrelease criminal justice system factors, social risk/environmental factors, and glycemic control among African American with history of criminal legal involvement and T2DM. RESULTS: Retained variables from the stepwise regression included age, comorbidity, type of medication, length of incarceration, insurance, and housing insecurity. The analysis revealed statistically significant associations between comorbidity, type of medication, and insurance type with glycemic control. Compared with using only pills or oral hypoglycemic agents, the combination of pills/oral hypoglycemic agents and insulin (β-coefficient: 1.44; 95% CI: 0.77, 2.12) and using insulin or injectables alone (β-coefficient: 0.95; 95% CI: 0.16, 1.73) were associated with an increase in HbA1c. Additionally, each additional comorbidity (β-coefficient: -0.25; 95% CI: -0.40, -0.11) was associated with a decrease in HbA1c. Compared with individuals with private/military/other insurance, those with Medicare (β-coefficient: 1.40; 95% CI: 0.43, 2.37) and Medicaid (β-coefficient: 1.11; 95% CI: 0.12, 2.10) were associated with higher HbA1c. CONCLUSION: Postrelease criminal justice factors and social/environmental risk factors were not statistically significant. Future studies should evaluate the relationship between insurance type and glycemic control among this population.