Diabetes Disparities in the Black Community
February is Black History Month, and we want to take this opportunity to recognize the significant impact of diabetes on Black communities.
According to the Centers for Disease Control and Prevention (CDC), Black Americans are approximately 60% more likely to be diagnosed with diabetes compared to non-Hispanic White Americans. In addition, Black individuals with diabetes are at increased risk of complications such as heart disease, stroke, kidney disease, and lower extremity amputations.
Social determinants of health play a significant role in the prevalence, management, and outcomes of diabetes among Black Americans. These determinants encompass various socio-economic, environmental, and cultural factors that influence health outcomes.
They also lead to an underrepresentation of culturally relevant healthcare for various communities, including Black Americans. Cultural beliefs, attitudes, and practices regarding health, diet, and exercise may influence diabetes prevention and management behaviors. If there is a lack of trust in the patient-provider relationship, it can exacerbate barriers to receiving care and decrease positive outcomes. According to a pilot study from 2019:
Trust in physicians depends on physicians’ appreciation of patients’ knowledge, beliefs, and attitudes and, for Black patients in particular, on patients’ perceived racism. The latter predicts lower rates of physician visits, medication adherence, and preventive care, which compromise glycemic control and increase the risk of progression of Diabetes Retinopathy to blindness.
Diabetes Educators have an opportunity to cultivate an environment of trust and address healthcare disparities by recognizing the intersection of race, socioeconomic status, and health. Additionally, practicing cultural humility to develop critical self-awareness of personal implicit or explicit values and behaviors that may contribute to health care disparities. Cultural humility acknowledges the role of power and privilege within the patient-provider dynamic and within the health care system itself. By taking a closer look at our own biases during interactions, we can start becoming more intentional and align with the individual’s needs and values when providing care.
Individual efforts will also need to be joined by community-based interventions, healthcare system reforms, policy changes, and targeted public health initiatives. However, by personally considering how we can address the social determinants of health and implement culturally relevant strategies within our clinics and hospitals, it is possible to reduce the burden of diabetes for the people we work with and improve health outcomes in Black communities.
Resources & Articles for further reading:
- Advancing Health Equity by the Centers for Disease Control and Prevention (CDC)
- Improving Equity and Access to Health Care: How Nontraditional Organizations Can Help Increase Clinical Trial Diversity by the American Diabetes Association (ADA)
- Trust and Glycemic Control in Black Patients With Diabetic Retinopathy: A Pilot Study
- Diabetes and African Americans
- Racial and Ethnic Disparities in the Management of Diabetic Feet Clayton EO, Njoku-Austin C, Scott DM, Cain JD, Hogan MV. Racial and Ethnic Disparities in the Management of Diabetic Feet. Curr Rev Musculoskelet Med. 2023 Nov;16(11):550-556. doi: 10.1007/s12178-023-09867-7. Epub 2023 Sep 21. Erratum in: Curr Rev Musculoskelet Med. 2024 Jan 25;: PMID: 37733148; PMCID: PMC10587034.
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