Background: Social determinants of health (SDOH) account for 50% of health outcomes compared to 20% by clinical care. This work highlights SDOH in Muslims with type 2 diabetes (T2D) who receive healthcare services in the US.
Methods: Semi-structured qualitative one-hour interviews were conducted with adult Muslim participants diagnosed with T2D for at least 6 months and using diabetes oral medications and/or injections. Maximum variation sampling captured the Muslim population’s heterogeneity with five groups who spoke different languages with different countries of origin.
Results: Twenty-two participants, mostly immigrants or refugees, were included. Themes were distributed across the 5 main SDOH domains. Economic stability included low income and/or working in demanding stressful jobs or multiple employments that hindered access to healthy food. Low education and limited English proficiency hindered patient-provider communication or ability to read instructions on medication bottles. Factors related to healthcare access and quality included health knowledge and advocating for oneself with providers. Neighbourhood and built environment themes included harsh winter weather, lack of access to convenient transportation, and lack of understanding about public transportation systems. Varying social support by family and friends were important to facilitate healthy behaviours and access to care.
Conclusions: Building compassionate trust-based relationships with patients is key. Healthcare providers can use cues to investigate SDOH. For instance, in addition to the regular SDOH screening, a missed appointment can be a cue to ask about transportation access or the convenience of the appointment time.
A. Ali: None. E.M. Vivian: None. B.A. Chewning: None.
This work is supported by the Small Grant Funding by the Department of Family Medicine and Community Health at the University of Wisconsin-Madison. Dr. Ali was supported by the University of Wisconsin Primary Care Research Fellowship, funded by grant T32HP10010 from the Health Resources and Services Administration.
