Abstract / Summary
Abstract Background Ethnic inequalities in type 2 diabetes (T2DM) disease burden are well documented in the UK. While considerable evidence exists on the effects of biological factors such as insulin resistance and behavioural determinants including diet and physical activity, important evidence gaps remain regarding the relative contribution of social determinants on T2DM disease burden. We explore the role of the social determinants of health on type 2 diabetes (T2DM) prevalence. Next, we investigate if these social determinants explained observed inequalities in T2DM prevalence between ethnic minority groups and the ethnic majority group in the UK. Methods Data came from the UK Household Longitudinal Survey from 2009–2023 (N = 101,304). Estimated a logistic model of the relationship between ethnic minority status, the social determinants of health and prevalence of T2DM. Next, a non-linear decomposition approach estimated the impact of social factors on explaining observed difference in T2DM prevalence between ethnic minority groups and the ethnic majority group. Results Compared to the ethnic majority group (White British), the odds of T2DM were significantly higher among people identifying as Asian (OR = 2.24, 95% CI: 2.05–2.44), Black (OR = 1.47, 95% CI: 1.30–1.66), and Mixed Ethnicity (OR = 1.46, 95% CI: 1.20–1.77). Socioeconomic characteristics explain 58% and 21% of the observed variance in T2DM prevalence among identifying as Black. and Asian respectively. Conclusion Policy needs to look beyond the healthcare sector and address broader structural factors such as the social determinants of health to reduce ethnic inequalities in T2DM. This is particularly important in sorpporting the NHS 10 year plan prevention agenda.