Managing Type 2 Diabetes in an Urban Environment
Diabetes obstacles in Detroit.
December 2010 — I was born in the city of Detroit. I was raised and educated, bumped and bruised, and loved and cared for by my family in the city of Detroit. Detroit is my home and I continue to live in this city, regardless of its bad reputation, politics gone wrong, and its people being on the top list of every bad health story streaming on national news channels. Why? Because this city has a comeback spirit, roots in the motor vehicle industry, and music that became the backdrops of many movements to improve our lives as we live together and learn tolerance.
I stay because of the people, the artists, the children, the specialty stores, and the beautiful riverfront. I stay because we are the only city in the United States north of Canada. I work here at a small catholic liberal arts college and currently, I am teaching a course on community and organizational change. But never has it ever been clearer to me that managing my type 2 diabetes in an urban setting has its significant challenges.
Detroit has very interesting dynamics that plague its dwellers, such as the fragmented public transportation system. The transportation system is at bare minimum because the car companies want to ensure that Detroit residents have to purchase cars to get around to support that industry. The effect has been fewer opportunities for residents to walk to bus stops or train stations.
We tend to drive everywhere in this motor city, and if we are walking it is because we have no other choice or we are actively choosing to walk for exercise (I could do better with this). However, I am challenged by the extent to which residents are provided with police protection and safety. If I want to walk, I have to make sure that I do so in a group and that we pick a populated area, as well as carry a big stick for the stray dogs and other unmentionables.
There are no major chain grocery stores in the city of Detroit. We have privately owned grocery stores and specialty markets in certain pockets of the city, but the issue is that they are either too expensive or have substandard fresh foods. I have to go into a nearby suburban city just to grocery shop for fresh produce.
Soy-Glazed Squash Grilled Herb Mustard Steaks Apple-Nut Salad Sugar Snap Peas in a Snap Sweetened Green Beans and Red Onions Speedy Chicken and Ravioli Tomato Strata Slow-Cooked Spicy Lamb Shanks Gingered Almonds Molho Cru (Portuguese Pickle)
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...