Diabetes podcast

Diabetes, especially type 2, disproportionately affects African-American communities due to social determinants of health. Factors like residential segregation, limited access to healthcare and fresh food, and socioeconomic challenges contribute to higher rates of diabetes and obesity. The price of insulin has also skyrocketed, impacting uninsured and low-income populations. The Southeast and Appalachian regions of the US, where many Black Americans reside, have higher diabetes rates due to limited healthcare access in rural areas. Diabetes is not just a medical issue, but a social problem linked to race, class, and resource availability. Addressing these factors is crucial for better health outcomes and a more equitable society. Welcome to Apoc.us episode where we delve into the complex web of how diseases intertwine with social identity. Today, we focus on diabetes, a condition not only affecting the body, but one that also becomes entangled with broader societal constructs. Diabetes, a chronic, long-lasting health condition that affects how your body turns food into energy. Characterized by high blood sugar levels, it affects millions worldwide. There are two main types, type 1, which is typically diagnosed in childhood and is caused by the body's inability to produce insulin, and type 2, which is more common and often develops in adulthood. Diabetes, particularly type 2, disproportionately affects African-American communities. But why? It's not simply a matter of biology. It's deeply entrenched into social determinants of health. Let's explore how. Imagine a neighborhood where fast food joints outnumber fresh produce markets, where stress is a constant companion due to economic hardships, and where access to quality health care is limited. This is a reality for many African-American neighborhoods, contributing to the diabetes epidemic. Residential segregation, inadequate access to affordable housing, and disparities in health insurance coverage combine to form a significant challenge. The uneven impact of diabetes on Black communities didn't emerge by chance. Residential segregation, with examples including redlining and blockbusting, have a historical legacy in many cities, which has resulted in Black communities being disproportionately located in areas with limited access to health care, healthy foods, and fresh foods. According to the Wall Street Journal, in Tulsa, Oklahoma, after a line of Black doctor offices in the Greenwood neighborhood were burned down during the Tulsa Race Massacre, the Black community's medical infrastructure entered a long decline that has not recovered since. There is currently a huge divide between North Tulsa, the area in which Black residents make up a third of, and anywhere else in Tulsa. North Tulsans die up to 13 years earlier than the neighbors to the south, and face the scarcity of primary care doctors, shown by federal data. Nearly three-fourths of them live in what is called a food desert, with limited access to a grocery store, fresh produce, and nutritious food options, resulting in the district having the highest city death rates in diabetes, according to the Tulsa County Health Status Report. This lack of environmental support for healthy lifestyles and access to health care and hospitals contribute to higher rates of obesity and diabetes in the Black community. Socioeconomic factors also play a significant role. Black individuals are more likely to face economic hardships, including unemployment and lower wages, which can then limit their ability to afford nutritious food or access health care services. The disparities in health insurance coverage mean that many Black individuals are uninsured or underinsured, making it very difficult for them to be able to afford regular checkups or manage chronic conditions like diabetes. Without adequate access to preventative care and treatment, diabetes can go undiagnosed or poorly managed, which can then lead to worse health outcomes. In Eliza Segal's paper looking at the racial disparities in the prevalence of and morbidity from diabetes in the United States, she looks at how the price of insulin has exploded by over 600% in the past two decades, which many have accused the pharmaceutical companies of taking advantage of insulin as a drug, knowing that it would still be purchased regardless of the price. These insulin costs disproportionately impact the uninsured and low-income populations, which are majority Black, putting them at higher risk for complications. The rates of diabetes are particularly high in the Southeast and Appalachian regions of the United States, forming a cluster that the CDC called the Diabetes Belt. The disparity in diabetes rates in this region mirrors specific population concentrations, with the majority of Black Americans living in the Carolinas, Georgia, Alabama, Mississippi, and Louisiana. Many of the counties included are rural, where accessing healthcare is more difficult due to great distances between providers and residents, lack of affordability, and limited public transport. Diabetes isn't just a medical condition, it's a social issue intertwined with race, class, and access to resources. By understanding the societal factors at play, we can then work towards creating equitable solutions and better health outcomes for all. Thank you for joining us on this journey to unpack the complexities of diabetes. Hopefully, together, we can strive for a healthier, more just society.