Diabetes

Diabetes, Minority Status, and the African American and Hispanic American Communities
Diabetes, Minority Status, and the African American and Hispanic American Communities

In March of 2003, a bill known as the "Minority Population Diabetes Prevention and Control Act of 2003" was introduced to Congress, and then referred to the Committee on Energy and Commerce. According to this bill's findings, "minority populations, including African Americans, Hispanics, Native Americans, and Asians, have the highest incidence of diabetes and the highest complications of the disease" (1). The alarming rate at which the incidence of diabetes is affecting African American and Hispanic American communities has led the government, health care professionals, clinics, and other organizations to begin to question the process by which information and treatment is being accessed by members of these communities.

Diabetes mellitus is defined as "a group of diseases characterized by high levels of blood glucose, which result from defects in insulin secretion, insulin action or both" (2). There are two types of diabetes, one that "occurs when the body produces little or no insulin, and that typically affects children and young adults," and the other, which "typically develops in adults, and occurs when the body does not use insulin effectively", types II diabetes being the most common (3). According to the CDC and the National Center for Health Statistics, "the number of Americans with diabetes in the year 2000 was 17 million or 6.2 percent of the population, as compared to 15.7 million (5.9 percent) in 1998" (4). However, and on average, Hispanic Americans and African Americans are almost twice as likely to have diabetes in comparison to white Americans. In addition, African Americans and Hispanic Americans show a higher incidence of suffering from diabetes related complications including but not limited to eye and kidney disease, amputations, heart disease, heart stroke etc (5).

Various factors are said to increase the chances of developing type II diabetes. These factors fall under two categories-genetics and medical/lifestyle risk factors, which include impaired glucose tolerance, gestational diabetes, hyperinsulinemia and insulin resistance, obesity and physical activity (6). Although studies have shied away from making direct correlations between obesity/physical activity and the susceptibility of developing type II diabetes, researchers suspect, however, that a lack of exercise and obesity, as well as other unidentifiable factors, may be contributing to the high diabetes rates in African American and Hispanic American communities. The NHANES III survey indicated that "50 percent of African American men/65 percent of Mexican American men, and 67 percent of African American women/74 percent of Mexican American women participated in little or no exercise" (7). In addition, both African Americans and Hispanic Americans experience higher rates of obesity than white Americans; these rates continue to be on the rise.

With this information in mind, it is necessary to examine the prevalence of this disease within these groups, while at the same time, examining the disparities in access to care, treatment, information, and health care in comparison to Caucasian patients-those that are and aren't diabetic, and how this further complicates the ability of these communities to combat diabetes and other health-related problems. An associate professor at the Johns Hopkins Bloomberg School of Public Health stated that "simply expanding insurance coverage to previously uninsured minority patients, although helpful, may not overcome disparities in the qualitative experience of primary care among racial and ethnic groups. It is particularly crucial to identify disparities in the experience of primary care across racial and ethnic groups, since the minority population will almost equal the size of the non-Hispanic white population by the middle of the next century" (8). At the same time, however, the issue is not only about preferential and/or differences in treatment and health care options among minority and Caucasian groups, it is also about getting minorities to access any type of health care regardless of whether they have health insurance or not. The reality is that minorities are most likely to have no health insurance and therefore no access to health care. Hence, "lack of health insurance is linked to less access to care and more negative care experiences for all Americans. Hispanics and African Americans are most at risk of being uninsured. Nearly one-half of working-age Hispanics (46%) lacked health insurance for all or part of the year prior to the survey, as did one-third of African Americans. In comparison one-fifth of whites and Asian Americans ages 18-64 lacked coverage for all or part of the year" (9).

Lack of access to proper health care, low attainment of health insurance, and a growing diabetes epidemic in African American and Hispanic American communities is a complicated and alarming set of circumstances. However, this type of medical care alienation/ignorance and the implications it has on these communities is a small part of a greater dialogue and debate about the status of minorities in the United States, and their ability to access adequate cultural, social, and economic capital. I would argue that diabetes the disease could be replaced by many other diseases and health related problems-HIV/AIDS, obesity, strokes, high blood pressure, etc. The question that remains is whether minority groups can gain access to health care and other types of capital, from which many are deprived, without changing or challenging the existing structures.

References

1) Minority Populations Diabetes Prevention and Control Act of 2003, http://www.theorator.com/bills108/hr1144.html 2) Diabetes in Hispanic Americans, http://diabetes.niddk.nih.gov/dm/pubs/hispanicamerican/index.htm 3) Diabetes in Hispanic Americans, http://diabetes.niddk.nih.gov/dm/pubs/hispanicamerican/index.htm 4) Diabetes Among Racial and Ethnic Minorities in Nebraska 1992-2001, http://www.hhs.state.ne.us/srd/DiabetesReport03.pdf 5) Diabetes in African Americans, http://diabetes.niddk.nih.gov/dm/pubs/africanamerican/index.htm 6) Diabetes in Hispanic Americans, http://diabetes.niddk.nih.gov/dm/pubs/hispanicamerican/index.htm 7) Diabetes in African Americans, http://diabetes.niddk.nih.gov/dm/pubs/africanamerican/index.htm 8) Minorities' Primary Health Care Substandard Compared to Whites, http://www.jhsph.edu/Press_Room/Press_Releases/PR_1999/minority_care.html 9) Minority Americans Lag Behind Whites on Nearly Every Measure of Health Care Quality, http://www.cmwf.org/ --------------------------------------------------------