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Purpose <p>Diabetic retinopathy (DR), a complication of type 2 diabetes (T2DM), can lead to vision loss if undetected. This review examines how social determinants of health (SDOH) influence DR prevalence and screening.</p> Methods <p>Following PRISMA guidelines and PROSPERO registration (CRD42024603749), this review searched four databases through October 26, 2024, for studies on SDOH and DR. Titles, abstracts, and full texts were screened, risk of bias was assessed with the EPHPP tool, and pooled effect sizes were calculated using a random-effects model with 95% CI.</p> Results <p>This analysis included 44 studies with 633,387 T2DM patients. Gender was not significantly associated with DR (OR = 0.91, 95% CI 0.73–1.14, <i>P</i> = 0.428). Among 12 studies reporting age as a continuous variable, there was no significant difference in mean age between patients with and without DR (MD = 1.47 years, 95% CI -0.71 to 3.64, <i>P</i> = 0.187; I² = 99%). Eight studies categorizing age showed non-significant higher DR odds for those ≥ 60 vs. &lt;60 (OR = 1.19, 95% CI 0.93–1.51, <i>P</i> = 0.166; I² = 66%). Higher education was linked to lower DR risk (OR = 0.77, 95% CI 0.66–0.90, <i>P</i> = 0.001). Higher income and insurance access were associated with lower DR prevalence and higher screening rates. Racial and ethnic results were mixed, with some studies reporting higher DR in non-white groups and lower screening among Hispanic and Asian populations.</p> Conclusion <p>SDOH strongly influence DR outcomes. Education, income, and insurance were linked to lower risk and better screening, while age and gender showed no clear effect. Persistent racial disparities highlight the need for targeted screening in underserved groups.</p>

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The impact of sociodemographic factors on diabetic retinopathy screening and prevalence: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Alaa Tarazi,
  • Othman Ammar,
  • Yazan AlSawaftah,
  • Khaled El-Hilo,
  • Nakhleh Abu-Yaghi

摘要

Purpose

Diabetic retinopathy (DR), a complication of type 2 diabetes (T2DM), can lead to vision loss if undetected. This review examines how social determinants of health (SDOH) influence DR prevalence and screening.

Methods

Following PRISMA guidelines and PROSPERO registration (CRD42024603749), this review searched four databases through October 26, 2024, for studies on SDOH and DR. Titles, abstracts, and full texts were screened, risk of bias was assessed with the EPHPP tool, and pooled effect sizes were calculated using a random-effects model with 95% CI.

Results

This analysis included 44 studies with 633,387 T2DM patients. Gender was not significantly associated with DR (OR = 0.91, 95% CI 0.73–1.14, P = 0.428). Among 12 studies reporting age as a continuous variable, there was no significant difference in mean age between patients with and without DR (MD = 1.47 years, 95% CI -0.71 to 3.64, P = 0.187; I² = 99%). Eight studies categorizing age showed non-significant higher DR odds for those ≥ 60 vs. <60 (OR = 1.19, 95% CI 0.93–1.51, P = 0.166; I² = 66%). Higher education was linked to lower DR risk (OR = 0.77, 95% CI 0.66–0.90, P = 0.001). Higher income and insurance access were associated with lower DR prevalence and higher screening rates. Racial and ethnic results were mixed, with some studies reporting higher DR in non-white groups and lower screening among Hispanic and Asian populations.

Conclusion

SDOH strongly influence DR outcomes. Education, income, and insurance were linked to lower risk and better screening, while age and gender showed no clear effect. Persistent racial disparities highlight the need for targeted screening in underserved groups.