Epidemiology of Diabetes, Hypertension, and Cancer in Underserved Areas: An Evidence-Based Review

Abstract

Underserved areas in the United States bear a substantial burden of chronic diseases, including diabetes, hypertension, and cancer. These diseases severely impair quality of life and account for a large share of excess morbidity and mortality across the nation. Despite constituting a major public health problem, they have been neglected in scientific research and in interventions tailored to address these disparities. To inform effective interventions, this synthesis describes the epidemiology and determinants of diabetes, hypertension, and cancer, and the implications for public health strategies aimed at improving access to prevention and care in these areas. An integrated conceptual framework was developed based on the World Health Organization’s social determinants of health. Focusing on evidence from the United States, key knowledge gaps were identified through a deductive approach and by synthesizing recent reviews of the epidemiology of these diseases in low-resource settings and their social and structural determinants. After mapping knowledge gaps across the three conditions, a targeted literature search was conducted to fill selected gaps and strengthen the evidence base, including a more extensive consideration of cancer.