For many populations in the United States, limited resources create the divide between a person’s desire to fight diabetes and access to the treatment that will limit the impact of the disease. Millions of Americans lack health insurance while suffering from the complications of diabetes. Without the ability to pay for treatment and services, comorbid conditions like heart disease, kidney disease, blindness, and lower limb amputations may arise. As a result, uncontrolled diabetes can place a larger burden on overall health care costs.
Critics of people with chronic diseases, such as diabetes, contend that continued poor health habits contribute to the diabetes disease burden. However, often times, a person’s inability to control their diabetes is not from lack of motivation. It stems from a variety of social, economic, and cultural factors that hinder a person’s ability to manage diabetes and influence their own healthy choices.
What can state legislators do to address diabetes and disparities?
Local, state, and national laws that do not consider socio-economic and cultural factors are at a disadvantage in effecting sound policies. According to Dr. Enrique Caballero, Director of the Latino Diabetes Initiative at the Joslin Diabetes Center, disparities easily emerge from a disconnect between patients, providers, and overarching health systems and policies.
Health care providers may lack cultural awareness and face language barriers that limit the quality of information conveyed about diabetes care to an ethnically diverse population. As a result, stereotypes and biases emerge from miscommunication between providers and patients that impede trust and inhibit clinical goals for the patient.
Ultimately, people with diabetes need support that encourages health literacy, sustains active patient self-management, while considering values and ethnic traditions that are important to them. It is not difficult to see how health and policy systems without culturally insightful programs, inadequate interpreter services, lack of adequate training, time pressures, and resource constraints contribute to gaps in diabetes health equity.
Consider the factors that challenge diabetes health equity:
Dr. Gary Puckering, CEO of the National Minority Quality Forum, notes that diabetes prevalence and rates of hospitalization differ depending on geography. Many sub-groups are disproportionately affected by diabetes. By locating the areas where health equity is challenged, state legislators can provide support directly to high risk communities who are in greatest need.
The following resources can help state legislators pinpoint high-risk areas in diabetes:
Gary Puckering, CEO of the National Minority Quality Forum
National Minority Quality Forum
Enrique Caballero MD, Director of Latino Diabetes Initiative at the Joslin Diabetes Center
Addressing Diabetes Disparities Presentation