# Impact of philanthropic investment on integrating social determinants of health into diabetes care at US federally qualified health centers

## TL;DR

This study shows that philanthropic funding focused on social determinants of health can significantly improve diabetes outcomes in underserved patients.

## Contribution

The study evaluates the impact of a shift in philanthropy toward addressing social determinants in diabetes care.

## Key findings

- Participants in the program had a significant reduction in HbA1c levels within 60 to 119 days.
- Patients with social determinant needs had higher baseline HbA1c levels.
- Integrating SDOH interventions led to better diabetes outcomes in under-resourced populations.

## Abstract

Assess the impact of a change in a philanthropic funding strategy toward focusing on the inclusion of responses to the social determinants of health (SDOH) in diabetes care.

Retrospective analysis of routinely collected clinical and social determinants of health data.

Federally Qualified Health Centers Across the United States who were selected to receive funding after applying.

People living with diabetes who received care support that was partially or wholly supported from philanthropic funding provided by Direct Relief.

The primary intervention was the injection of funding from Direct Relief to support the integration of interventions responsive to the SDOH. Example interventions include referral to SDOH support, home based monitoring, inclusion of community health workers, virtual care, and community-based care.

The primary outcome measure was the change in HbA1c from baseline to two to four months for all patients contributing data.

Participants in the HBHC program demonstrated a reduction in glycosylated hemoglobin of −1.25 points ([95 % CI, −1.45 - -1.06], p < 0.01) after 60-to-119-days. Participants with family and housing needs, nutrition needs, and social and emotional health needs had statistically significantly higher baseline HbA1c's than patients without these needs.

Future philanthropically supported efforts should encourage integration of SDOH interventions into clinical services for under-resourced patients living with diabetes. Additional prospective, controlled studies should be completed to more definitively determine the impact of investment on specific interventions designed to respond to the most frequently encountered SDOH needs.

Unlabelled Image

•Philanthropic funders rarely track the impact of their investment on health outcomes.•Prescriptive approaches that focus only on clinical needs are typically used.•Direct Relief changed to a holistic approach that responded to social determinants.•Significant reductions in the baseline HbA1c were observed within 60 to 119 days.•Patients with certain social determinant needs had higher baseline HbA1c's.

Philanthropic funders rarely track the impact of their investment on health outcomes.

Prescriptive approaches that focus only on clinical needs are typically used.

Direct Relief changed to a holistic approach that responded to social determinants.

Significant reductions in the baseline HbA1c were observed within 60 to 119 days.

Patients with certain social determinant needs had higher baseline HbA1c's.