The Disparate Impact of Diabetes on Racial/Ethnic Minority Populations

Abstract

D iabetes is a devastating disease that is affected by interdependent genetic, social, economic, cultural, and historic factors. In the United States, nearly 26 million Americans are living with diabetes, and another 79 million Americans have prediabetes.1 This means almost one-third of the total U.S. population is affected by diabetes.2 Diabetes not only affects the quality of life of people with the disease, but also presents a tremendous economic burden on our health care system. Diabetes, including diagnosed and undiagnosed diabetes, prediabetes, and gestational diabetes mellitus (GDM) and their complications, accounted for $218 billion in direct and indirect costs in 2007 alone.3 Much of the economic burden of diabetes is related to its complications, including blindness, amputation, kidney failure, heart attack, and stroke. Racial and ethnic minorities, defined as American Indians and Alaska Natives, black or African Americans, Hispanics or Latinos, and Asian Americans, Native Hawaiians, and other Pacific Islanders, have a higher prevalence and greater burden of diabetes compared to whites, and some minority groups also have higher rates of complications.4,5Despite medical advances and increasing access to medical care, disparities in health and health care still persist. In 2003, the Institute of Medicine released a landmark report titled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” providing evidence that racial and ethnic minorities are treated differently from whites in the U.S. health care system, resulting in poorer health for millions of Americans.6 Specifically, the report noted that African Americans, Hispanics, and Native Americans experience a 50–100% higher burden of illness and mortality from diabetes than white Americans. The diabetes epidemic continues to grow at an alarming rate. Every 17 seconds, someone in the United States is diagnosed with diabetes. Every day, 230 Americans with diabetes will undergo an amputation, …