By Veronica Rivera / For The Herald
The U.S. diabetes epidemic has now persisted for more than 30 years, but it is not merely a medical problem.
Although diabetes is a very real disease that affects people everywhere, the epidemic we are experiencing in the United States does not follow the natural course of an infectious disease destined to plague our country. It isn’t a coincidence that a specific, concentrated area of the U.S. — which also happened to be red-lined — has a prevalence of diabetes over 3 percent higher than the rest of the country.
Red-lining was a practice in which the Homeowners’ Loan Corporation categorized the risk of mortgage lending in certain areas based on the characteristics of the people living there.
These characteristics often included race, ethnicity and immigrant status. The remaining maps of this practice, along with the identities of the populations living in “hazardous” or “red-lined” areas, closely correspond with those now residing in regions with greater odds of being diagnosed with diabetes, according to the National Instututes of Health.
Along with diabetes and other chronic diseases, these same neighborhoods “suffer not only from reduced wealth and greater poverty but from lower life expectancies,” reports the National Community Reinvestment Coalition.
There is well-researched consensus linking low socioeconomic status with a higher prevalence of diabetes, yet somehow, legislators often refer to this epidemic as one of those unfortunate, yet expected, medical problems in this country.
As of 2021, this epidemic has affected 38.4 million people; millions of whom now have an increased risk of kidney damage, eye damage and cardiovascular disease. On top of these serious health concerns, the average diabetes patient is expected to spend approximately 2.3 times more on medical expenses than those without diabetes, a number projected to increase by the NIH by 28 percent from 2017 to 2030. This same population is a staggering 20 percent more likely to report household food insecurity than their non-diabetic counterparts, who are more likely to have a higher socioeconomic status.
These same populations also happen to be historically marginalized in our country. If the previous information wasn’t enough to suggest that non-medical factors are driving our diabetes epidemic, consider this: people with low socioeconomic status, who are more likely to experience food insecurity and live in historically red-lined areas, are also more likely to belong to minority groups. The U.S. region with a 3 percent higher prevalence of diabetes is known as the “diabetes belt” or “stroke belt,” which also has a high incidence of cardiovascular disease.
According to the Centers for Disease Control and Prevention, this “belt,” which consists of 644 counties in several southeastern states, has a majority population of non-Hispanic African Americans, a population already reported to be at higher risk for diabetes. Another affected community is the Hispanic/Latino population. As of 2022, Hispanic adults were reported to be 60 percent more likely to be diagnosed with diabetes than their non-Hispanic counterparts, according to the federal Office of Minority Health.
The list of so-called “coincidences” goes on. While diabetes is undeniably a real health issue, the U.S. diabetes epidemic is a societal problem begging to be addressed.
Although diabetes education, healthy eating infographics and increased screening are important, it is imperative that we also tackle the root causes. The overwhelming number of correlations all point to a historical pattern of prioritizing some communities’ needs over others.
This harmful pattern has led to significant disparities faced by marginalized communities and those with low socioeconomic status.
It is crucial for citizens to call-out local legislation that perpetuates this injustice and for those in positions of power to recognize what actions they can take to address the issue. This may include improving neighborhood infrastructure to be more walkable or increasing access to fresh produce and lower-calorie food options.
On a personal level, we can all contribute to improving our communities through small but meaningful actions: supporting local food banks, volunteering to prepare nutritious meals, or spearheading efforts to encourage outdoor activities for all ages.
Only when we acknowledge the non-medical history of this epidemic and how it harms our most vulnerable minority communities will we be able to begin moving toward a real solution to the diabetes epidemic.
Veronica Rivera is a second-year public health and global health student at the University of Washington where she’s spent recent months learning about and researching diabetes, its prevalence, disparities, and its social determinants. She was born and raised in Snohomish County, currently residing in north Bothell.
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