{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:39:34Z","timestamp":1790991574035,"version":"4.1.0"},"reference-count":40,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100017618","name":"Division of Diabetes, Endocrinology, and Metabolic Diseases","doi-asserted-by":"publisher","award":["K23DK131261"],"award-info":[{"award-number":["K23DK131261"]}],"id":[{"id":"10.13039\/100017618","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017618","name":"Division of Diabetes, Endocrinology, and Metabolic Diseases","doi-asserted-by":"publisher","award":["R01DK107956"],"award-info":[{"award-number":["R01DK107956"]}],"id":[{"id":"10.13039\/100017618","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017618","name":"Division of Diabetes, Endocrinology, and Metabolic Diseases","doi-asserted-by":"publisher","award":["R01DK11672"],"award-info":[{"award-number":["R01DK11672"]}],"id":[{"id":"10.13039\/100017618","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017618","name":"Division of Diabetes, Endocrinology, and Metabolic Diseases","doi-asserted-by":"publisher","award":["U01DK119083"],"award-info":[{"award-number":["U01DK119083"]}],"id":[{"id":"10.13039\/100017618","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100022690","name":"JDRF","doi-asserted-by":"publisher","award":["University of Michigan"],"award-info":[{"award-number":["University of Michigan"]}],"id":[{"id":"10.13039\/100022690","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To determine the association between social determinants of health (SDOH) and a diagnosis of diabetic foot ulcer (DFU) infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Targeted interrogation of electronic health record data using novel search engines to analyze individuals with a DFU infection during a 5-year period (2013\u20132017) was performed. We extracted geolocated neighborhood data and SDOH characteristics from the National Neighborhood Data Archive and used univariate and multiple logistic regression to evaluate associations with outcomes in the population with diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Among 4.3 million people overall and 144,564 individuals with diabetes seen between 2013 and 2017, 8,351 developed DFU, of which cases 2,252 were complicated by a DFU infection. Sex interactions occurred, as men who experienced a DFU infection more frequently identified as having nonmarried status than their female counterparts. For the population with DFU infection, there were higher rates for other SDOH, including higher neighborhood disadvantaged index score, poverty, nonmarriage, and less access to physician\/allied health professionals (all P &amp;lt; 0.01). In multiple logistic regression, those individuals who developed DFU infection came from neighborhoods with greater Hispanic and\/or foreign-born concentrations (odds ratio 1.11, P = 0.015).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>We found significant differences in neighborhood characteristics driving a higher risk for DFU infection in comparisons with the grouping of individuals with diabetes overall, including increased risk for individuals with Hispanic and\/or foreign-born immigration status. These data strongly support the need to incorporate SDOH, particularly ethnic and immigration status, into triage algorithms for DFU risk stratification to prevent severe diabetic foot complications and move beyond biologic-only determinants of health.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc23-1787","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T17:58:08Z","timestamp":1705687088000},"page":"508-515","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":12,"title":["Residential Address Amplifies Health Disparities and Risk of Infection in Individuals With Diabetic Foot Ulcers"],"prefix":"10.2337","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2561-9243","authenticated-orcid":false,"given":"Brian M.","family":"Schmidt","sequence":"first","affiliation":[{"name":"1Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyuan","family":"Huang","sequence":"additional","affiliation":[{"name":"2Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mousumi","family":"Banerjee","sequence":"additional","affiliation":[{"name":"2Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim S.","family":"Hayek","sequence":"additional","affiliation":[{"name":"3Division of Cardiology, Department of Medicine, University of Michigan Health, University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2042-1350","authenticated-orcid":false,"given":"Rodica","family":"Pop-Busui","sequence":"additional","affiliation":[{"name":"1Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"2024022320373379800_B1","article-title":"Incidence of Diabetic Foot Ulcer and Lower Extremity Amputation Among Medicare Beneficiaries, 2006 to 2008","author":"Margolis","year":"2011"},{"key":"2024022320373379800_B2","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1056\/NEJMra1615439","article-title":"Diabetic foot ulcers and their recurrence","volume":"376","author":"Armstrong","year":"2017","journal-title":"N Engl J 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Social determinants of health at CDC, 2023. Accessed 1 February 2023. Available from https:\/\/www.cdc.gov\/about\/sdoh\/index.html#:~:text=They%20are%20the%20conditions%20in,climate%20change%2C%20and%20political%20systems"},{"key":"2024022320373379800_B11","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.amepre.2015.08.024","article-title":"County health rankings: relationships between determinant factors and health outcomes","volume":"50","author":"Hood","year":"2016","journal-title":"Am J Prev Med"},{"key":"2024022320373379800_B12","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.diabres.2017.02.008","article-title":"Podiatry impact on high-low amputation ratio characteristics: a 16-year retrospective study","volume":"126","author":"Schmidt","year":"2017","journal-title":"Diabetes Res Clin Pract"},{"key":"2024022320373379800_B13","doi-asserted-by":"crossref","first-page":"497","DOI":"10.2174\/1573399814666181017104818","article-title":"A tale of two eras: mining big data from electronic health records to determine 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