Addressing health disparities in diabetes requires a broader look at systemic racism

Poor social conditions caused by systemic racism contribute to health disparities in people with diabetes, according to a paper published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Minorities are disproportionately affected by diabetes because of poor social conditions that contribute to negative health outcomes such as poverty, unsafe housing, lack of access to healthy food and safe physical activity, and inadequate employment and educational opportunities. These are known as the social determinants of health and are the result of residential racial segregation and a lack of economic investment in Black communities. Unethical practices and experimentation in minority communities have also caused racial bias in our medical systems and a lack of trust between minority patients and health care providers.

"Traditionally, physicians have focused on the biological contributors to disparities in diabetes, obesity and other chronic diseases; however, given the bright light shone on health disparities during the COVID-19 pandemic, we need to view the contributing factors and solutions more broadly," said study author Sherita Golden, M.D., M.H.S., of Johns Hopkins Medicine in Baltimore, Md. "This will give us agency in contributing to and advocating for health system, public health and policy-level interventions to address the structural and institutional racism embedded in our medical and social systems."

To address health disparities in diabetes, the authors recommend health systems implement the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care. These standards ensure interpretation services are available to all patients and that patient education materials are at a literacy level most people can understand. They also recommend more training among health care providers on unconscious bias, anti-racism, and the value of diversity in clinical care settings.