The association between social determinants of health and self-reported diabetic retinopathy: An exploratory analysis

Emily L. Silverberg, Trevor W. Sterling, Tyler H. Williams, Grettel Castro, Pura Rodriguez de la Vega, Noël C. Barengo (Coresponding Author)

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)
9 Downloads (Pure)


One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person’s environment that may impact health. The objective of this study was to determine whether there is an association between SDOHs and DR in patients with type II diabetes. This cross-section study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). This study included people with self-reported diabetes in the US in 2018 (n = 60,703). Exposure variables included homeownership, marital status, income, health care coverage, completed level of educa-tion, and urban vs. rural environment. The outcome variable was DR. Logistic regression analysis were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Alaskan Native/Na-tive American (OR 2.11; 95% CI: 1.14–3.90), out of work (OR 2.82; 95% CI: 1.62–4.92), unable to work (OR 2.14; 95% CI: 1.57–2.91), did not graduate high school (OR 1.91; 95% CI: 1.30–2.79), only gradu-ated high school (OR 1.43; 95% CI 1.08–1.97), or only attended college or technical school without graduating (OR 1.42; 95% CI: 1.09–1.86) were SDOHs associated with DR in patients with diabetes. Health care providers should identify these possible SDOHs affecting their diabetic patients.

Original languageEnglish
Article number792
Pages (from-to)1-12
Number of pages12
JournalInternational journal of environmental research and public health
Issue number2
Publication statusPublished - 2 Jan 2021
Externally publishedYes


  • Built environment
  • Community
  • Diabetes
  • Diabetic retinopathy
  • Economic stability
  • Education
  • Ethnicity
  • Health care
  • Race
  • Social determinants of health

Field of Science*

  • 3.3 Health sciences
  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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