By Quisha Umemba, MPH, BSN, RN, CDCES, CHWI
At Diversity in Diabetes (DiD), we are dedicated to creating awareness, providing education and developing solutions that address the lack of diversity in diabetes care and management and that lead to inequities and poor health outcomes in individuals and communities of color.
Our work includes:
- Advocating to increase the representation of healthcare professionals in diabetes care and management.
- Advocating to increase knowledge of diabetes treatment options.
- Advocating to increase the utilization of technology.
- Improving access to Diabetes Care Self-Management Education and Support (DSMES).
With April being National Minority Health Month, it’s the perfect time to highlight the importance of reducing health disparities for persons with diabetes. The theme for National Minority Health Month this year is Give Your Community a Boost! This theme focuses on the continued importance of COVID-19 vaccination, including boosters, as one of the strongest tools we have to end the COVID-19 pandemic which has disproportionately affected communities of color. The same racial/ethnic minority groups that fall ill from COVID-19 at disproportionate rates are also those most affected by diabetes. Similar to COVID-19, certain communities and racial groups are uniquely at risk for health issues, such as prediabetes. Prediabetes is a condition that comes before type 2 diabetes and means a person’s blood sugar levels are higher than normal but not high enough yet to be diagnosed as diabetes. In fact, 39% of African Americans have prediabetes, and only 1 in 10 are aware that they do.1 Also, currently the death rate from COVID-19 has been reported to be 2–3 times higher among Black versus White individuals.2
There are various ways that diabetes-related health disparities can be reduced. We have included three different ways to help do this below.
1. Refer to DSMES
Refer all people with diabetes (PWD) to Diabetes Self-Management Education and Support (DSMES). But don’t just refer them, eliminate the barriers that would make participation difficult such as distance, costs, day and time, etc. One way that we do this at DiD is by addressing the issue of access by offering virtual programs. Yes, we understand that we won’t be able to reach everyone virtually. There will still be challenges for those with technology and connectivity issues, however, we have been able to reach participants both here in the US and overseas through our 12-week Virtual Diabetes Education Program (VDEP) which offers education, support, resource navigation and at-home A1c testing free of charge to our community courtesy of 9am Health.
We’ve also launched a virtual support group called “Insulin Inclusive' in partnership with Risely Health and Black Diabetic Girl. During a time when so many have been disconnected from others because of COVID-19, our virtual programs have helped bring education, support, and community to those that might not have otherwise had the opportunity to access these types of services. And speaking of community…
2. Combat Mistrust at the Community Level
As an advocacy organization, we encourage healthcare systems and clinicians to build trust within communities. Building community trust is crucial to improving people’s participation in testing and contact tracing efforts during COVID-19. To build a community of trust, public health officials and researchers must develop culturally competent mechanisms and transparent practices to encourage participation among communities made vulnerable by COVID-19. Get out into the community, ask for their input, identify trusted community leaders and invite them to the table for decisions that will affect them and their health. Train and mobilize a culturally competent workforce like Community Health Workers. Last, assemble a team of invested partners and stakeholders with resources to support initiatives around diabetes care that make a bigger impact on the diabetes community-at-large.
3. Provider Self-Reflection
We advocate that all clinicians and healthcare professionals that work in the diabetes space take a long, hard look in the mirror. Self-reflection is at times difficult, but also critical. We need providers that understand having bias doesn’t make them a bad person, it makes them human. It’s acting on that bias that leads to disparities in care and poor health outcomes in our most vulnerable patients. When talking to providers, we ask that they not focus so much on race that puts their patients at risk, but on racism, which is actually what puts their patients at greater risk. Yes, some risk factors are due to genetic disposition, however, most risk factors are due to the social environment in which one lives. Poor diet, lack of physical activity, lack of diabetes education, and lack of access. Racism plays a fundamental role in the social determinants of health and often these are the issues that are often overlooked in persons of color.
All of society is susceptible to cultural stereotypes that influence how we process information about others leading to unintended biases in decision-making; healthcare professionals included. National Minority Health Month is the perfect reminder we need to work together to highlight the importance of creating awareness and reducing health disparities in racial/ethnic minority groups especially as it relates to diabetes care. This is a time for you to share what you are doing to improve the health of racial and ethnic minorities and connect with your larger community to strive for better health!
- Centers for Disease Control and Prevention. National Diabetes Statistics Report. Prevalence of Prediabetes Among Adults. Available at: https://www.cdc.gov/diabetes/data/statistics-report/prevelance-of-diabetes.htm. Accessed March 30, 2022.
- Centers for Disease Control and Prevention. Weekly Updates by Select Demographic and Geographic Characteristics: Provisional Death Counts for Coronavirus Disease 2019 (COVID-19) 2020. Available at: https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm. Accessed March 30, 2022.
ADCES Perspectives on Diabetes Care
The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.
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HEALTHCARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your diabetes care and education specialist or healthcare provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. To find a diabetes care and education specialist near you, visit DiabetesEducator.org/Find.