How Does Diabetes Affect Special Populations?

Diabetes is now the sixth leading cause of death in the United States -- and for American Indians, African Americans, Asian/Pacific Islander Americans, and Hispanics/Latinos, diabetes is in the top five.⁸⁷ Many elders in the United States are more at risk for diabetes due to their race or ethnicity. Women, people with lower incomes or assets, people who did not complete high school, and people living in rural or central urban areas are also more likely to have diabetes. Genetics and health status are not the only reasons for this. These issues are also discussed in chapter 3, with examples of programs that have been successful in addressing some aspect of these barriers.

Some studies have shown a difference in the health status of people of color and other groups (compared to white men with higher income and education who live in the suburbs) that could not be explained by income or education. For example, black men with the same income and education as white men, living in the same area, experience higher rates of disease.⁸⁸ Further research has shown that people of color and women of color in particular do not receive equal treatment for health conditions.⁸⁹

In the United States, all people of color have a higher chance of developing diabetes than white people. Recent research suggests that people with diabetes are less likely to exercise and more likely to be overweight, or at least have an increased percentage of abdominal fat.⁹⁰ Older adults in general are more likely to develop diabetes than younger adults, and elders of color are among the most likely of the U.S. population to develop diabetes. Note also that many people of color, especially women, develop diabetes in their 30s and 40s and sometimes their 20s, long before they are considered "elders."

⁸⁷ Table E in Anderson, R.N., and Smith, B.L. (2003) "Deaths: Leading Causes for 2001." National Vital Statistics Reports 52(9), p. 9. Hyattsville, MD: National Center for Health Statistics.

⁸⁸ Louisiana Health Department. Black, S.A. (2002) "Diabetes, diversity, and disparity: What do we do with the evidence?" American Journal of Public Health 92(4):543-548.

⁸⁹ Institute of Medicine. (2002) Unequal Treatment: What Healthcare Providers Need to Know about Racial and Ethnic Disparities in Healthcare. Washington, DC: National Academy Press.

⁹⁰ Kissebah, A.H., et al. (1982) "Relationship of Body Fat Distribution to Metabolic Complications of Obesity." Journal of Clinical Endocrinology and Metabolism 54:254-260.