According to the Center for Disease Control, in 2014, over 29 million people had diabetes in the United States – a disease that is more common among the poor, the less educated, and racial and ethnic minorities. While some people inherit genetic susceptibility to Type 2 diabetes, the onset of this disease can be exacerbated by factors that are all common to underserved neighborhoods, such as poor diet, lack of exercise, and limited access to quality healthcare. This is a complex problem that requires a multifaceted solution.
First, we can consider how little time lower-income individuals have to take care of their health. Lower-income jobs tend to come without benefits such as paid time off, and some do not pay their workers a living wage, forcing them to pull longer hours than higher-income workers. This leaves them little time to prepare and eat healthy meals, exercise, and learn about their health. The high prevalence of diabetes in poor communities affects everyone. It is a tremendously expensive disease due to its chronic nature, and many diabetics are on Medicare and Medicaid. Their medical bills are subsidized by the taxpayer. Lower rates of diabetes will not only lead to healthier, more productive lives and improved public health, but it will also relieve public programs, insurance companies, and the country of huge financial burdens based on the cost of treatment.
Here, I will explore three of the primary factors that link poor socio-economic status to diabetes.
Many health-conscious people pay attention to the food that they eat in order to avoid gaining weight and other complications from poor diet, like diabetes. But for many people in underserved communities, having a poor diet is usually not a choice. Rather, food deserts, which lack healthy, affordable food options, and jobs that require long or unusual hours, contribute to dietary malnutrition and set individuals up for eating habits that can cause diabetes later in life. Furthermore, underserved communities tend to attract cheap, convenient food options, which contain large amounts of salt and sugar. It is difficult to make fresh food, which expires and requires time to prepare, affordable. For individuals who do not have the time to prepare meals, or have the resources to choose healthier options, keeping a healthy diet can be extremely challenging. Furthermore, fast food and cheap, low-quality carbohydrates such as candy, cookies, and soda may cost less money at the grocery store, but they can cost consumers more in the long-term as poor diet translates into poor health.
Exercise and Health Literacy
We can also attribute the high prevalence of diabetes in low-income communities to the lack of health literacy and education in these areas. People who live in poor communities and who are educated in low-performing schools do not have access to resources to learn about science, health, and exercise. They most likely have not been taught the importance of eating healthy and exercising, and may not have even been properly taught how to research these topics on their own. Without knowing how to find or consume this information, it is difficult to find a place to begin learning. Consequently, if we can improve education and increase community outreach in low-income communities, we might also have the potential to impact diabetes development.
Children in these communities, in particular, are not only limited by their educational opportunities, but also by the practices they grow up with at home. If they’re living in communities where their parents, despite their intentions to raise their children to the best of their ability, cannot find or afford healthy food and don’t have time to exercise, they’re not going to have much opportunity to learn these habits at all. Think about it this way: even in wealthy communities, it is easier to skip going to the gym or to order takeout than it is to exercise or prepare healthy meals. Imagine how much harder this becomes for people who have limited time and money.
Access to Healthcare
If poor access to healthy food, little opportunity to exercise, and little exposure to health education aren’t enough, individuals in underserved communities also tend to suffer from a lack of access to quality healthcare. For many poor Americans, even going for a check-up can become costly. In 2013, the average price for a new, uninsured patient going to see a primary care physician was $160. For a single parent making minimum wage and raising kids, he or she might have to choose between going to the doctor and paying rent. If people don’t go to the doctor, it becomes impossible for healthcare providers to assess their health and recommend changes to diet and exercise that can help them avoid diabetes and other conditions.
What You Can Do to Help
Diabetes is a complicated, costly disease that hits some communities harder than others. We all have a part to play in improving community health among those who do not have access to healthy food and exercise options. Those who are in a position to help should do what they can to improve working conditions, advocate for health literacy, improve education, and expand access to medical care. Through these efforts, we could see a reduction in the amount of patients who are being treated for diabetes, which will, in turn, lower the amount of medical costs borne by taxpayers and health insurance companies for diabetic medical care.
Pamela Bilo Thomas is a third-year computer science PhD student at Notre Dame studying under Dr. Tim Weninger. Her main areas of focus are machine learning and data mining and is interested in improving media literacy to combat the spread of misinformation on social media in middle-income countries. She can be found on Twitter at @pambilothomas.