The Moderating Effect of Social Support on the Association Between Healthcare Discrimination and Quality of Life in Persons with Type 2 Diabetes ^†

Background/Objectives: Healthcare discrimination poses significant challenges to the health-related quality of life (HRQoL) of people living with type 2 diabetes (T2D). However, the role of social support in alleviating these effects has not been fully explored. Drawing on Cohen and Wills’ social support buffering model, this study examined whether social support moderates the association between healthcare discrimination and HRQoL among individuals with T2D. Methods: We analyzed data from 5180 adults with T2D enrolled in the All of Us Research Program. Healthcare discrimination was assessed using the modified Everyday Discrimination Scale (mEDS), social support with the Medical Outcomes Study Social Support Survey (MOS-SSS), and HRQoL (physical and mental domains) with the PROMIS Global Health Scale. Moderation analyses were conducted through linear regression models. Results: Greater exposure to healthcare discrimination was associated with poorer physical and mental HRQoL. Social support demonstrated a significant moderating effect on mental HRQoL: as social support increased, the negative association between healthcare discrimination and mental well-being weakened. However, this buffering effect was not observed for physical HRQoL. Conclusions: Findings suggest that social support can mitigate the adverse mental health consequences of healthcare discrimination among individuals with T2D. Interventions aimed at strengthening social support networks warrant investigation as potential strategies to improve the mental HRQoL of people with T2D who encounter discrimination in healthcare environments.