Moving Beyond the Individual Level With Uncontrolled Diabetes

The negative impact of residing in a disadvantaged neighborhood and its subsequent implications for poor glycemic control are significant considerations for moving beyond the individual level in patients with diabetes. An area deprivation index (neighborhood disadvantage) is presented in a case example as a tool to examine contextual risk factors (eg, social and environmental factors) in a patient with uncontrolled diabetes. Interventions at the individual and community level illustrate how an area deprivation index can help health care providers overcome challenges presented by patients with uncontrolled diabetes. •Individual factors are often insufficient for glycemic control.•Contextual risk factors are conditions that impact health and consider person, place, and time.•The Area Deprivation Index can be used as a tool for assessing contextual risk factors, broadly defined as social and environmental conditions fostering uncontrolled diabetes.•A case study illustrates the use of the area deprivation tool by a nurse practitioner.•Based on area deprivation scores, community resources can be arranged to prevent complications and promote improved diabetes self-management.