Social Determinants of Health and Meeting Leisure-Time Physical Activity Recommendations in Adults with Diabetes
Abstract
Introduction and Objective. Social determinants of health (SDoH) are known barriers in the management of diabetes. Suboptimal physical activity is known to increase the risk of diabetes-related complications making physical activity fundamental for patients with diabetes. Our study aimed to assess the association between several indicators of SDoH and meeting the recommended levels of leisure-time aerobic physical activity (LTPA) in adult patients with Diabetes Mellitus (DM). Methods. For this cross-sectional study we used data from the National Health Interview Survey (NHIS) 2020 adult dataset and included participants who reported a prior diagnosis of Type 1 or Type 2 DM (n=2,778). Participants reporting an inability to exercise or those with any missing data were excluded. Our outcome was meeting the recommendation guidelines for LTPA defined as 150 minutes of moderate exercise per week or 75 minutes of vigorous exercise per week. Multivariable logistic regression analysis to calculate odds ratios (OR) and 95% confidence intervals (CI) was performed. Results. Overall, 69.9% of the study participants did not meet the recommended LTPA. A total of 9% had type 1 diabetes and 32% were insulin dependent. Individually, several SDoH were associated with not meeting LTAPA: Poverty ratio < 1 >(OR=0.33,95%CI[0.22-0.49]), unemployment (OR=0.68,95%CI[0.55-0.84]), lack of sidewalks (OR=0.72,95%CI[0.58-0.88]), community crime (OR=0.71,95%CI[0.50-1.02]), rural county (OR=0.64,95%CI[0.46-0.88]), and food insecurity (OR=0.66,95%CI[0.46-0.95]). In multivariable models, several SDoH were predictive of not meeting LTPA recommendations: Poverty ratio of < 1.0 (OR=0.50; 95%CI 0.31-0.82), education level less than high school (OR=0.45; 95%CI 0.29-0.71), a high school degree or GED (OR=0.57; 95%CI 0.44-0.74), or an associate degree (OR=0.62; 95%CI 0.44-0.86). Conclusions-Implications. Several SDoH measures were found to be associated with not meeting the aerobic physical activity guidelines in patients with diabetes. Awareness of these factors can be used to develop screening tools to identify patients in need and to implement public health initiatives.
Keywords
Social determinants of health, diabetes, physical activity guidelines
Presentation Type
Poster Presentation
Social Determinants of Health and Meeting Leisure-Time Physical Activity Recommendations in Adults with Diabetes
Introduction and Objective. Social determinants of health (SDoH) are known barriers in the management of diabetes. Suboptimal physical activity is known to increase the risk of diabetes-related complications making physical activity fundamental for patients with diabetes. Our study aimed to assess the association between several indicators of SDoH and meeting the recommended levels of leisure-time aerobic physical activity (LTPA) in adult patients with Diabetes Mellitus (DM). Methods. For this cross-sectional study we used data from the National Health Interview Survey (NHIS) 2020 adult dataset and included participants who reported a prior diagnosis of Type 1 or Type 2 DM (n=2,778). Participants reporting an inability to exercise or those with any missing data were excluded. Our outcome was meeting the recommendation guidelines for LTPA defined as 150 minutes of moderate exercise per week or 75 minutes of vigorous exercise per week. Multivariable logistic regression analysis to calculate odds ratios (OR) and 95% confidence intervals (CI) was performed. Results. Overall, 69.9% of the study participants did not meet the recommended LTPA. A total of 9% had type 1 diabetes and 32% were insulin dependent. Individually, several SDoH were associated with not meeting LTAPA: Poverty ratio < 1 >(OR=0.33,95%CI[0.22-0.49]), unemployment (OR=0.68,95%CI[0.55-0.84]), lack of sidewalks (OR=0.72,95%CI[0.58-0.88]), community crime (OR=0.71,95%CI[0.50-1.02]), rural county (OR=0.64,95%CI[0.46-0.88]), and food insecurity (OR=0.66,95%CI[0.46-0.95]). In multivariable models, several SDoH were predictive of not meeting LTPA recommendations: Poverty ratio of < 1.0 (OR=0.50; 95%CI 0.31-0.82), education level less than high school (OR=0.45; 95%CI 0.29-0.71), a high school degree or GED (OR=0.57; 95%CI 0.44-0.74), or an associate degree (OR=0.62; 95%CI 0.44-0.86). Conclusions-Implications. Several SDoH measures were found to be associated with not meeting the aerobic physical activity guidelines in patients with diabetes. Awareness of these factors can be used to develop screening tools to identify patients in need and to implement public health initiatives.