Neighborhoods with a predominantly Black population, research has shown, are less likely to offer such options. And Black Americans are broadly affected by other problems rooted in systemic racism that can affect health.
“This is not a minute thing,” Joseph says. “This is a big challenge that we are facing. And that’s why in some ways, the disparities that we see in diabetes haven’t been changing because we’ve tried to address them in small bites. But we really need broad, overarching solutions that are based on policies that address the inequities that we see in communities of color.”
The beginnings of a solution, he said, might be education. It needs to be culturally relevant and “delivered by individuals that have relatable backgrounds and experiences.”
Annette Lartigue of Trenton, New Jersey, has dealt with diabetes for decades. Her mother was what she called “a diabetic in denial,” and Lartigue was hospitalized with gestational diabetes after a car crash when she was pregnant with her daughter 33 years ago. Gestational diabetes resolves after giving birth, but nearly 1 in 5 women like Lartigue go on to develop diabetes.
Despite that, she said, “I did not, for a very long time really, get my life together” to address her diabetes. “And there’s no excuse for it, except that I thought I could do it on my own.”
Although access to healthy food was never an issue, Lartigue says, “there weren’t many doctors who looked like me, understood my history – or my mother’s for that matter.”
She had similar trouble connecting with nutrition professionals, a field that is mostly white. They were “typically someone who weighs 98 pounds and wants you to eat two pieces of celery and a teaspoon of cottage cheese” and say that’s going to make you feel better. “Every time I walked into a nutritionist’s office, I was like, ‘I’m not dealing with you. You don’t understand me,” she says.
Her turnaround began when she met a Black doctor who told her, “‘You know, we can do this.” He promised that if she would work with him, he would work with her.