Socioeconomic Disparities In Diabetes

Diabetes has recently become a focal point of health care systems around the world due to its high prevalence and the severity of secondary complications caused by the disease. Over the course of my project on diabetes, I have had the opportunity to speak with a group of diabetics to understand from a patient’s perspective how diabetes is managed in a rural community. While I found that while some patients ignored treatment and refused to make any dietary changes, the majority of the patients I interviewed were well-informed and actively managing diabetes in their everyday life.

The Hispanic ethnic group comprises more than 50 million of the American population; this about 16 percent of the population 1. The USA Census Bureau forecasts that in 2050, one out of three people living in America will be of Hispanic origin 2. Hispanics refer to people of Puerto Rican, Cuban, Mexican, Central or South American background 3. They also include people of other Spanish culture despite their race. This paper focuses on the impact of socioeconomic status of Hispanics on the incidence of Type II diabetes in East Harlem. East Harlem is located on the northeast corner of Manhattan, New York. East Harlem, also known as Spanish Harlem or El Barrio. In addition, about one-third of the East Harlem residents live below the poverty line, compared to the NYC in general East Harlem has one of the highest proportions of households in poverty 4 . Relationships between socioeconomic status, ethnicity, and chronic disease undoubtedly have complex explanations. The socioeconomic status has been used to explain the higher prevalence and higher

The first issue that could be found in Matthew O’Brien is his statement that only poor people contract diseases. The main illness that the author associates with poverty is known as hypoglycemia or low blood sugar. The staff at Mayo Clinic, a group of medical professionals dedicated to studying diseases and teaching people about them defined hypoglycemia as “a condition characterized by an abnormally low level of blood sugar (glucose), your body’s main energy source.” They go on to state that “a variety of conditions, many of them rare, can cause low blood sugar in people without diabetes. Like fever, hypoglycemia isn’t a disease itself—it’s an indicator of a health problem.” It can be concluded that people cannot get

Although heredity plays an important role whether a person inherits diabetes and to what extent, it can be controlled through useful methods that are affordable. By changing environmental risk factors, people can reduce their risk of developing diabetes. Increasing awareness of diabetes which is a major setback for some socio-economical background and rural areas as not enough awareness is made to the general public. Identifying people at risk for the disease is also another

Many studies have examined the link between poverty and diabetes. The CDC (2015b) have identified the following as primary factors that lead an individual to have an increased risk of developing diabetes: being overweight or obese; having a parent or sibling with diabetes; having African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino heritage; having a history of gestational diabetes; having blood pressure measuring 140/90 or higher; abnormal cholesterol; and being physically inactive.

Many people are reluctant to seek medical attention due to fear of costs and causing more financial constraints. Most especially for individuals or families who have to choose between paying rent and securing their meals, in which case, diabetes (or other diseases for that matter) is not seen as an imminent threat, therefore it is not a priority. While some may have health coverage, they may not have the advantage to cover co-payments for the visit, medications, diagnostics, or other treatments.  Second, language barrier and other discriminations contribute to health disparity. Because they are unable to communicate their concerns and in fear of judgment, language/discrimination discourages people from seeking medical help— the assumption that they (minorities) will be treated unfairly or not given enough or of equal treatment. Undocumented individuals are also less likely to seek help in fear of being caught. Lastly, the issue of cultural disconnection— in this dimension,  participants admitted to the fear creating a stigma and receiving negative feedback from their providers (who only favor biomedical treatments).  There is fear of being an object of ridicule and rejection if they admit to the use of alternative medicines and remedies. Fear of reporting use of other remedies may adversely affect provider’s recommended regimen. In considering these social and economical factors, people become chronically ill and progressively worse until the situation becomes acute and no longer manageable. These dimensions, and other contributing factors, place limitations and restrictions in individual’s power to make health decisions, and inevitably create health disparities. Page-Reeves and others state, “ although disparity can take many forms, health disparities can be understood as one of the most concrete manifestations of inequity, often  determining who will live and who will die— with the poor and immigrants suffering

These include hospital stay and the high rate of readmission to hospital for screening and due to complications. Medications for the patients also contribute significantly to diabetes management since the drugs are prescribed for maintenance of the condition and thus need to be taken regularly. Inpatient visits to the hospital is the leading value of cost in the management of the disease (American Diabetes Association, 2013). The people who have diabetes are sicker and weaker when compared to the general population. The cost of their health care spending is also higher than the cost for healthy individuals. On the view of indirect costs due to diabetes, there are several conditions that lead to an increase in expenditure of the patients. For instance, the likelihood of developing disabilities due to complications as a result of diabetes is quite high. The workforce is therefore negatively affected and leads to a decline in the economy of the country. Out of all the deaths reported in the year 2012, the number in which diabetes was named as the primary cause amounted to 30% diabetes (American Diabetes Association, 2012; National Diabetes Statistics Report, 2014; American Diabetes Association, 2013). The premature deaths due to diabetes led to loss of income and loss of productivity in the country. The public therefore needs to be educated to reduce this cost as it is shown that the cost of managing diabetes is reduced when the patient has enough information about the condition. For instance, persons with better glycemic control have low levels of developing complications and report a decrease in visits to a doctor with those with uncontrolled diabetes having to visit the hospital three to eight times more (Handelsman et al.,

Diabetes is a metabolic disease and caused by high blood sugar level over a long period of time. It generally occurs when pancreas fail to produce enough insulin. Symptoms of diabetes include frequent urination, increased thirst and increased hunger. There are three forms of Diabetes. Type I Diabetes Mellitus, Type II Diabetes Mellitus and gestational diabetes. It is a growing epidemic and apart from the economic burden, diabetes inflicts severe societal costs in terms of decreased quality of life of people afflicted with diabetes. Social determinants of health are defined as surroundings in which people are born, live, spend their life and grow old (Healthy People 2020). The association of social determinants with disparities is important

Diabetes affects over 180 million people in the US and is projected that by 2025 this figure will increase to 300 million.

Improving the health of the socially and economically disadvantaged is a major task. Many Americans are living with poor health because of their socioeconomic statuses and it has many negative effects on their long term health. Improving access to health care is not enough to help fix the lower death rates among low income families. Our social status in our economy has large effect on our lives including how we are able to live our lives and in tern it has large measurable effects on our health. San Antonio is no exception, in low income areas the mortality rates by diabetes are stunning and need to be changed in order to help improve the lives of so many people. In my essay I will be proposing a plan to help lower

In the article “Health disparity and structural violence”, Researches suggest that minority population have high risk for diabetics than the social majority. Decreased level of education and increase level of poverty add the risk to develop diabetic in minority. “There are significant disparities associated with diabetes based on race and ethnicity”(Page-Reeves.etal,2013) Some types of common fears have been seen in this minority group which prevent them to approach health care.

A cross-sectional study of a quantative approach was done by enrolling 141 diabetic patients that met the criteria by being members of three municipalities of Rio Grande do Sul, Brazil, being eighteen years old and registered as having type two diabetes in their health unit (Girardi et al., 2015). The data that was collected was from August and September in 2012 (Girardi et al., 2015). Instruments that were used in collecting the data included sociodemographic data form and from Medical Outcomes Study Short Form-36 Healthy Survey (SF-36) designed to evaluate the quality of life (Girardi et al., 2015).

In this case, most individuals who are afflicted with this disease are between the ages of forty to sixty, which may be a result of certain social determinants. There are five main social determinants that influence the prevalence and incidence of type 2 diabetes mellitus. The first socio-ecological determinant is culture and community support, which pertains to the individual’s culture and how they view T2DM (Clark & Utz, 2014). Often, in this age group, if the community does not provide support and if there is a negative culture perception of the disease, there will not be a high number of individuals that partake in self-care for T2DM. Another factor is access to medical care, which implies that if people do not have access to care, he or she will not be able to screen for T2DM, or receive treatment to control the disease (Clark & Utz, 2014). Education is a crucial factor, since there is a direct link between educational attainment and improved health outcomes (Clark & Utz, 2014). In this age group, if individuals are uneducated about the disease, they are most likely unaware of the risk factors and treatment options for T2DM. Another factor is economic stability, which has a direct correlation with health outcomes (Clark & Utz, 2014). Thus, if a person is of higher socio-economic status, he, or she in this age group, is more likely to obtain medical

There are many contributing factors for the increasing prevalence of Diabetes among the natives of Kuwait like drastic epidemiological and cultural changes, sedentary life-style, unhealthy eating habits, ageing, over-weight and urbanization.2, 3 Studies reveal that the occurrence of Type-II Diabetes mellitus is also increasing among the younger individuals, mostly covering the ones below 30 years of age.4 It was also found that 73.4% of the people with Diabetes are below 60 years of age , i.e. in their productive years, especially in Arab regions including Kuwait, which may adversely affect the capabilities of individuals and the quality of life in the long-run.36 Also, the onset of Diabetes is characterized to be gradual, with around 30% of the patients presenting with complications at the time of diagnosis5 and an asymptomatic time period of 10 years in which the disease remains undetected.6, 7 Hence, Diabetes poses a huge burden over the economy as a consequence of loss of productivity and cost of health treatments.36

The main social problem is the higher prevalence of heart disease among the poor than the non-poor. This social problem has lead me to the following research question: in the United States, how is poverty associated with the prevalence of heart disease? To answer this question I will define heart disease, why it is an issue needing our attention, and whom it specifically affects. I will then delve into the many social mechanisms that facilitate this trend and show how they all work together to create an environment in which the poor are more likely to deal with heart disease than the non-poor. The mechanisms involved are individual and institutional, meaning that they operate and would have to be addressed at either the individual or institutional level. The individual focused mechanisms include smoking, physical inactivity, obesity, factors from early in life, and mental factors. The institution focused ones include quality of healthcare and lack of access to