Understanding Barriers to Addressing Social Determinants of Health in Diabetes: Perspectives of Managed Care Administrators
Date of Award
Summer 2025
Document Type
Dissertation
Degree Name
Doctor of Healthcare Administration (DHA)
Committee Chair
Mary Bynum
Committee Member
Chenelle Jones
Committee Member
Treasure Miller
Abstract
Managed care organizations (MCOs) play a vital role in controlling healthcare costs and improving care quality, yet expenditures in the United States continue to rise. At the same time, chronic conditions like diabetes remain a growing concern, now affecting 11.6% of the U.S. population. Social determinants of health (SDoH), which account for a sizable portion of health outcomes, further complicate efforts to improve care, particularly in marginalized populations. This qualitative study explored how MCO administrators view and respond to the barriers SDoH present in diabetes management. Guided by the Healthy People 2030 SDoH Framework, semi-structured interviews were conducted with seventeen administrators working in MCO across the U.S. The interviews were transcribed and analyzed using NVivo® 14, with reflexive thematic analysis used to identify key themes. Eight major themes emerged, reflecting systemic challenges, gaps in measurement, trust and literacy issues, and limitations in benefit design. At the same time, participants emphasized the importance of cross-sector collaboration, culturally responsive strategies, and policy advocacy. These findings offer insight into the practical realities MCO administrators face and suggest ways that policy and system-level changes could support more effective and equitable diabetes care.
Recommended Citation
Brigham, Erin L., "Understanding Barriers to Addressing Social Determinants of Health in Diabetes: Perspectives of Managed Care Administrators" (2025). All Doctoral Student Dissertations. 223.
https://fuse.franklin.edu/docpub/223
