A Series paper published in The Lancet demonstrates how structural inequity (structural racism and geographical inequity) has accelerated diabetes prevalence, morbidity, and mortality rates globally. The paper discusses how structural inequity leads to large, fixed differences in key, upstream social determinants of health. In a cascade of widening inequity, these differences influence downstream social determinants of health and resultant diabetes outcomes. Categories of social determinants of health with known effects on diabetes outcomes are reviewed, including public awareness and policy, economic development, access to high-quality care, innovations in diabetes management, and sociocultural norms. Regional perspectives are also provided by the authors, to highlight prominent, real-world challenges.
