Associations Between Social Determinants of Health and Outcomes of Chronic Medical Conditions.

Autor:	Hamilton A; Internal Medicine, University of Florida College of Medicine, Gainesville, USA., Beneke AA; Internal Medicine, University of Florida College of Medicine, Gainesville, USA., Meisel E; Internal Medicine, University of Florida College of Medicine, Gainesville, USA., Zhang C; Internal Medicine, Albert Einstein College of Medicine, New York, USA., Gao H; Statistics, University of Florida, Gainesville, USA., Portillo-Romero J; Internal Medicine, University of Florida College of Medicine, Gainesville, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Aug 22; Vol. 16 (8), pp. e67528. Date of Electronic Publication: 2024 Aug 22 (Print Publication: 2024).
DOI:	10.7759/cureus.67528
Abstrakt:	Social determinants of health, such as food insecurity, can significantly impact patient welfare, potentially increasing the prevalence of chronic illnesses while hindering their management, as shown in previous data collected by the National Health and Nutrition Examination Survey. This study aimed to investigate the association between food insecurity and other social determinants of health with hyperlipidemia, type 2 diabetes mellitus (T2DM), and hypertension. To that end, self-reported data on food security from clinical encounters and biological data from medical records were collected. This study utilized electronic medical record data from 349 patients aged between 18 and 85 years who answered two standard food insecurity screening questions. Each patient's current diagnoses and lab values, including blood pressure, fasting low-density lipoprotein (LDL) cholesterol, and hemoglobin A1c (HbA1c), were then collected. Among patients facing food insecurity (n = 48), 55% were diagnosed with hypertension (p = 0.019), 45% with hyperlipidemia, and 27% with T2DM (p = 0.005). By comparison, these values for food-secure patients were 39%, 54%, and 13%, respectively (n = 301, p > 0.05). Regarding control of these chronic illnesses, hypertension (defined as blood pressure >135/85 mmHg per American Academy of Family Physicians (AAFP) guidelines) was observed in 12% of food-secure patients (n = 301, p > 0.05) and 42% of food-insecure patients (n = 48, p = 0.0204), whereas differences in control of hyperlipidemia and T2DM were insignificant. These results suggest that food-insecure patients are more likely to be diagnosed with hypertension and T2DM but are less likely than food-secure patients to be diagnosed with hyperlipidemia. Consistent with previous research, this study highlights the potentially increased health risks for patients experiencing food insecurity and calls for further efforts to screen patients for social determinants of health. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Health Center Institutional Review Board issued approval IRB202200740. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Hamilton et al.)
Databáze:	MEDLINE
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