In honor of Black History Month, CWD wants to recognize some of the organizations that are working diligently towards reducing racial health disparities in the U.S. Before we can do that, we will provide some important context so that the challenges and the work are better understood.
What are health disparities or inequities?
Health disparities are defined by the U.S. Centers for Disease Control and Prevention (CDC) as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” (CDC: Health Disparities, 2020) There are many different types of disparities among a variety of different , such as disparities in income, insurance, access to healthcare, life expectancy, etc. Other examples of socially disadvantaged populations include those living in poverty, those in very rural living areas, people with different sexual orientations, and minority populations. For this article, we are going to focus on the Non-Hispanic Black population of the United States.
It should be noted that health disparities are caused due to the inequities in economic, social, political and environmental resources to populations, including minorities in the U.S. As a result of the inequities seen throughout the COVID-19 pandemic, the CDC has recognized racism as a Serious Threat to the Public’s Health and a major contributing factor to these health disparities.
What are the disparities for type 1 diabetes for Non-Hispanic Black Americans?
Considerable research in the past several years demonstrates the many disparities in Non-Hispanic Black children and adults with type 1 diabetes experience in the U.S. This data is unfortunately a continuation of a historic pattern in inequitable health outcomes for minority groups, and the most affected continue to be Non-Hispanic Black people.1-3 One of the biggest disparities found is the reduced use of diabetes technologies such as insulin pumps and continuous glucose monitors (CGMs), both of which have been proven to help improve diabetes health outcomes.
In one study, 11,469 records for patients with type 1 diabetes were reviewed, and the following was shown:2
- 50% of Non-Hispanic White participants used CGM
- 38% of Hispanic participants used CGM
- 18% of Non-Hispanic Black participants used CGM
- Participants were more likely to be prescribed CGM if they had private insurance
- Non-CGM users were significantly more likely to have diabetic ketoacidosis (DKA) or severe hypoglycemia
- Average HbA1c was 7.7% in CGM users, and 8.4% in non-CGM users
In the discussion of this study, the authors mentioned that there are many challenges within the US Medicaid system, including differing coverage based on states’ decisions and lack of coverage for diabetes technologies. However, in the T1D Exchange State of Diabetes Management from 2016-2018, the higher levels of HbA1c were still present in Non-Hispanic Black participants with type 1 diabetes regardless of socioeconomic status.4
What can we do about this?
There are many organizations, scientists, researchers, healthcare workers, community members, and people with diabetes who are working hard to reduce these barriers. Recognizing them and their work can help educate others about the challenges of racial disparities in diabetes and help hold people accountable for their role in health inequities. Here is our list of groups to know about in the fight for racial equity:
- The T1D Exchange started a Health Equity Advancement Lab to pilot new health equity initiatives and revising or developing new measures for health equity.
- Diversity in Diabetes is a non-profit focused on awareness of disparities, providing solutions as well as increasing representation in the diabetes space. They have hosted two summits titled People of Color Living with Diabetes that are recorded and online free of charge. CWD hosted Quisha Umemba in a recorded Screenside Chat in 2020, as well.
- The University of Florida Diabetes Institute has an upcoming webinar with Ashley Butler from Baylor College of Medicine on February 28, 2022, titled, “Equitable Approaches to Family-Based Psychosocial Care for African American and Latinx Families of Children with T1D.” The seminar is free and on Zoom, and you can register here.
- Also, at the UF Diabetes Institute, Ashby Walker, Director for Health Equity Initiatives, is conducting a study to provide UF college student mentors with at risk young adults and adolescents with T1D, and you can contact Dr. Walker at [email protected]. Dr. Walker also helps lead University of Florida’s Diabetes ECHO program, focusing on improving outcomes for people who get their diabetes care at primary care clinics throughout the state of Florida.
- The American Diabetes Association has a program titled #HealthEquityNow which has a Health Equity Bill of Rights for people with diabetes and can connect people to diabetes resources in their community.
- Ananta Addala, pediatric endocrinologist at Stanford University, conducts research on racial disparities and has a recorded presentation from Fall 2021 that you can watch titled, “Quantifying Inequities in Type 1 Diabetes Care.”
- Dope Diabetic Girls is a group on social media promoting a safe diverse space for women with diabetes. Co-Founder Kylene Redmond shares her story and has some incredible merch on her website, Black Diabetic Girl.
- Cherise Shockley, CWD Board member, founded @WOCdiabetes on social media and discussed how to get more diversity and inclusion in the diabetes online community in CWD’s Screenside chat in 2020.
- Just A Little Suga is a blog and online community created by Ariel Lawrence with the goal of connecting marginalized members of the diabetes community and creating a safe space for all.
In addition to supporting these groups and members of the diabetes community, educating yourself about the effects of racism in the United States is equally important. The challenges that we are facing will not go away overnight, and change happens when enough of us commit to making it happen.
CWD continues to evaluate the ways in which our organization can improve with regards to promoting health equity, inclusion, and diversity. During the pandemic, CWD created a Diversity, Equity & Inclusion (D, E & I) committee and continues to work towards improving outcomes for all people with diabetes. We hosted virtual sessions that highlight health disparities and discussing issues that minorities with diabetes have experienced. We’ve also held in-person sessions at Friends for Life conferences that highlight challenges of being mis-diagnosed and allow people to come together and find their support network in a safe, inclusive space.
We have a lot of work to do to as a society, as members of the diabetes community, and simply as human beings to help reduce the disparities for Non-Hispanic Black Americans. CWD is committed to making a difference in the lives of all people affected by type 1 diabetes, and to helping reduce healthcare disparities in any way we can. We hope that you’ll join us in attempting to write a new history where we are all truly treated equally.
- Inequities in Health Outcomes in Children and Adults With Type 1 Diabetes: Data From the T1D Exchange Quality Improvement Collaborative
- Patient Demographics and Clinical Outcomes Among Type 1 Diabetes Patients Using Continuous Glucose Monitors: Data From T1D Exchange Real-World Observational Study
- Racial disparities in treatment and outcomes of children with type 1 diabetes
- State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016–2018
Written and clinically reviewed by Marissa Town, RN, BSN, CDCES