Let’s look at the current diabetes numbers in the US.
The CDC reports that more than 37 million people in the US (one in ten) are living with diabetes, and more than 8 million are unaware of their condition.
Another 96 million people in the US are living with prediabetes. When you have prediabetes, your A1c level is higher than normal but not at the diabetes level yet. Prediabetes puts people at risk of developing type 2 diabetes and related complications. Among this group, 90% aren’t aware that they face these risks.
BIPOC communities are even more affected
What’s even more shocking is that these numbers are not consistent across all communities in the US. Black, Indigenous, and People of Color (short: BIPOC) communities are even more affected by diabetes. Across the board, in every minority community, we see more people with diabetes than in white non-Hispanic communities.
According to the latest numbers, diabetes is undermining minorities’ health – ultimately cutting lives short and affecting quality of life.
Compared to non-Hispanic white adults:
- Hispanic/Latino Americans are 70% more likely to be diagnosed with diabetes and 1.3 times more likely to die from diabetes.
- Black/African Americans are 60% more likely to be diagnosed with diabetes and are twice as likely to die from diabetes.
- Asian Americans are 40% more likely to be diagnosed with diabetes. Indian Americans are at an even higher risk at 70%.
- Indigenous/Native Americans are nearly three times more likely to be diagnosed with diabetes and 2.3 times more likely to die from diabetes.
Why are so many BIPOC people affected by diabetes?
Does the racism, discrimination, and inequity BIPOC people experience affect their health and healthcare?
Is it a matter of genetics or environment? Current thinking says it’s both.
Let’s take a look.
Could diabetes be predetermined?
In some ways, yes, because genetics plays a role in developing diabetes.
If your parents or siblings have diabetes, it also increases the likelihood of diabetes for yourself.
For BIPOC communities, these genetic tendencies reinforce the likelihood of developing diabetes.
Environmental and behavioral factors
Traditionally these effects have been discussed in the context of exposure to environmental toxins or maternal stress while still in the womb. But the discussion has expanded to look at how the effects of trauma are passed from one generation to the next — not just socially or behaviorally, but biologically.
Trauma from several generations
Trauma from several generations, caused by racism, discrimination, and inequity throughout their histories, puts BIPOC communities at higher risk of diabetes and other chronic health conditions. Your grandparents’ experiences may affect your health in very tangible ways today. Their ongoing experiences, particularly when it comes to social brutality and poverty, changed their biology. And those tendencies can be passed down to generations after them.
What role does stress play in developing diabetes?
Stress, anxiety, anger, and hostility are all linked to an increased risk of developing diabetes. In the past, the medical community looked at the effects of stress in terms of how it raises a stress hormone called cortisol, leading to higher blood glucose levels and, ultimately, diabetes. Stress can also be the source of unhealthy behaviors, like overeating.
Recently the discussion expanded on the effects of epigenetics. One researcher even called diabetes a post-traumatic stress disorder passed on through epigenetics.
For BIPOC communities, stress may be a consistent experience, increasing vulnerability to diabetes, high blood pressure (hypertension), and obesity.
Are stressors more widespread in BIPOC communities?
While everyone experiences some level of stress, stressors are ever-present in BIPOC communities. How they experience their environment, economy, and institutions can generate stress continually. This becomes more apparent when we look at BIPOC communities through the lens of the social determinants of health (SDOH).
- Education, income, and type of job
- Where you live, learn, and work
- Access to and distribution of food
- Availability and access to healthcare
- Social support
Lack of stability and predictability
When you experience stability and predictability, you can thrive. Knowing you have access to food, shelter, and safety, allows you to live healthfully. Access to education, government institutions, and social support can enable you to flourish. You can be confident that your world will not drastically change.
But for BIPOC communities, this kind of stability and predictability are often limited or absent.
Their vulnerability is apparent when looking at things like levels of environmental toxins present, gun violence, food deserts, and the lack of easy access to healthcare. They also play out in many more, often subtle, behaviors and habits. Driving the feeling that you must always be on alert or leave yourself vulnerable to attack. Nowhere feels safe: not school, not walking in the street, not where you stay. No one has your back: not the people you know, not the church, not the police. You can’t count on social support; therefore, your sense of belonging and identity is weakened.
Limited access to healthcare
There are many barriers to accessing healthcare services for BIPOC people affected by diabetes or any chronic condition. Often only limited healthcare services are available in their communities. Going to a doctor’s office or even picking up a prescription can mean traveling some distance. The out-of-pocket costs for healthcare can be unpredictable and difficult to afford. There is no guarantee of health insurance. All these factors undermine the person’s ability to manage their overall health and diabetes.
Can BIPOC communities break away from high rates of diabetes through virtual healthcare?
Virtual healthcare like 9am.health offers an alternative that can counter some of the barriers BIPOC people experience when trying to get the care they need when it comes to diabetes and other chronic illnesses.
Virtual healthcare can make accessing healthcare easier in many ways.
It makes healthcare available everywhere there is internet or reliable cell phone service.
Virtual healthcare does not necessarily require an office, so office hours are more flexible, making it easier to schedule services without disrupting the rest of your day.
Prescription medications are delivered directly to your door. If you can get the latest fashion or electronic gadget delivered directly to your door, there’s no reason Metformin or test strips can’t be shipped too.
You can schedule your lab tests from home, and the 9am Care Team will remind you when they are due.
Many digital health companies publish their prices or offer services at a fixed fee. Having a consultation with a doctor costs a set amount. The costs of prescriptions and labs are published. At 9am, you pay a monthly membership fee, with no surprise or hidden costs attached.
Knowing what things cost removes unpredictability. Even with health insurance, costs can vary, from annual deductibles to variable copays to whether the prescription is even covered.
Digital healthcare also delivers more personalized care. At 9am.health you have access to a team of diabetes specialists who get you the care you need. They look at your diabetes history and recommend a tailored treatment plan that fits your life. If you have questions, the answer is only a chat message away.
Since location doesn’t limit access, specialists are more readily available. A person can seek a medical professional with a specific clinical or cultural background.
All-in-one diabetes care
With 9am.health, you'll get everything you need to manage your diabetes in one place. Learn more about our affordable membership options, including free prescription delivery, at-home testing options, and access to an entire team of diabetes specialists.