Objective: The prevalence of diagnosed diabetes among adults aged 18-45 years old continues to increase. Since type 2 diabetes (T2D) is preventable through lifestyle modification, implementing lifestyle intervention in those at high risk for T2D may help to reduce the overall diabetes burden. A better understanding of how social determinants of health (SDOH) are related to T2D risk can help to better identify those who are at high risk of T2D for intervention. This study aims to examine the association between a wide array of SDOH factors and risk of T2D in young adults aged 18-45.

Methods: We included data on 14,325 individuals with and without T2D in the 2007-2016 National Health and Nutrition Examination Survey. Forty-four factors covering three SDOH domains (education access and quality, economic stability, and healthcare access and quality) in the databases were selected. Stepwise logistic regression was used to identify statistically significant SDOH risk factors for T2D and estimate the corresponding odds ratios (OR) and 95% confidence intervals (CI) , controlling for age, sex and race/ethnicity.

Results: Among 14,325 sampled individuals, 394 (2.75%) had T2D. SDOH risk factors that were associated with a higher risk of T2D included educational level below high school (OR: 1.89, 95% CI: 1.22-2.86, ref: education above high school) , receiving social security/railroad retirement income (1.89 [1.38-2.56], ref: not receiving social security income) , receiving food stamp benefit (1.45 [1.11- 1.89], ref: not receiving food stamp benefit) , unstable housing (1.50 [1.16-1.93], ref: owning a house) , unstable employment (1.34 [1.04-1.73], ref: stable employment) , and having a higher number of meals not prepared at home in a week (1-10: 1.36 [1.00-1.86]; ≥11: 2.23 [1.35-3.68], ref: 0) . SDOH factors play an important role in the risk of T2D in young adults.

Conclusions: Our findings may help improve tools for screening or prevention of T2D in clinical and community settings.


Y.Zhang: None. P.Zhang: None. M.E.Pavkov: None. Y.Wang: None. J.Guo: None. Y.Zhang: None. H.Shao: Board Member; BRAVO4HEALTH, LLC.

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