African Americans are disproportionately affected by diabetes. There are about 4.9 million Black people who have diabetes. One thing is clear about the serious problem of diabetes among Black people in the United States: It’s not just one thing causing the problem.
“It’s really at all levels,” Dr. Joshua J. Joseph, assistant professor of medicine in the Division of Endocrinology, Diabetes and Metabolism at The Ohio State University Wexner Medical Center in Columbus says. It’s not just the choices people make – it’s the entrenched issues that lead them to make those choices.
The statistics are stark. According to the Department of Health and Human Services’ Office of Minority Health, 13.4% of Black men and 12.7% of Black women have been diagnosed with diabetes. Combined, their rate is 60% higher than that of white people.
In the U.S., Black people are twice as likely as their white counterparts to die of diabetes. They are three times as likely to end up hospitalized for diabetes-related complications. They are more than twice as likely to undergo diabetes-related leg or foot amputation. And they are more than three times as likely to have end-stage kidney disease.
Researchers have hunted for genetic causes, Joseph, who leads a research group dedicated to improving diabetes prevention and treatment says. But “genetics just does not explain a lot of Type 2 diabetes that we see in the United States.”
The central issue, he said, is lifestyle factors that drive obesity, which a recent study in the Journal of the American Heart Association found may account for up to half of all Type 2 diabetes cases in the United States. And about 55% of Black women and 38% of Black men have obesity, according to American Heart Association statistics.
“But those lifestyle factors, they don’t come out of thin air,” Joseph says. This is why he emphasizes the need to look at “upstream,” communitywide issues.
As a doctor, he can tell a patient to eat fruits and vegetables and cut back on sugar-sweetened beverages. But “if the environment that they live in does not have healthy food options, then that’s going to be very difficult for them.”