African American people are more likely to develop diabetes than white American people. This may be because they are more likely to experience barriers to methods that could lower their likelihood of developing it.

According to the Centers for Disease Control and Prevention (CDC), around 10.5% of the population of the United States had diabetes in 2018.

In the report, diagnosed diabetes was at 11.7% among non-Hispanic Black people in the U.S. and 7.5% among non-Hispanic white people in the U.S.

In 2018, non-Hispanic Black people were twice as likely as non-Hispanic white people to die from diabetes, according to the U.S. Department of Health and Human Services.

These racial disparities concerning diabetes may be due to a combination of environmental, socioeconomic, physiological, and genetic factors.

This article will look at how a person can prevent or manage diabetes as well as outline the roadblocks that affect African American people regarding these same measures.

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If a person has type 1 diabetes, it means that their body cannot produce insulin. The bodies of people with type 2 diabetes can produce insulin, but they do not respond to it so well.

Both type 1 and type 2 diabetes can lead to dangerously high blood sugar levels, which can, in turn, lead to serious health complications.

Learn more about the differences between type 1 and type 2 diabetes here.

Type 1 diabetes is more prevalent in white people. This could be due to the genes a person inherits from each of their parents.

According to the American Association of Retired Persons, Black people are at significantly higher risk of developing type 2 diabetes than white people.

A range of factors can increase a person’s risk of developing diabetes. It would be incorrect to say that genetics alone increase a person’s risk of developing the condition.

A large number of factors contribute to these statistics. The sections below will look at some of these in more detail.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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According to the U.S. Department of Health and Human Services, in 2018, the age-adjusted percentage of non-Hispanic Black people over the age of 18 years with diabetes was 13.4% for males and 12.7% for females.

The age-adjusted death rate from diabetes among non-Hispanic Black people over the age of 18 years was 47.6% among males and 33.1% among females.

If a person has a family history of either type 1 or type 2 diabetes, they may be more likely to develop it themselves.

Perhaps due to the statistics showing the higher death rates from type 2 diabetes among Black populations, people have assumed that Black individuals have certain genes that make them more likely to develop the condition.

However, according to a 2013 review, studies are increasingly showing that there is no genetic difference between white and Black people in terms of their risk of type 2 diabetes.

For example, in a 2017 study, initial data showed that Black people had a significantly increased risk of developing type 2 diabetes. However, once researchers had taken into account biological, neighborhood-related, psychosocial, socioeconomic, and behavioral risk factors, the disparity was no longer there.

This suggests that these factors play more of a role than race in a person’s likelihood of developing the condition, despite what people have previously believed.

Learn more about genetics and diabetes here.

Around 1 in 3 U.S. adults have prediabetes. Undergoing regular health checkups can catch it before it progresses to diabetes.

This means that people with access to these checkups can make substantial changes to their lifestyle to try to prevent diabetes.

The following factors can mean that someone should discuss getting a blood sugar test with a doctor:

Inequity regarding checkups

It may be more difficult for African American people than it is for white American people to get regular health checkups. There are several reasons for this, which the sections below will look at in more detail.

Socioeconomic barriers

African American people face many forms of discrimination. One type of discrimination they face relates to their careers. This can lead to them earning less than other racial groups, specifically white American people.

Therefore, the cost of healthcare with or without insurance is likely to be a barrier to regular checkups.

Also, according to the Century Foundation, African American people are less likely to have health insurance than white American people.

Residential segregation

Residential segregation can also block a person’s access to regular health checkups.

Historically, legislation has forced African American people to live in less wealthy residential neighborhoods, and these neighborhoods may have fewer healthcare centers.

Moreover, according to the Century Foundation, healthcare professionals based in areas with a higher proportion of African American residents can be of lower quality than those in predominantly white areas.

White-centric healthcare culture

According to one 2015 study, clinical trials of diabetes treatments have often focused on white participants.

Doctors treating diabetes in African American people have to base their treatment recommendations on information that is relevant to mostly white populations.

Therefore, doctors may not always have appropriate treatment plans to recommend for African American people.

Experiencing high levels of stress, including social stress, is also a risk factor for diabetes.

Stress can increase the risk of developing diabetes.

However, there is also a link between stress and the management of diabetes. For example, certain stressors can destabilize blood sugar levels.

Learn more about the link between stress and diabetes here.

Inequity regarding stress

Many people assume that African American people have a higher risk of developing diabetes due to genetic factors that lead to higher levels of cortisol in their bloodstream. Cortisol is the main stress hormone, and it can increase blood sugar levels.

However, having higher cortisol levels may also be a result of the additional stress that African American people must endure on a daily basis as a result of racial discrimination.

One 2021 article found that telomere length, which can be a factor in a person’s likelihood of developing diabetes, can vary among African American people. The paper mentions that social stress could affect telomere length.

Also, a 2019 study shows a link between racial discrimination and poor health outcomes. It demonstrated that experiencing racial discrimination can lead to a higher likelihood of a person developing inflammatory or chronic conditions.

Socioeconomic barriers

Residential segregation can impact African American people’s ability to reduce their risk of diabetes due to stress-related factors.

Living in a poorer neighborhood or a neighborhood with poorer conditions means that a person’s base stress level may be higher than that of someone living in a wealthier neighborhood.

In childhood and parents

In 2012, the Journal of Clinical Endocrinology & Metabolism published a thorough overview of racial health disparities.

It suggested that the conditions to which a person is exposed before they are born can biologically impact them. This may substantially increase their risk of developing obesity and type 2 diabetes as an adult.

These conditions may include:

  • undernutrition and stress while in the uterus
  • maternal stress throughout pregnancy
  • maternal obesity during pregnancy

People who have obesity are more likely to develop diabetes than those who do not.

To decrease this risk, the National Institute of Diabetes and Digestive and Kidney Diseases recommend that people with obesity make certain changes to their diet and exercise habits to prevent developing diabetes.

Inequity regarding diet and exercise

Age-adjusted obesity is more prevalent among African American people than it is among white American people.

Some people assume that African American people have a different and less healthy cultural diet than white American people. However, there are other factors that are more likely to cause obesity in African American people than the specific foods they consume.

Socioeconomic barriers involving food

The 2019 Census revealed that 17.4% of African American families were living under the poverty line, compared with just 5.5% of non-Hispanic white families.

Fast food and items of junk food tend to be cheaper than fresher, healthier alternatives. Therefore, the disparate rate at which African American people are living below the poverty line could be a reason that it may be more difficult for African American people to manage their weight.

Socioeconomic barriers involving exercise

African American people may find it more difficult to exercise for leisure.

According to one 2013 study, this could be another effect of residential segregation. For example, there may not be as many safe places for an African American person to exercise in their neighborhood as there are for people living in other neighborhoods.

The study paper also mentions walkability in towns as a factor that can affect a person’s daily exercise. Some neighborhoods give a person less access to supermarkets within walking distance. This also has links to increased body mass index (BMI).

People have assumed that the higher rates of mortality and diabetes among African American people are solely due to genetic differences.

However, recent research has shown that genetic differences play a minimal, if not non-existent, role. In reality, environmental factors and the behaviors they lead to are more likely to cause a person to develop type 2 diabetes.

African American people face barriers every day that make it more difficult for them to prevent or manage diabetes.