ArticleJournal of general internal medicine2026
Differential Effects of Social Determinants of Health Factors on Mortality in US Adults with Prediabetes: National Health and Nutrition Examination Survey 2005-2018.
Obinna Ekwunife, Xuemeng Wang, Raphael A Fraser, Jennifer A Campbell, Rebekah J Walker, David Jacobs, Leonard E Egede
Abstract read
In one paragraphArticle in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 · The registryThe trial behind it
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5 · Who and what moneyAuthors and funding
7 authors.
Obinna EkwunifeDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Xuemeng WangDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Raphael A FraserDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Jennifer A CampbellDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Rebekah J WalkerDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
David JacobsDivision of Outcomes and Practice Advancement, Department of Pharmacy Practice, School of Pharmacy, University at Buffalo, Buffalo, NY, USA.
Leonard E EgedeDivision of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. legede@buffalo.edu.ORCID 0000-0003-1546-1515 Funding
HOME DM-BAT: Home-based Diabetes-Modified Behavioral Activation Treatment for Low Income Seniors with T2DM Diversity SupplementR01DK118038 · NIDDK · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI EGEDE, LEONARD E. · 2019 to 2023
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$2.5MImpact of structural racism on hospital/clinic closures, community assets, and health outcomes in urban communitiesR01MD018012 · NIMHD · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI Leonard E. Egede, Sebastian Linde · 2023 to 2026
$2.4MCardiovascular Risk Reduction for Adults with Food Insecurity Using Structured Incentives (CVD-FIT)R01MD018721 · NIMHD · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI Rebekah J Walker · 2024 to 2026
$2.0MIntegrative Informatics Approach to Predict Readmissions and Improve Outcomes in COPDK23HL153582 · NHLBI · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI JACOBS, DAVID · 2021 to 2025
$962kConditional Cash Transfer Intervention to Improve Health Outcomes among Inner-City African Americans with T2DMK01DK131319 · NIDDK · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI Jennifer Annette Campbell · 2022 to 2026
$682kNHLBI NIH HHS K23 HL153582NIDDK NIH HHS K01DK131319NIDDK NIH HHS R01DK118038NIDDK NIH HHS R01DK120861NIMHD NIH HHS R01 MD013826NIMHD NIH HHS R01MD013826NIMHD NIH HHS R01 MD017574NIMHD NIH HHS R01MD017574NIMHD NIH HHS R01MD018012NIMHD NIH HHS R01 MD018721NIMHD NIH HHS R01MD018721
6 · The paper itselfAbstract
objectiveThis study investigated the association between social determinants of health (SDOH) factors and mortality in a nationally representative sample of U.S. adults with prediabetes.
methodsData from 9,971 adults with prediabetes, drawn from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018 and linked to the National Death Index (NDI), were analyzed. Five domains of SDOH-economic stability, environment, education, healthcare, and social/community context-were evaluated as independent variables. Cox proportional hazards regression models were used to assess the relationship between SDOH factors and all-cause mortality, evaluating (1) individual SDOH, (2) combined SDOH, and (3) fully adjusted models that accounted for demographics, lifestyle factors, and comorbidities.
resultsA sample of 9,971 individuals, representing 51,836,778 US adults with prediabetes based on NHANES weighting procedures were included in the study, with 46.8% aged 20-54, 40.6% aged 55-74, and 12.6% aged 75 or older. Females comprised 53.7%. Racial/ethnic composition included 62.7% non-Hispanic White, 14.6% non-Hispanic Black, and 22.7% from other racial/ethnic groups. In the fully adjusted model, economic instability (HR = 1.38; 95% CI: 1.07 to 1.78; p = 0.012), limited education (HR = 1.25; 95% CI: 1.04 to 1.52; p = 0.020), and social/community context (HR = 1.36; 95% CI: 1.10 to 1.69; p = 0.006) were significantly associated with increased mortality risk.
conclusionsEconomic instability, limited education, and social/community context were significantly associated with higher mortality among individuals with prediabetes. Addressing these SDOH factors are necessary for equitable diabetes prevention and improved public health outcomes.
Indexed as
Prediabetic StateSocial Determinants of HealthAdultAgedFemaleHumansMaleMiddle AgedMortalityNutrition SurveysSocioeconomic FactorsUnited StatesYoung Adultdiabetes preventionhealth equitymortalityprediabetesSocial Determinants of Health (SDOH)US
Identifiers
PMID41233690
PMCPMC12960854
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