Race and Ethnicity’s Role in Diabetes Prevention and Management
With Diabetes and most other diseases, a person’s race, socioeconomic status, ethnicity, and genetics all play a role in the risk of developing diabetes and managing it. Social determinants in health lead to major differences in how people are affected by diabetes, creating many health disparities across the country. The Centers for Disease Control and Prevention state that over 37 million people in the U.S. are diabetic. 96 million people, more than one-third of the population, are prediabetic. Diabetes is also the eighth leading cause of death in America. This shows just how hard it is for people of color to get proper care and treatment for Diabetes because of their naturally higher risks, socioeconomic status, and other societal factors such as access to healthy food and healthcare.
The Main Racial Health Disparities for Diabetes in America
A study by the CDC from 2018-2019 showcases the percentages of U.S. adults 18 and older with Diagnosed Diabetes. The Data shows that Black, Asian, Indigenous, and Hispanic communities have more diagnosed diabetes and are more affected by it compared to white, non-Hispanic communities.
American Indian or Alaska Native – 14.5%
Asian, non-Hispanic – 9.5%
Black, non-Hispanic – 12.1%
Hispanic, overall – 11.8%
White, non-Hispanic – 7.4%
Socioeconomic Factors
Other studies have also shown that those with lower socioeconomic status(SES) are more likely to develop Type 2 Diabetes. It has also shown that the higher the income, the higher the education level, meaning people with those two traits have a lower chance of developing diabetes and experiencing its complications. In America, lower education and income rates have been mainly associated with the Hispanic and Black communities. For example, in 2016, Black people in the 90th percentile of their income only earned 68% of what white people in their 90th percentile earned. Overall blacks earned 65% as much as whites. Hispanic people at their highest income percentile earned only 65% as much as whites in 2016. While this is a major increase from the 1900s, it is still a problem. This supports the claim that socioeconomic factors around people of color are the main cause of the health disparities in diabetes.
Quality of Care
A 2017 study, was conducted by researchers from Vanderbilt University and Meharry Medical College. By analyzing cross-sectional data of adults diagnosed with diabetes in the 2013 Expenditure Panel Survey, they found that among adults with diabetes in the U.S., 74.9% received two or more HbA1C tests, 64.9% had an eye exam, 69% had a foot exam, 65.1% had a flu vaccination, and 85.4% had a cholesterol test. Compared to white populations, all the tests had lower percentages for Hispanics, and HbA1C tests, flu vaccinations, and eye exams were lower for Blacks. HbA1C tests, foot exams, and eye exams were lower for Asians. This means that people of color wouldn’t know they have diabetes, making the disease worse because it’s not being treated. The researchers found that these disparities in quality of care prevailed because people of color lacked the same health insurance and diabetes education when compared to whites.
Unemployment
In America, people of color are more likely to be unemployed than Whites. The unemployment rate in the United States in 2022, by ethnicity is
Black/African-American: 6.1%
Puerto Rican: 5.7%
Hispanic/Latino: 4.3%
Mexican American: 4.3%
White/Caucasian: 3.2%
Unemployment influences people’s access to quality healthcare, insurance, and healthy foods which are the main factors when it comes to diabetes prevalence and management.
Food and Exercise
Consistent exercise and a healthy diet are extremely beneficial when it comes to reducing the risk of diabetes and the health outcomes that are caused by it. People of color tend to have less access to healthier foods and are more food insecure when compared to their white counterparts. In 2021, 4.5% of Whites were in households with low food security and only 2.2% were in households with very low food security. However, 12.7% of blacks were in households with low food security and 7% were in households with very low food insecurity. 12% of Hispanics were in households with low food security and 4.6% in households with very low food insecurity. These drastic percentage differences show just how many households of color are food insecure when compared to white households. Food insecurity is often associated with low-income families, which are primarily people of color. Food insecure communities also have little to no access to healthy whole foods but have disproportionate access to unhealthy junk food, one of the main risk factors for Type 2 Diabetes.
In addition to less access to healthy foods and food insecurity, people of color tend to exercise less consistently. A study by the CDC in 2022 researched the difference in the prevalence of physical activity in the U.S. by race/ethnicity. The results showed that Hispanic adults had the highest prevalence of physical inactivity with 32.1% followed by Black adults (30%), Indigenous adults (29.1%), White adults (23.0%), and Asian adults (20.1%). Exercise is a key component for the prevention and treatment of Type 2 Diabetes as it reduces blood pressure and mitigates the effects of diabetes-associated conditions.
Health Insurance
People of color tend to be more uninsured compared to their White counterparts making them unable to get consistent checkups/treatment for Diabetes. In 2021, Nonelderly American Indians and Alaskan Natives had the highest uninsured rate with 21.2%. This was followed by Hispanics (19%), Black/African-American (10.9%), Native Hawaiian and Pacific Islander (10.8%), and White (7.2%).
Solving these Disparities
The racial health disparities in diabetes prevalence and treatment are caused by many social determinants such as socioeconomic factors, health insurance, and unemployment. These determinants stem from racism in America, which has been ongoing for decades now. Everyone deserves to get the quality care and treatment they need, but that isn’t the case for people of color. We have to solve these problems so everyone including people of color gets the care, medication, and education they need to live healthy lives.
References
Adult Physical Inactivity Prevalence Maps by Race/Ethnicity | Physical Activity | CDC
How Race and Ethnicity Affect Diabetes Prevalence, Management, and Complications (diatribe.org)
U.S. food secure and food insecure individuals by race and ethnicity 2021 | Statista
U.S. unemployment rate, by ethnicity 2022 | Statista
By the Numbers: Diabetes in America | Diabetes | CDC’
Racial and ethnic income inequality in America: 5 key findings | Pew Research Center
Health Coverage by Race and Ethnicity, 2010-2021 | KFF
Insulin: What Is It, How Do You Take It, Side Effects (clevelandclinic.org)
Cost of an Insulin Pump – 2023 Healthcare Costs (costhelper.com)