Many factors impact our health and our diabetes risk. The importance of biology and genetics is widely recognized. However, additional important factors, such as socioeconomic status, play a big role as well. This is often called the “social gradient in health.” This means the lower one’s socioeconomic status, the worse their health. We see this pattern across many different communities and cultures around the world.

When creating healthcare solutions and interventions, it is important to consider social factors. When social factors are not taken into account and healthcare solutions are based only on a person’s biology, disparities of communities facing a disproportionate burden of diabetes may become worse.

Digital divide

With the recent COVID-19 pandemic, diabetes care has moved from in-person visits to virtual platforms. This has left behind many populations without consistent access to technology and has impacted their health, too. Researchers from Sansum Diabetes Research Institute in Santa Barbara call digital literacy and internet connection “super social determinants of health” because of their impact on a person’s health and other factors.

Example of Washington, D.C.

The capital of the U.S., Washington, D.C., is a clear example of the impact of social gradients in the U.S. today. For example, Washington, D.C., has 8 wards across 6.5 miles. The wards are very close together, however, there are many differences between the health, socioeconomic status, race, and digital access across the wards. Wards 2 and 6 are made up of mostly White people while the adjacent Wards 7 and 8 are home to mostly Black people. Wards 7 and 8 have rates of diabetes 1.5 to 5 times greater than Wards 2 and 6. These wards show researchers that urban minorities with diabetes do not have many options to move up the social gradient ladder. We also see that Black communities are especially impacted. Further, Black populations often depend on health care facilities that lack resources, and may live in areas that can be diabetes-promoting. As researchers point out, this pattern shows a “consistent downward social gradient from the healthy White wards to the comparatively unhealthy Black wards.”

Next Steps

Even though Washington, D.C., is the center of political and health care leaders, it seems as if they have not adequately addressed policy interventions to help us achieve equity in our nation’s capital. Looking forward, it is extremely important to connect social support with medical care while addressing poverty and promoting environmental justice as well.


Photo by Maria Oswalt on Unsplash