Diabetes and African-Americans Still Too Closely Linked
A celebration of Black History Month with an eye toward ending health disparities.
By A.Paul Chous, MA, OD, FAAO
February is Black History Month which, along with the Federal holiday commemorating one of our greatest American heroes — Dr. Martin Luther King, Jr. — represents a chance for all of us to reflect on the numerous contributions made to our nation by Americans of African descent. For those of us in the diabetes community, we also honor and remember famous African-Americans who have had diabetes, including people like baseball great Jackie Robinson, Nobel Prize winning political scientist and United Nations diplomat Dr. Ralph Bunche, and singing legend Ella Fitzgerald. We would also do well to think of the myriad and often untold/under-recognized hard work of diabetes researchers and health care professionals who happen to be black, but also the disproportionate number of African-Americans affected by diabetes and its complications. In this light, Black History Month gives us an opportunity to highlight persisting health disparities and hopefully (ironically), relegate those disparities to the annals of history.
African-Americans are roughly twice as likely to be diagnosed with type 2 diabetes. Once diagnosed, they are more likely to have poorer blood glucose, blood pressure and blood lipid control, and are significantly more likely to suffer cardiovascular complications like stroke and heart attack, as well as small blood complications like kidney and eye disease. In fact, African-Americans with diabetes are 70% more likely than non-Latino Whites to develop severe diabetic retinopathy that threatens vision, and are less likely to receive timely treatment that is crucial to prevent long-term, significant vision loss. African-Americans are also at least twice as likely to develop and suffer severe vision loss from glaucoma, another eye disease that is associated with having diabetes. The reasons for these disparities are numerous, but undoubtedly include aggregate inequalities in education (particularly health education), income, and access to quality health care that includes "culturally competent" providers and methods of delivering top-notch care on a consistent basis. Such health disparities not only negatively affect the human potential of individuals with diabetes, but are antithetical to democratic values like liberty and the equal opportunity upon which it depends.
And because diabetes disproportionately affects people of color, the most fundamental way to prevent complications in the African-American community, as in any community, is to prevent diabetes in the first place by employing every tool to encourage regular physical activity, healthy food choices, and on-going health education (in my view, the best time to see a diabetes educator is well before you've been diagnosed with diabetes — this is especially true for the 79 million Americans with pre-diabetes, a disproportionate number of whom are also black). With the costs of diabetes care expected to top 350 billion dollars per year by 2030, both our Nation's economy and the welfare of our citizenry demand that we be much more proactive in combating a largely preventable disease. We can spend a lot less now on prevention, or a lot more later on treating diabetes and its dreaded complications; ultimately, it depends on what kind of society we want to live in.
For more information on diabetic eye disease, consult Dr. Chous' book Diabetic Eye Disease: Lessons From a Diabetic Eye Doctor, Fairwood Press, Seattle, 2003.
Read more about Dr. Chous here.
Visit Dr. Chous' website here.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
Angel Meringue Dessert Peach Smoothie with Ginger Ale Mixed Berry Jam Lemon and Garlic Shrimp Kabobs Garden Vegetable Fettuccini Salad Mixed Mediterranean Vegetables and Couscous Chicken and Vegetable Stew Tempeh and Noodle Soup Tandoori Chicken Apricot Tea Sparkler
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...