Diabetes among the African- American Women in America

Posted: January 5th, 2023

Diabetes among the African- American Women in America

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Diabetes among the African- American Women in America

Diabetes is defined as the abnormal sugar metabolism condition occurring when the body produces too much insulin or when the level of insulin produced is below the average body requirement. Diabetes manifests itself in two types; type 1 and type 2. Immune system’s attack on the insulin producing pancreatic cells leads to development of type 1 diabetes. Type 1 diabetes manifests itself at both at adolescent and later stages of development opposed to type 2 diabetes occuring at later stages of development. Diabetes is still a catastrophe in the united states with statistics indicating approximately sixteen million Americans to be diabetic (Zare et al., 2020). Among the African- American women, diabetes has escalated to epidemic proportions with one per five black women aged above fifty-five years being diabetic. As a future health educator, the study on Diabetes among African-American women will offer detailed information on the causes of the problem, attitudes in the society about the problem, possible and available means of prevention as well as available reading resources concerning diabetes.

African- American women are part of the minority groups in the United States suffering from diabetes, an example of a chronic disease. In the recent statistics, it is evident that 50- 100% percent of the African- American women are likely to be diabetic as opposed to their American ethnic counterparts (Zare et al., 2020). There has been a heated debate on the reasons for the disparities of the rate of disease being reported between the American ethnic women and African- American women (Cunningham et al., 2018). Much of the studies have postulated on the behavioral, environmental, physiological, socioeconomic and genetic factors to be the major contributing factors to this condition among the African-American women hence the need to undertake the study. In addition, the study is based on the fact that diabetes is more prevalent among the African- American women in America. The knowledge gained from this study will be building block for future task as a health educator.

African- American women exhibit a higher rate of diabetes with the same being reported in various health facilities within the United States. Different predisposing factors have been presented forth to explain the possible causes of diabetes among the African- American women that is obesity, lack of exercise, genetic associations, high blood pressure and sedentary lifestyles. Obesity is one of the leading causes of diabetes among the African- American women with the individuals who are obese or overweight being at a higher probability of developing diabetes particularly type 2 diabetes in reference to Body Mass Index (BMI) (Williams et al., 2019). Body’s mass index is calculated as the average body weight of an individual divided by their squared height measured in meters. It determines the amount of abdominal fat for that individual. A body Mass Index of 30 or above is considered to be obese. Obesity is caused by certain health conditions, sedentary lifestyles, lack of healthy foods, emotional factors as well as lack of sleep and age. Accumulation of abdominal fats within the body leads to cells producing pro-inflammatory chemicals which translates to the body becoming insensitive to insulin. This can be further explained by the fact that body produces by disrupting the insulin function responsiveness and its ability to respond to the insulin produced. Obesity interferes with the body metabolism by causing the fat tissues to release fat molecules into blood. This alters the insulin responsive cells leading to insulin insensitivity by the body. Due to increased insulin resistance, glucose builds up within the body leading to higher blood sugar level within the body (Cunningham et al., 2018). According to body mass index, African- American women are obese, hence explaining the high rates of diabetes.

High blood pressure or hypertension has been associated to causing diabetes. It is referred to being a silent killer condition due to inability to manifest symptoms thus few individuals seek medical attention at early stages. High blood pressure indicates that the blood is pumping through the heart and blood vessels with such an extra force (Williams et al., 2019). Consisted high blood pressure overworks the heart leading to its enlargement which increases the risk of individual suffering from stroke. Raised systolic blood pressure by 20mmhg increases the risk of developing diabetes by 58% while elevated diastolic blood pressure by 10mmhg increases the risk of developing diabetes by 52%. Hypertension is associated with obesity which is the leading cause of type 2 diabetes (Zare et al., 2020). The combination of hypertension and diabetes increases the chances of the development of other diabetes – related complications such as kidney diseases and retinopathy. This is also supported by the development of other health conditions among the African- American women in United States such as heart attacks, stroke and heart failure. Gestation diabetes among the pregnant African- American women increases the development of type 2 diabetes later stages of development (Williams et al., 2019). The indication of higher blood sugar among the pregnant mothers raises the concern of further development of the individual to diabetes. Gestational diabetes leads to various other complications like pre-eclampsia with the main symptom being reported as high blood pressure.

Sedentary lifestyles among the African- American women act as intermediate risk factors of diabetes. The sedentary lifestyle is attributed to socioeconomic status of the women in the United States. These sedentary lifestyles include; poor nutrition, increased incidences of poor health behaviors such as smoking and alcohol intake in addition to stress especially among the middle aged women (Commodore-Mensah et al., 2018). Stress is associated with glucose tolerance impairment even in the nondiabetic individuals. Stress leads to depression where the depressed individuals present a higher chance of development of diabetic complications. This explains the high number of premature deaths as the individuals are even less motivated to adhere to medication in addition to being less socially and physically motivated (Cunningham et al., 2018). Depression also contributes to diabetes development in addition to hypertension. Low socioeconomic status of the women in United States, leads to the women undergoing maternal malnutrition even during pregnancy. The women are also unable to access adequate health care which puts them at risk of development of diabetes at later stages of development.

Exercise improves glycemic control hence preventing complications associated with diabetes. Sedentary lifestyle increases the development of obesity which interferes with insulin sensitivity and increases the development and worsening of diabetes among the African-American women. Exercise is a remedy in prevention of complications associated with various other diseases like hypertension (Commodore-Mensah et al., 2018). The African- American women due to their low socioeconomic status, are less involved in the exercise as well as physical activity since they are always utilizing every opportunity in seeking for available options to earn extra pen to enable them sustain their lifestyle obligations. The extra work hours to work is due to the expensive lifestyles within the country.

Access to health care is often encountered with various challenges in attitudes and beliefs. The general population has diverse beliefs and attitudes towards the same with some being affiliated to certain factors. Accessibility of medical health care among the African American women faces a roadblock as opposed to native individuals. For instance, it is two times more likely for an African American woman to die of diabetes as opposed to American native woman at national health facility in United States. This is due to racial discrimination by some American native Doctors and nurses against black immigrants (Lopez-Jaramillo et al., 2018). The African –American women are less willing to seek health care from a qualified doctor or a government facility in America due to childhood experiences. The African –American women strongly belief that traditional medicine is the only remedy to their health condition hence no need to seek conventional medicine services. Due to the strong spiritual faith and belief by the African- American women, church participants are highly likely to attend class or workshops offering education on the diabetes self-management practices but only if offered by the churches. The doctors as well as other healthcare professionals have a great influence on the health of their patients. As of date, African- American women are highly likely to participate in diabetes screening program only if requested by doctors or other health care professionals directly attached to them (Zare et al., 2020). The newly immigrated African- American women possess a protective health effect where they belief in racial discrimination even in the access of the medical health contributing to the high number of the unreported diabetes cases. This attitude and belief however diminishes after certain period of time following the reported consultation of health services without encountering any form of discrimination (Commodore-Mensah et al., 2018). Although most people belief that the African- American women are discriminated in their access to medical health care, it is usually occurring in rare instances since the present date healthcare providers are mixed up and therefore provide health care to all individuals without bias. The belief and attitude instituted among the African- American women through the previous culture practiced in America scare them away leading to more undiagnosed cases.

 Joslin Diabetes center is a diabetes organization based in Boston, Massachusetts in United States. The Joslin Diabetes center is committed to achieving her goals of commitment to pursing innovative pathways of discovering, prevention and treatment as well as securing the two types of diabetes. Joslin Diabetes is also focused to managing the other complications associated with Diabetes. This is through the recruitment of the best leaders and experts in the research and clinical practice. Joslin Diabetes organization enjoy the affiliation of the Harvard Medical school (Salastekar et al., 2017). This commitment to the goals has enabled the organization to become the best facility in innovative, education as well clinical care in diabetes. The Joslin organization has gained ratings and voted the exemplary in education, research and also provision of best health care hence the best recommended to provide health care to the African- American diabetic patients in United States. It is primarily concerned with Diabetes and thus has got a large number of board- certified physicians which help in the treatment of diabetes and associated complications. The organization supports the world’s largest diabetes research hence ensuring efficient and modern services are available within their facility as well outside community. The organization has faced various challenges such as the revenues since diabetes is not a profitable market (Salastekar et al., 2017). Modern world does not require expensive treatment nor surgeries due to advancement in technology and thus the organization has been out-challenged by the other upcoming organizations that are gaining various modern day opportunities apart from eye and disease cancer services. Diabetes condition is so common such that it can be treated at home and most of the diabetic individuals are able to closely monitor at home, hence no need to keep attending clinics like Joslin. Furthermore, the company does not offer inpatient services.

Bridgett Rahim Williams in his book “African American Women with type 2 Diabetes: Understanding Self-management”, explains the self-management behaviors to be the highly motivating factor causing the morbidity and mortality in various chronic diseases such as diabetes which inappropriately affects the African- American patients. The curiosity within this book context is satisfied in the description of health behaviors, beliefs as well as other factors which are fundamental to self-management and glucose control like support system and access to care (Williams et al., 2019). The book further illustrates on the self-management education and the role in diabetes management. Florida is referred as the case study in this book. The article “Black women’s Recommendations for Developing Effective Type 2 diabetes Programming” by group of Qual Nurs, describes the mechanisms for development of effective type 2 diabetes with particular reference to 29 black women (Schoenthaler et al., 2020). The article further offers guidance to scholars and health care professionals aimed at improving the effectiveness of diabetes programs among black women and families in United States making the article more appealing for use in education on Diabetes among African American Women education. In addition, the article shares the opinion on whether family members should be included in programs supporting individuals diagnosed with diabetes (Schoenthaler et al., 2020). In the documentary “Exploring African Americans’ High Maternal and Infant Death Rates”, Cristina Nova and Jamila Taylor describe the condition of heart attack that befall on Erica Garner (Lopez-Jaramillo et al., 2018). The activist first chocked her father to death and her pregnancy stress weakened her body immune system according to the documentary hence suffering the second attack which led to her coma till demise. The death occurring in both the studies are tragic and thus indicate a tragedy befalling the African- American women in United States. As evident in the documentary, African- American women from all backgrounds face racial and gender discrimination. From the documentary, the impacts of institutional sexism negatively affect the women’s health hence negative effects being implicated in the African American- women and infants (Salastekar et al., 2017). The biasness in health care systems and gaps within the health care workforce leads to further aggravation of the racial disparities.

The diabetes condition among the African- American population is a matter of national concern marred by the higher rates of condition being reported as well as mortalities and morbidities. The united states have thus formulated various means of prevention and management of the health issue. The black Women vote “The 2020-2021 Health Policy Agenda” has been created to aid in informing and supporting various partnerships with policymakers and various other stakeholders on the critical health policy issues that have an impact on the improvement of the black woman in United States. This policy enables the voters, to engage in policy discussions in critical health issues affecting the black women and seek meaningful solutions. The Black- Women’s health imperative is a virtual program established by government for the black woman (Commodore-Mensah et al., 2018). This program offers a yearlong evidence based program dubbed “Change your lifestyle” which offer tools and support needed in the prevention of chronic diseases such as diabetes. The program offers personal coach, hence help in changing of the relationship with food especially the African- American Women. The government has also engaged in the community based programs which involve on the engagement of the government with the diabetic as well as the prediabetes and diabetic African American women. The programs offer education prevention program which focus on the various predisposing factors of diabetes.

Health literacy of the diabetic patients in the United States has been seen as one of the adequate self- management and control of diabetes among the African American Women in the United States. This can be accounted from various pilot studies which have linked disparities in diagnosis and control of diabetes mellitus to be the most common factor affecting the African American women especially those with lower socioeconomic status (Williams et al., 2019). The educational approach has been supported by various pilot programs being undertaken to test feasibility as well as preliminary efficacy of a health literacy-enhanced diabetes prevention mechanisms. The study utilizes the PLAN4 success which is the Prevention through lifestyle intervention and Numeracy of diabetes in low income African- American women with diabetes (Commodore-Mensah et al. 2018). The utilization of the PLAN 4 success has been associated with improved glucose control as well as psychological outcomes hence the success of the program.

Strong leadership is essential for the realization of the vision of a transformed health care particular on diabetes among the African American Women in the United States. These leadership skills are manifested through the advocating of various policies at both local and national levels. Being a patient advocate, I highly propose the involvement of nurses on various decision making processes especially those entailing on the quality health care delivery improvement. According to Schoenthaler, Leon, Butler, Steinhaeuser, and Wardzinski, (2020), nurses need also to be actively involved in the advisory committees. Nurses must also build a good rapport as well as partnerships with other stakeholders in the health care of delivery to African American women in the United States. For instance, the nurses must be in good terms with the physicians, elected officials and public to help improve the system.

Ultimately, the African- American Women have been found to exhibit higher rates of diabetes cases in United States opposed to their counterparts. The incidences of this condition has been attributed to various factors such as obesity, hypertension and sedentary lifestyles. The sedentary lifestyles are linked to their low socioeconomic status within the country. The sedentary lifestyles include the long- time engagement in the routine work of employment such that they are left with a little time to physical exercise leading to obesity. The African – American women also engage in various other vices such as smoking and alcohol intake which increases their chances of developing the diabetic condition. There are various social attitudes and beliefs in regard to this health condition which translates to the ease of accessibility of health care among this study population. The beliefs and attitudes are associated to certain affiliation like religions or other factors such as culture in addition to experience. Joslin Diabetes center organization within the sates offers a substantial health solution to this particular study with the utilization of the best educational, research and clinical practice resources. There are various educational resources available which gives insight in the study subject like “African American Women with type 2 Diabetes: Understanding Self-management” by William. The United States government has utilized various programs to help in addressing the diabetes among African American women since it has been document as a matter of national concern. Several policies have been adopted like “The black Women vote “The 2020-2021 Health Policy Agenda” and self-management program among the affected individual. As a health educator, various policies should be advocated like the allowing of the participation of nurses in the important policy formulation policies like the participation on policies involving the patient health care improvement. Nurses must also be establishing a good rapport among the shareholders within the system like the general public, elected leaders, physicians and other nurses.

References

Commodore-Mensah, Y., Selvin, E., Aboagye, J., Turkson-Ocran, R. A., Li, X., Himmelfarb, C. D., … & Cooper, L. A. (2018). Hypertension, overweight/obesity, and diabetes among immigrants in the United States: an analysis of the 2010–2016 National Health Interview Survey. BMC Public Health, Vol. 18, no. 1, pp.1-10.

Cunningham, A. T., Crittendon, D. R., White, N., Mills, G. D., Diaz, V., & LaNoue, M. D. (2018). The effect of diabetes self-management education on HbA1c and quality of life in African-Americans: a systematic review and meta-analysis. BMC health services research, Vol. 18, no. 1, pp. 367.

Lopez-Jaramillo, P., Barajas, J., Rueda-Quijano, S. M., Lopez-Lopez, C., & Felix, C. (2018). Obesity and preeclampsia: common pathophysiological mechanisms. Frontiers in Physiology, https:// doi org 10.3389/2018.01838/

Salastekar, N., Desai, T., Hauser, T., Schaefer, E. J., Fowler, K., Joseph, S., & TINSAL‐CVD study team. (2017). Salsalate improves glycaemia in overweight persons with diabetes risk factors of stable statin‐treated cardiovascular disease: A 30‐month randomized placebo‐controlled trial. Diabetes, Obesity and Metabolism, Vol.19, no. 10, pp. 1458-1462.

Schoenthaler, A., Leon, M., Butler, M., Steinhaeuser, K., & Wardzinski, W. (2020). Development and Evaluation of a Tailored Mobile Health Intervention to Improve Medication Adherence in Black Patients with Uncontrolled Hypertension and Type 2 Diabetes: Pilot Randomized Feasibility Trial. JMIR mHealth and uHealth, Vol. 8, no. 9, pp. 7135.

Williams, E. M., Dismuke, C. L., Faith, T. D., Smalls, B. L., Brown, E., Oates, J. C., & Egede, L. E. (2019). Cost-Effectiveness of a peer mentoring intervention to improve disease self-management practices and self-efficacy among African American women with systemic lupus erythematosus: analysis of the peer approaches to lupus self-management (PalS) pilot study. Lupus, Vol. 28, no. 8, pp. 937-944.

Zare, S., Ostovarfar, J., Kaveh, M. H., & Vali, M. (2020). Effectiveness of theory-based diabetes self-care training interventions; A systematic review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, Vol. 14, no. 4, pp. 423-433.