The whole world is experiencing diabetes-related health disparities, co-morbidities and its complications. There is a wide range of literature available showing that ethnic and race minorities are at a greater risk of developing diabetes compared to the majority groups. The disparities are a result of a combination of factors; they are both clinical and biological. They are also strongly associated with the system of health and factors related to social dynamics. The term ethnicity is a complex one. It reflects a convergence of multi-dimensional factors ranging from biological ones to geographically-influenced contributors. Other strong influencers include political, economic cultural, legal and social factors, including racism. Thus, it is important to understand the idea of racism and ethnicity if one is to figure out the full stretch and effect of disparities in healthcare and health, generally (Spanakis & Golden, 2013).
The USA has a large Latino population which is also diverse in its nature. The Latino population in the US traces its origin from many varying locations, geographically. Most of them come from Latin America and Mexico, though. Indeed, Mexican Americans and Mexicans constitute about 4% of the Latino population in the country. Latinos from Puerto Rico come second in number with 9.4%, those from Salvadore make up 3.8%, 3.1 Dominicans, and 2.3% Guatemalans. Overall, the minority minorities constitute about 16%. According to demographic information sources, Latinos make up the largest minority group in the US. Many studies have pointed to a worrying trend that most of the Latinos in the US have limited or no access to important services including healthcare services and cover for the same. The studies also indicate that Latinos, generally receive worse healthcare services compared to others and experience worse morbidity (Ortega, Rodriguez & Vargas Bustamante, 2015). It has also been established that the shifting demographics of the Latinos in the US presents a serious challenge to the policy makers in the healthcare sector. Further, studies indicate that, by 2015, one person out of 5 American residents will be a person of Latin origin. The population I a mixture of Latinos that immigrated and those that were born within the US borders. The Latino people also have varying behavioral and cultural tendencies that may affect their attitude towards healthcare, hence access to the same. It has been established that diabetes incidence among adults aged above 20 years is more common among Latinos compared to whites of non-Hispanic roots. Since, Latinos are often misconstrued to be one homogenous group; the differences in the rates of diabetes prevalence among the subgroups are usually left unidentified or unmentioned. It has since been established that Puerto Ricans and Mexicans manifest a higher prevalence rate among the Latino sub groups. The same studies show that Latinos of Cuban and Southern American roots demonstrate a similar prevalence as the non-Hispanic whites (López & Golden, 2014).
Several risk factors play into the chances of one developing pre-diabetes which moves gradually to the type 2 diabetes level. Some of the factors are beyond one’s control. They include
· History of one’s family: one has a higher chance of developing diabetes if there is a relative with a history of diabetes
· Ethnic and or racial background: Colored people such as African Americans, Hispanic, Asian Americans, Pacific Islanders and Native Americans tend to have a higher vulnerability towards diabetes.
· Age: Older individuals have a higher chance of developing diabetes compared to their younger counterparts. While it has been more common in people above 45 years, healthcare experts are increasingly diagnosing children with the condition (American Heart Association, 2018).
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Although some factors that contribute to diabetes incidence are beyond human control, others can be mitigated and even eliminated. It has been established that people can delay or reduce the probability of developing diabetes by making some lifestyle changes. For example, obesity is a major predisposing factor of diabetes. Another modifiable human behavior is physical inactivity. When high blood pressure remains untreated it not only damages the cardiovascular system but is also noted as a possible diabetes trigger (American Heart Association, 2018).
Usually, minorities live in neighborhoods that are rated as inferior because they lack access to healthy food, gyms and manifest a high level of crime. The lack of value food sources, exercise amenities and the prevalence of stressors such as high crime rates and limited levels of social cohesion are all connected to poor health. Lack of food stores and supermarkets is also associated to a higher BMI. Locations with longer distances to walk to the supermarket have been linked to lower BMI. A multi-ethnic Atherosclerosis study showed that people living in better neighborhoods manifest higher sensitivity to insulin and a lower risk of developing type 2diabetes. Poor living standards areas are linked to a higher rate of smoking, insufficient attention to blood pressure control. The latter is a known diabetes trigger. Low income areas also present major challenges in the management of chronic ailments. Prices have also been noted to be higher in poor neighborhoods compared to wealthier residential locations (Spanakis & Golden, 2013).
Solutions to Addressing the Health Concern and the Implications
If the tide on the high cardiometabolic problems is to be turned around, it is important necessary to include provider, patient factors and the health system. Language barriers, lack of access to healthcare service, perceived discrimination, poor numeracy, distrust, poor health literacy and financial constraints can lead to poor diabetes treatment outcomes among disadvantaged groups (López & Golden, 2014). Micro and macro-vascular problems that are related to diabetes can be prevented by normalizing blood glucose, pressure and lipid levels. Intensive self management of diabetes can help to improve blood glucose levels. DSM has been hailed for its capacity to improve self management approaches and the patient confidence to finish the activities successfully. There is a need for close cooperation between the healthcare providers. Such cooperation faces challenges with Latino patients with limited English speaking skills, also commonly referred to as LEP when they are not in contact with healthcare providers with knowledge of the language that they speak. The situation is likely to stay that way for some time because according to the latest statistics from the national medical student surveys show that there is a significantly low number of Latino students in the health training institutions compared to the population that needs healthcare and do not speak English. A recent survey of Latino diabetes patients in safety nets indicated that they need support for self management. The survey also showed that the patients believed that they would be far better off if they had better communication with the healthcare providers. Further relevant DSM interventions in culturally appropriate form and language have signaled high acceptability, feasibility and effectiveness in enhancing the level of knowledge about the diabetes condition and the required physiological precautions. Consequently, the systems that have been made to enhance DSM for the Latino community have the likelihood to improve outcomes in healthcare provision (López & Grant, 2012).
It has been established that interventions that connect blood glucose self monitoring to behavioral advise and education.....
American Heart Association. (2018). Understand Your Risk for Diabetes. Retrieved from http://www.heart.org/HEARTORG/Conditions/More/Diabetes/UnderstandYourRiskforDiabetes/Understand-Your-Risk-for-
Cersosimo, E., & Musi, N. (2011). Improving treatment in Hispanic/Latino patients. The American journal of medicine, 124(10), S16-S21.
López, L., & Golden, S. H. (2014). A New Era in Understanding Diabetes Disparities Among U.S. Latinos—All Are Not Equal. Diabetes Care, 37(8), 2081–2083. http://doi.org/10.2337/dc14-0923
López, L., & Grant, R. W. (2012). Closing the gap: eliminating health care disparities among Latinos with diabetes using health information technology tools and patient navigators. Journal of diabetes science and technology, 6(1), 169-176.
Ortega, A. N., Rodriguez, H. P., & Vargas Bustamante, A. (2015). Policy dilemmas in Latino health care and implementation of the Affordable Care Act. Annual review of public Health, 36, 525-544.
Spanakis, E. K., & Golden, S. H. (2013). Race/Ethnic Difference in Diabetes and Diabetic Complications. Current Diabetes Reports, 13(6), 10.1007/s11892–013–0421–9. http://doi.org/10.1007/s11892-013-0421-9