Healthcare Disparities and Diabetes Prevalence

Feb 4, 2019 by

More people than ever before depend on the federal government for health insurance in the form of Medicare, Medicaid, or the Children’s Health Insurance Program.  Despite this, political debate constantly rages around whether or not to expand or reduce the government’s role in healthcare, but without their help, the gap between those with coverage and those without would expand at an alarming rate. People across all demographics suffer from disparities in healthcare based on income and one of the most common diseases people face when you begin to factor in race, ethnicity, and gender is type 2 diabetes.

The Centers for Disease Control and Prevention (CDC) estimates that nearly 10% of the U.S. population suffers from diabetes, both diagnosed and undiagnosed. Furthermore, they estimate that nearly 34% of the adult U.S. population has signs of what is called pre-diabetes. To decrease the rate of type 2 diabetes, we need to confront environmental factors, test early, and teach people how to recognize signs of pre-diabetes and diabetes so they can seek proper medical guidance.

Of course, there have been great strides made in treatment and overall understanding of diabetes, but even with all of the advancements, there are still large gaps in diabetes prevalence between different ethnic and racial populations. Although the NIH has identified more than fifty genetic markers that influence diabetes, none of the markers completely explain the different rates of diagnoses between races. As mentioned, some of the risk factors are based on a person’s surroundings while others are based on genetics.

Instead of focusing on genetic factors, which we can’t control, the CDC focuses on preventative measures. Both the CDC and NIH have found that prevention and intervention are effective across all ethnicities and races. Recognizing environmental factors along with personal lifestyle choices may be the first step in decreasing overall risk.

One major environmental factor that received widespread attention during the Obama years is poor access to healthy food. Certain neighborhoods do not have a grocery store for miles, in what Michelle Obama famously referred to as “food deserts.” Access to a grocery store with fresh and healthy food is important, but the problem goes deeper than a simple matter of accessibility. It can partly be blamed on eating and shopping habits as well.

When people have been used to eating what is close at hand for most of their lives (fast food, food from convenience stores, and processed food), those habits are hard to break. We need to see more education about how detrimental an unhealthy diet can be along with increased access to fresh food. Only then will we begin to see positive change.

Beyond simply food, environmental factors also include insufficient exercise, high stress, and exposure to chemical pollution. For many Americans, lack of energy and time are the two main reasons they do not exercise. For a person working overtime just to pay the bills, it makes sense that exercise is not at the top of his or her to do list. For those who are overworked, working in a high-risk job, or have a lack of job stability, not only are they foregoing exercise, but it’s a good bet their stress level is at an extremely high level.

Stress has been found to be a major risk factor in type 2 diabetes. It produces the hormone cortisol, which raises blood glucose levels and blood pressure. Also, certain chemical pollutants found in water, the air, and the ground have been linked to type 2 diabetes and obesity. Although it seems like some of these risk factors can be taken care of on a personal level, they must be regulated from the top-down first.

Even with the alarming prevalence of type 2 diabetes, many do not know they have it until their symptoms take a turn for the worse. There are recommended tests based on predisposed risk factors, even for people who are asymptomatic, which include: being overweight, being 45 years or older, having a immediate family member with type 2 diabetes, exercising less than three days per week, having diabetes during pregnancy, or being part of an ethnic group which has a higher rate of diabetes. Ethnic groups at a higher risk include African Americans, Hispanic Americans, Native Americans, Pacific Islanders, and Asian Americans.

Early diagnosis and treatment can save years of life and billions of dollars. For poor communities and those without access to healthcare, minimizing environmental factors and increasing physical activity is especially important. For more information about prevention, please visit the CDC’s page for their national diabetes prevention program.


Senior Living Writer, Reader, Elder Care Policy Advocate

Max Gottlieb is the content manager of Prime Medical AlertALTCS, and Senior Planning in Phoenix, Arizona. Prime Medical Alert allows older adults to age in place while Senior Planning provides free services to seniors, the disabled, and veterans. Senior Planning specializes in long term care—mainly finding or arranging care and applying for state and federal benefits.

Max’s mission is to educate the general public about long term care, equipping them with the knowledge and tools they need to care for their elderly loved ones. He graduated with honors from CUNY-Hunter College with a degree in English Literature.

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