# Association of socioeconomic and demographic determinants with clinical outcomes in Iraqi patients with diabetes: A cross-sectional study

## TL;DR

This study explores how social factors like housing and income affect diabetes outcomes in Iraq, finding that while they don't impact blood sugar control, they influence patient satisfaction and medication adherence.

## Contribution

The study is the first to examine the relationship between social determinants and diabetes outcomes in the Iraqi population.

## Key findings

- No social determinants were significantly correlated with HbA1c levels.
- Patient satisfaction was positively linked to social support and income, and negatively linked to housing insecurity.
- Social support was the only factor significantly correlated with improved medication adherence.

## Abstract

Social determinants of health (SDH) profoundly influence diabetes outcomes; nevertheless, their impact on the Iraqi diabetic population remains under researched. The objectives of this study were To investigate the relationship between particular social determinants of health (SDH) variables namely food and housing insecurity, social support, income, and education and clinical outcomes, including HbA1c levels, medication adherence, and patient satisfaction among Iraqi diabetic patients. A cross-sectional study involving 212 diabetic patients in Iraq was conducted. Participants attending a healthcare facility in Iraq filled out validated questionnaires regarding social determinants of health, medication adherence, and satisfaction. HbA1c readings were extracted from medical records. Data were examined utilizing Spearman’s correlation. The average HbA1c was 7.4% ± 2.7. A majority of individuals had moderate housing insecurity (79.2%) and low food insecurity (75%). The principal discovery was that no social determinants of health variables exhibited a significant connection with HbA1c levels. Patient satisfaction exhibited a positive correlation with social support (p < 0.001) and higher income (p = 0.023), while demonstrating a negative correlation with housing insecurity (p = 0.040). Social support was the sole factor substantially correlated with improved medication adherence (p = 0.003). In conclusion, SDH were not directly associated with diabetes control but significantly influenced patient-reported experiences. Social assistance and money increased contentment, whereas housing insecurity diminished it. Social support was a significant factor in drug adherence. The results underscore the necessity of addressing psychosocial and economic issues to enhance the quality of diabetes care in Iraq.