Date of Award

Spring 2026

Degree Type

Thesis

Department

Public Health

Director of Thesis

Dr. Edena Guimaraes

Second Reader

Isabella Alonso

Abstract

Type II diabetes mellitus (T2DM) represents a significant public health burden in South Carolina, where 13.5% of adults are affected, surpassing the national rate of 12%. This integrative literature review examines the social determinants of health most strongly associated with T2DM morbidity and mortality in South Carolina, including race and ethnicity, socioeconomic status, rural or urban residence, educational attainment, healthcare access, and food insecurity. Evidence drawn from peer-reviewed studies, epidemiological reports, and state health data reveals that African American, rural, and low-income populations bear a disproportionate share of the diabetes burden in the state. These disparities arise through multilevel mechanisms including structural racism, chronic psychosocial stress, material deprivation, healthcare access barriers, and food insecurity. The review further identifies evidence-based interventions including community-based lifestyle programs, telehealth delivery models, and integrated clinic-community approaches that have demonstrated effectiveness in comparable populations. Findings suggest that socioeconomic status, healthcare access, and racial background are the most influential determinants of diabetes outcomes in South Carolina, and that addressing these factors through coordinated policy, clinical, and community-level action is essential to reducing the state's disproportionate diabetes burden.

First Page

1

Last Page

47

Rights

© 2026, Alexander G. Downs

Download

Share

COinS