Health Disparities and Diabetes

Health Disparities and Diabetes

As we learned in lecture, a health disparity is an inequality that occurs in healthcare and access to healthcare across different racial, ethnic, and socioeconomic groups. A prime example of a health disparity is diabetes, which African Americans, Latinos, and lower income earners are twice as likely to develop than white people and higher income earners are. They are also much more likely to suffer from complications due to their diabetes, such as leg amputations.

How does the Social- Ecological Model (SEM) help to explain this health disparity? On the societal level, Hispanics and Blacks make only a percentage of what white men make, even if they are doing the same job. With less money, these populations are unable to pay for the best health care. Also, statistically, lower income patients were far less likely to receive the yearly tests recommended by the American Diabetes Association. Hispanics and African Americans also have a much smaller chance of meeting the A1C goal than whites. Also, even though most clinicians know that diet and physical activity play a huge role in maintaining diabetes, fewer Hispanics, African Americans, low income earners, and people with less than a high school education were never given instructions for a changed diet or increased physical activity by their physicians. On the community level of the SEM, diabetes in poor areas is more prevalent, and many patients have worse outcomes than those in upper class neighborhoods. Why is that? Is it because they can not afford the healthier diet, or their health care providers are not as good as those in rich areas? On the individual level, if I barely have enough money to buy cheap food, how am I supposed to change my diet completely to healthier options? If I have to work my minimum wage job sixty hours a week, how am I going to exercise more? The other factors in my life, due to my socio-economic position, make it much harder for me to improve my condition.

One initiative that has been implemented to help inform more patients about their condition and how to improve it, is for doctors to learn medical Spanish. This is allowing more doctors to communicate more clearly with their Hispanic patients. On an individual level, this initiative will increase Hispanic patients’ knowledge about what they need to do to maintain their diabetes and keeping it from getting worse.

9 thoughts on “Health Disparities and Diabetes

  1. Hi Andrew,

    You are absolutely correct in saying that lower-income people are at a significant disadvantage when it comes to health care. Unfortunately, these people cannot afford the diet and medicine that health issues like diabetes require to be taken care of. This is why it is our job and the government’s job to help raise them up to a status where they can afford health care and a good diet. Connecting back lecture two weeks ago, this is why the Affordable Care Act and Medicare is so important for the population with low incomes. These health care policies allow for a more equal world to occur, which is especially important in the world of health care where issues often become intense and fatal. Nobody should have to live in a world where they have to worry about not being able to treat their health issues and by eliminating health disparities as much as possible, we can keep that from happening.

    I think your idea of doctors being required to speak Spanish is an interesting proposal but may be difficult to implement. Perhaps, instead, there could just be a Spanish interpreter in every hospital? Overall, this was a very well-written and fascinating blog post.

  2. I agree with Andrew that they are many health disparities among many minority groups and women compared to caucasian and males. According to the socio-ecological model, where community and societal factors has an effect on healthcare and relationships, many minorities are not reaching the same care and equality as caucasian males do. A huge factor that plays a the role that has affected the socio-ecological model would be implicit bias. I think we have to be more careful when it comes to treating patients.
    Although some of the socioeconomic factors have a big effect on the quality of health care received, implicit bias has also played a role. Many doctors unconsciously have a slight stereotype of judgement against someone without knowing it. We have to figure out a way to improve these circumstances. Diversity is one way where different perspectives can give us an insight on other people’s cultures and difference. I like how Andrew suggested of implementing the idea of learning another language like Spanish in medical hospitals. I think having an interest and incorporating other cultural and worldly ideas into ourselves will definitely help improve some of the language barriers due to the socio-ecological model.
    My question would be in what ways can we reduce the factors of health disparity besides the monetary aspect. I know money is an important highlight of some of the problems but are there others?

  3. It’s evidently and unfortunately true that there are many health disparities between minorities and Caucasians, among them diabetes. Lower-income people have less of the resources that high-income people have which lessens their ability to combat their health care problems. This disparity is sustained through the multiple levels of the SEM you discussed as well as interpersonal and institutional levels. On all levels, it is evident that people in minorities do not receive the same care as others. This is where unconscious biases are found. People are not able to change their lifestyle due to being occupied by other major responsibilities. Also, health care professionals sometimes, as you said, cannot communicate effectively with patients who speak other languages and come from different ethnicities/backgrounds. One way to help repeal this barrier would be to have the training of health care professionals changing continuously and including diverse people on the medical staff in hospitals. This would allow for better communication and understanding between patients and their doctors which would in turn lead to better health across most minorities. Diversity can be such a powerful and useful asset to a group of health care professionals and really any group, which is why it is so important to be celebrated.

  4. Hi Andrew,

    I think your post definitely demonstrates how the SEM helps explain health disparities. It is true that many socio-economic factors – factors that are out of individuals’ control – can influence the health of individuals. Unfortunately, these factors often put minority groups at a disadvantage. For instance, you mention in your post that many minorities and low-income earners are more susceptible to diabetes. One of the reasons is that they don’t have the resources and access to preventive, quality health care. Other socio-economic status also prevents them from living healthily; fast food and other less healthy diet options are usually cheaper than the healthier ones, so they may be the only affordable options for many minority groups and low-income earners.
    Therefore, I think health care providers need to be able to see the “bigger picture”. Without understanding the role of socio-economic factors in influencing the health of patients, it is easy to judge and hold implicit bias against the patients. For example, a doctor may see a fat patient and immediately “think” that the patient must have chose an unhealthy lifestyle and bring the disease onto him or herself. Such implicit bias can result in unsuitable attitudes, unfair treatment, and damages to the patient-doctor relationship. Perhaps the patient has a family history of diabetes, perhaps the patient is not able to afford the “healthier” food, or perhaps the patient doesn’t have time to exercise due to work. So instead of just jumping to the conclusion, a healthcare provider must take the socio-economic factors into account and be aware of his/her own implicit bias. Only in such way could he or she give the most suitable treatment and the most quality care.

  5. I agree with your analysis that there is a correlation between a socioeconomic group and their access to healthcare. If we collectively try to find solutions to the underlying problem, then the result could be much more effective. The idea of finding better ways to educating those who are more prone to diabetes either currently or in the future might be more effective to educate them in mass format. In addition to having doctors learn a foreign language (Spanish) to be able to explain their health care needs, another idea could be to provide a mobile learning atmosphere for those in impoverished areas. This could be done by bringing a mobile screen/video that provides an educational lesson in their native language to locations where they might not have this information available (like a village that does not have readily available access to technology) on the causes of diabetes, how you can prevent diabetes and maybe even provide some simple healthier snacks alternatives to the individuals who watch the video. This would give those a chance to work on lifestyle changes from the beginning rather than just treating the problem at the end.

  6. I agree that there are health disparities that a group of people may have that another does not. This comes back down to the status of those people in the groups that are mainly affected. However, I do believe that we need to take into account when it comes around to talking about diabetes is that one form is in their genes, whereas the other is based due to their eating habits.
    If a certain group lets say African Americans are paid less than what their counterparts are paid. They might live in a food desert meaning that they do not have access to certain healthy or local food. Thus, some parents who might not have enough money might take their kids to a fast food place or allow said kids to eat junk food. A solution to some of these problems would be to offer local gardens, nationwide food program, and school meals that do not have that many chemicals.

  7. The association between poor health and low socioeconomic status that Andrew points out is a striking reality. In fact, in my Women’s Studies 220 class, I learned that in the United States, socioeconomic status is the number one determining factor in illness and early deaths. Because some of the other biggest contributing factors to health are the conditions in which we live, learn, work, and play, I believe the best way to remedy the diabetes epidemics present among minority groups is to spread preventative health information in these places and shape these places in a way that facilitates healthy living. For example, here on the Hill we have Palmer field right at our feet, and in our halls, there are flyers everywhere spreading information regarding wellness events, 5ks, and social clubs. In order to do the same for low-health areas, public health initiatives need to be created and funded.

  8. Hey Andrew,
    First and foremost this post about SEM does help explain the topic of health disparities. There is a direct relationship to socioeconomic groups and access to healthcare. The more money will lead to better healthcare and vice versa. I agree with what you said on a societal level how white men make more money than non-white men, even if they are doing the same job. It is important how stated facts, for example, how blacks and Hispanics cant receive the recommended treatment with less money. With not enough money, they can’t afford certain foods as you mentioned and putting in more hours reduces your chances of exercising. These are all excellent points that you made. I like the initiative for doctors to learn medical Spanish. This would help the Spanish-speaking community to do what is necessary to treat their diabetes. This was well written and I enjoyed reading it.

  9. I think that diabetes is a great example of health disparities. Blacks and Latinos often have this disease and others at higher rates than their counterparts. These groups are on the lower end of socioeconomic status and this correlates to their lower levels of health. Affording healthcare, and having pleasant experiences in health facilities, can be very hard due to being apart of these racial groups. I think its great that doctors are learning Spanish. I do not necessarily want to be a doctor but I am learning Spanish so that I will be able to connect to more people while working as a public health professional. I think that having a personal connection to a different culture helps with implicit bias and will help make healthcare better for everyone.

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