Combatting Healthcare Disparities: Diabetes



A few weeks ago, I joined Community Conversations in discussing findings that are helping to inform our understanding of diabetes. Diabetes affects about 26 million people in the United States [1]. But among minority communities—black women in particular, the prevalence is even more startling. Diabetes is nearly twice as prevalent among black women than it is among non-hispanic white women [1]. This is an alarming statistic, especially since the burden of living with diabetes can take such a physical, emotional and economic toll on individuals, communities and families. Equally important to uncovering such disparities is to question why such differences in health outcomes persist—why are black women so disproportionately affected by diabetes and what can we do as a community to address this?


Our health is multidimensional—the product of many different competing and coordinating factors which must all be taken into account when trying to understand a condition such as diabetes. While scientists are actively pursuing research in understanding the role that certain genes could play in predicting diabetic risk [2],[3], they are also looking into the ways that mental health, socioeconomic status, and other factors interact with each other and affect prognosis [4],[5],[6]. This is important to keep in mind, because diabetes is not a descriptor for, or destiny of, any community. The startling statistics that we see should compel us to seek answers on behalf of our own individual health, and that of those who surround us. They should not lead to reductionist thinking, or a surrender to the idea that one factor like genetics is the sole predictor of disease outcomes. As mentioned in the Community Conversation discussion, there are so many small ways that we can make positive changes for our health, and it is important to engage with all of the risk factors that affect our wellbeing. For example, developing an exercise routine to improve fitness, investigating healthy eating options to improve nutrient and caloric intake, and consulting with mental health providers are all tangible things that we can do to improve our overall health and risk for conditions like diabetes.


Those are just a few of the skills we can cultivate in preventing against and coping with diabetes. Understanding and managing our health requires problem-solving, reflection and a holistic approach to wellness. In order to fight this epidemic, we must be active advocates for our individual and community health, as well as engaged consultants within our healthcare network.


[1] http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlID=18

[2] Shana McCormack and Struan F. A. Grant, “Genetics of Obesity and Type 2 Diabetes in African Americans,”Journal of Obesity, vol. 2013, Article ID 396416, 12 pages, 2013. doi:10.1155/2013/396416

[3] Paper on Genetics and Diabetes from the World Health Organization: http://www.who.int/genomics/about/Diabetis-fin.pdf

[4] Gravlee, C. (2009). How Race Becomes Biology: Embodiment Of Social Inequality. American Journal of Physical Anthropology, (139), 47-57.

[5] Gaskin, D., Thorpe, R., Mcginty, E., Bower, K., Rohde, C., Young, J…Dubay, L. (n.d.). Disparities in Diabetes: The Nexus of Race, Poverty, and Place. Am J Public Health American Journal of Public Health, 104(11), 2147-2155.

[6] Mezuk, B., Eaton, W., Albrecht, S., & Golden, S. (2008). Depression And Type 2 Diabetes Over The Lifespan: A Meta-analysis. Diabetes Care, 31(12), 2383-2390.

Image: http://web.jhu.edu/jhnmagazine/summer2009/features/strong_women.html

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Community Conversations: Sister to Sister, a women's health initiative, is an an ongoing, open forum to explore health issues of particular relevance to Black women and their families. 

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