/ Access, quality and equity of care

Social determinants of health interventions for diabetes in Black and South Asian populations in Ontario: An international systemic review

• Maura Eswaradas, Yu-Ling Yin, Rachael Tontodonati, Yoonhee Lee and Christine Sheppard
Black woman with diabetes injecting insulin

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Overview

The social determinants of health contribute to increased diabetes risk, hinder effective blood sugar management and exacerbate disease complication. Extensive research highlights the higher rates of diabetes and related complications in Black and South Asian-origin populations in Canada. These groups also face greater exposure to social factors that have been linked to diabetes incidence and progression, such as poverty, discrimination, food insecurity and poor housing.

This study examines the effectiveness of social determinants of health interventions for diabetes in order to identify promising approaches to mitigating diabetes outcomes for these populations.

Key findings

  • Culturally tailored diabetes management programs for Black and South Asian-origin populations, such as HEAL-D and DESMOND, have shown positive outcomes in improving HbA1c levels, weight and physical activity.
  • It is essential that self-management education interventions targeting healthcare access be individualized according to not just the type of diabetes, but also to the unique context of each individual. This includes taking into account the person’s literacy level, cultural background, health beliefs and preferences, as well as their socioeconomic status, and other health challenges.
  • Social support, especially from family and peers, is a key factor in managing and reducing the risk of diabetes.
  • There is a lack of focus on other social factors, like food insecurity, which contribute to diabetes risk.

Recommendations

Further research is needed to address broader social determinants in diabetes care.

We are grateful for funding from the Ministry of Health of the Province of Ontario, which enabled this study.   

This international systematic review is a complement to a related Wellesley Institute scoping review examining social determinants of health and diabetes in Black and South Asian-origin populations in Ontario.

Social determinants of health interventions for diabetes in Black and South Asian populations in Ontario: An international systemic reviewDownload the research report
Supplemental materialDownload the supplemental material
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Maura Eswaradas

Maura Eswaradas

Maura Eswaradas is a researcher and epidemiologist with interests in chronic disease epidemiology, health equity and the social determinants of health. She is passionate about using evidence to understand health discrepancies across different populations and to support program and policy change. Her work at Wellesley Institute focuses on diabetes outcomes and its social determinants of health across racialized populations. Maura holds a Master of Public Health with a specialization in epidemiology from the Dalla Lana School of Public Health at the University of Toronto. Prior to joining Wellesley, she worked for governmental organizations where she performed quantitative analyses using various kinds of data, supported the production of indicators to guide evidence-informed decision-making, and produced various kinds of knowledge translation products.

Yu-Ling Yin

Yu-Ling Yin

Yu-Ling (Yuri) Yin is a researcher at Wellesley Institute and holds a Master’s degree in social work from the University of Toronto, specializing in mental health and health, with a focus on immigrants and people living with disabilities. Prior to starting at Wellesley Institute, he was a social worker with over seven years of experience supporting people living with developmental disabilities in Taiwan.

Rachael Tontodonati

Rachael Tontodonati

Rachael Tontodonati was a student researcher at Wellesley Institute in 2025. A registered social worker, she is currently completing her Master's degree in social work at the University of Toronto, specializing in mental health and health. Prior to starting at Wellesley, she was a social worker with over two years of experience supporting people experiencing psychosis. 

Yoonhee Lee

Yoonhee Lee

Yoonhee Lee holds of Master of Information degree, and works for University of Toronto Libraries.

Christine Sheppard

Christine Sheppard

Dr. Christine L. Sheppard holds a Master’s in Social Work, specializing in gerontology, from the University of Toronto, and a PhD in Health Studies and Gerontology, with a focus on aging, health and well-being, also from the University of Toronto. Prior to starting at Wellesley Institute, she was a CIHR-funded post-doctoral fellow at Sunnybrook Research Institute, specializing in knowledge translation in urban housing and health.