Diabetes in African Americans, Term Paper Example

Introduction

There are three types of diabetes-Type I, Type II, and gestational diabetes. Type I comprises about 5-10 percent of all cases of diabetes. Gestational diabetes is identified during pregnancy, but is a temporary condition. Blood sugar levels return to normal after pregnancy.  Diabetes is a chronic that causes an imbalance in the sugar levels and insulin production in the body of a person with this illness. More than 20 million people will be diagnosed with diabetes during their lifetime. Of these 20 million people, 90 percent of them will have type II diabetes. (Ham, Kruger, & Locke, 2009). Complications from diabetes can lead to heart disease, obesity, and high blood pressure. Type II diabetes is six time more likely to affect minority groups, such as African American, as compared to non-minority groups. According to the U.S. Department of Health and Human Services, African Americans are twice more likely to be diagnosed with any form of diabetes than Caucasians. Race is a major risk factor of diabetes. Diabetes is also common among groups that live in poverty, but proper intervention and lifestyles changes can decrease the rate at which it affects member of the African American population. Over the years, diabetes has been treated as t medical condition; however, genetics and individual choices play a large role in the prevalence of the disease. This notion of the disease has caused the increase and continued prevalence of the disease. Type II diabetes is the most common type of the disease, but it is usually not diagnosed until severe complications arise. About one third of people with diabetes went undiagnosed for an extended period of time.  Intervention for the disease must incorporate cultural features, address specific social and physical aspects of the African American community, and provide early intervention through education, lifestyle intervention, and food environment.

Research/Theory

Health behaviors tend to be influenced by one’s income and educational background. Many studies have looked at how poverty affects diabetes. The relative deprivation theory is fitting of many cases where African Americans are affected by diabetes. Relative deprivation occurs when person objectivity towards health is impaired as a direct result of their financial situation. Statistically, African American head of house hold typically earn about 20,000 dollars less than Caucasian households (Adler & Newman, 2002). The poverty rates of African American are about 24.5 percent. According to the deprivation theory, African American have unequal access to the following: healthcare practitioners, awareness of diseases, risk factors, increases exposure to psychological stressors, low economic status, structural limitations, limited access to fresh fruits and vegetables, lack of ability to afford healthy foods, lack of health promoting behaviors, cultural perceptions of excess weight, and family history (Ham, Kruger, & Locke, 2009).

Many risk factors must be considered when examining diabetes. Obesity is one of the greatest indicator if diabetes. Type II is the most prevalent type of diabetes in the United States. Many factors can lead to developing diabetes- age, obesity, and lack of physical activity, race, and eating habits. According to statistics groups of minorities (African Americans, Hispanics, Indians, some Asians, and native Hawaiians) have a very high risk of developing type II diabetes.  Many of these risk factors are associated with culture and heath behaviors.  Healthy diets and exercise, cultural beliefs about weight and weight management, cooking methods, access to health care facilities, and their perception of the health care provider plays an important role in the control and prevention of diabetes in minorities (Boardman, Onge, Rogers, Richard & Justin, 2005). The greatest prevalence of overweight is seen in minority groups. Members of minority groups are 10 percentage points more likely to overweight than non-Hispanic whites (Ham, Kruger, & Locke, 2009). There is even a higher prevalence for African American women. For example, in 2001-2008, “20- to -39 year old Non- Hispanic Blacks women were seen to have a 70.3% prevalence rate of obesity and overweight, while Non-Hispanic whites were seen to have a prevalence of 49%. More than 50% of African American women over the age of 40 are obese and over 80% overweight. The prevalence of extreme obesity in African American women was more than twice than that of White and Mexican” (Ham, Kruger, & Locke, 2009).

One study conducted addressed the effectiveness of intervention programs in African American communities. This study was conducted to give insight into the cultural and health views of African Americans. One noted change that positively affected and improved the prevalence of diabetes in this community was exercise. There seemed to be a link between social and health perception among African Americans in this community. The research has indicated that African Americans are more likely to live a healthier lifestyle if there is a change within their environment. (Ham, Kruger, & Locke, 2009). The evidence has revealed that when a person realizes the relationship between exercise, proper diet, and stable glucose level can have a positive effect on the over all health.

Much literature suggests that African Americans do not partake in much physical activity because of their perception of body weight. This particular study examined the health benefits of African Americans who participate in physical activity as little as once a week. Along with this study, participants were also educated on nutrition. The findings concluded that learning about the food pyramid and how food consumption affects the body along with moderate exercise had a great impact on the degree or extent of problems due to diabetes. Body image across cultures varies greatly. African Americans perceptions of their bodies are affected by cultural values, society influences, media influences, and what is considered beautiful or attractive to members of the same culture. For example, evidence support the fact that members of African American culture are more tolerable or even prefer heavier bodies. In one study conducted on high school teens reported that more African American girls wanted to gain weight than teen white girls of the same age. Also, more African American girls gained weight because their parents had expressed to them that they were too thin (Two Feathers, 2005). The positive perspective and widely acceptance of heavier bodies among the African American population has created a high tolerance of overweight and obese members of this culture. The perception can form an attitude that being heavy or overweight is normal. Among adolescent girls African American girls are twice as likely to be overweight than white girls (Two Feathers, 2005).

Researchers have concluded that body image is established fairly early in life. So, in order to target being overweight must be stressed to adolescents as well as adults. Lowering one’s chances of being overweight will drastically lower one’s chances of developing diabetes. If overweight members of the African American community are seen as been normal, there is no motivation for adolescent members of the African American culture to control their weight. For example, many African Americans girls stated that they had been taught to ignore weight related comments and were not motivated to change their poor eating habits due to them. (Nwasurua, Osuagwu, & Bae, 2007 ).Regardless to color or ethnic group, many adolescent view themselves as being immune from health problems and may not take preventative measures seriously (Nwasurua, Osuagwu, & Bae, 2007). Weight intervention and prevention must address both children and adults.

Analysis

In the United States about 30 percent of the population is considered to be obese (Ham, Kruger, & Locke, 2009). The obesity rates among African Americans are exceptionally high. About 66 percent of African American women are overweight and 79 percent of African American men are overweight. African American men over the age of 20 are four times more likely to be obese than Caucasian men of the same age. These statistics are due partly to the way African Americans prepare their foods and the types of food they consume. Another study found that African Americans said that the way prepared their foods the same way they grew up eating them. (Two Feathers, 2005). This suggests that being overweight can be linked to cultural eating habits.

Socioeconomic status can also result in poor health habits which can lead to type II diabetes. This factor is a major contributor to the high prevalence of type II diabetes in African Americans. Many African Americans reported that they rarely consider the health benefits of a food product when they purchase it. They are more concerned with the quantity of the product to ensure that they will have enough to feed their families for a period of time. Many African Americans in low income families are providing for their families on a fixed income. Consequently, they often buy foods that are less healthy because they cost less. “A low socioeconomic status contributes to certain lifestyle factors that can play a role in the prevalence of diabetes” (Two Feathers, 2005).

Incidence                                                                                                                             

Globally, more than 150 million people are afflicted with type II diabetes. Fourteen million of those are in North America. This number is expected to increase by 24 percent by 2025. Today, diabetes affects about 7 percent of the United States population and is the sixth leading cause of death. Some complications of diabetes are damagage and malfunction of kidneys, nerves, heart, eyes, and blood vessels (Boardman, Onge, Rogers, & Richard, 2005). Diabetes can also affect the feet and many people have limbs amputated due to progression of the disease. In addition to these progressive disorders, diabetics can encounter diabetic ketoacidosis and hypersomolar which are the result of a biochemical imbalance. Infections such as pneumonia and influenza are very dangerous for people with diabetes because they are more likely to die from these illnesses than people who are not suffering from diabetes. Diabetes is also associated with increase risk of hear disease and stroke. In 2008, more than two thirds of all heart related deaths were diabetes related (Boardman, Onge, Rogers, & Richard, 2005). Also, nearly 75 percent of all adults with hypertension also have diabetes (Boardman, Onge, Rogers, & Richard, 2005).

A chronic illness can threaten a person’s self-image. Often when a person is diagnosed with a chronic formulate future identities of failure. As a result, when a person is diagnosed with a disease like diabetes, they often set goals that they feel are achievable by someone who has the disease. In other words, the person outlook on life changes after diagnosis. However, the person’s perception of the disease is often linked to the progression of the disease. According to Two Feathers, there are varying degrees of acceptance and denial that comes along with the diagnosis of a chronic illness. The five stages are denial, anger, bargaining, depression, and acceptance. Some people remain in denial for an extended period of time. They refuse to accept their diagnosis (Two Feathers, 2005). This refusal is usually accompanied by a refusal to accept medical attention for the illness.  They add, “For most individuals, denial will gradually fade into acceptance. Denial is healthy so long as it serves as a protective function in the short term. Denial can result when a patient is conflicted or uncertain about how the illness will be incorporated into their life” (Two Feathers, 2005). Culturally, African Americans seem to view illness as a weakness, as a result, many tend to ignore warning signs and refuse treatment after being diagnosed. Denial is just one of many strategies used to manage uncertainty.  Some clinicians even categorize uncertainty as an unorganized illness because it can remain after the person has been diagnosed (Boardman, Onge, Rogers, & Richard, 2005).

Many African Americans pride themselves in having strong identities. One’s identity can define and differentiate them from others. Some of these identities are derived from cultural ties to communities and relationships. When these identities are internalized, they become a part of a person’s self-concept. This concept is defined as relatively stable by Boardman, Onge, Rogers, & Richard. An African American with diabetes can internalize this illness which will alter their self concept. For example, African Americans are known for eating certain foods or using certain seasons. Often members of the African American culture consume these items because they believe they will be ridiculed if they do not.

Morbidity and Mortality

Diabetes is a major cause of premature illness and death in many countries. Many of the deaths are related to cardiovascular disease, which is directly linked to diabetes. These disease causes damage to blood vessels. General complications from diabetes causes about a third of the world’s deaths (Boardman, Onge, Rogers, & Richard, 2005).  Close to four million people between the ages of 20-79 can be attributed to diabetes. This number can be compared to the deaths of several infectious diseases combined. Countries with the highest number of diabetes are: The United States, China, India, and Russia. Women with diabetes have a higher chance of dying from the disease than men (Boardman, Onge, Rogers, & Richard, 2005).

Promoting Healthy Living

Lifestyle measures are effective in preventing and delaying onset of type II diabetes in African Americans. To help prevent diabetes a person needs to achieve and maintain a healthy body weight. In order to do this, one must become physically active for at least 30 minutes a day. One should exercise regular or moderate activities several days a week. More activity will be needed to loose weight and when a healthy weight is established a common pattern can be established to maintain the desired weight. Healthy food choices must be made daily. This is a gradual process that must be done over time and not “cold turkey”. People who attempt a lifestyle change over night usually fail (Ham, Kruger, & Locke, 2009). Fruits and vegetables servings can be used in place of snacks such as chips or candy. Many people do not realize that tobacco can increase the risk of cardiovascular diseases. If one is a smoker, it is best to eliminate this from one’s life. This process my require the help of a healthcare provider. However, if one has already been diagnosed with diabetes, there are lifestyle changes that can help to control the disease and in some cases reverse it. Early diagnosis is the key. If one has family history, weight issues, or any other indicators that he/she could possibly be at risk of getting the disease, he/she should be testes. Testing is done by using a small blood sample. Often, organizations help to promote healthy living and disease control. Many communities have facilities or centers that offer free screenings and educational information. Once one has been educated about the disease, he/she can control it or prevent it. Studies show that people who venture into a healthy lifestyle change or weight loss journey do better when they have a partner. Seventy-seven percent of people who attempt to make a life style change did so with a partner (Ham, Kruger, & Locke, 2009).  Finally, Ham, Kruger, & Locke say intervention programs work by focusing on population-wide approaches to promote healthy diet and regular physical activity, thereby reducing the growing global problem of overweight and obesity.

Summary

Diabetes is a chronic disorder that can have devastating effects, but it is controllable and preventable. Proper diet and physical activity are imperative to eradicating the disease. African Americans are particularly prone to the disease because of many cultural barriers. In recent years there has been a great increase in the prevalence of the disease. In order to eradicate this disease, families, communities, and cultures must share information and assist each other in the battle to healthier, more productive lives.

References

Alder, Nancy; Newman, Katherine. (2002) Socioeconomic disparities in health: Pathways and Policies. Health Affairs. 21. (2). Pp.60.

Boardman, Jason; Saint Onge, Jarron M.; Rogers, Richard G.; Denney, Justin T. (2005) Race Differentials in Obesity: The Impact of Place. Journal of Health and Social Behavior. 46. pp. 229-243.

Ham, Sandra A.; Kruger, Judy; Tudor-Locke, Catrine; (2009) Participation by US Adults in Sports, Exercise, and Recreational Physical Activities. Journal of Physical Activity and Health. (6). pp. 6-14.

Nwasurua, Chiagozie; Osuagwu, Christie; Bae, Sejong; Singh, Karan P.; Egede, Leonard E. (2007). Racial Differences in Diabetes Self- Management and Quality of Care in Texas. Journal of Diabetes and Its Complications. November

Two Feathers, Jacqueline; Kieffer, Edith C.; Palminsano, Gloria; Anderson, Mike; Sinco, Brandy; Janz, Nancy; Heisler, Michele; Spencer, Mike; Guzman, Ricardo; Thompson, Janice; Wisdom, Kimberlydawn; James, Sherman A. (2005) Racial and Ethnic Approaches to Community Health (REACH) Detroit Partnership: Improving Diabetes- Related Outcomes Among African American and Latin Adults. American Journal of Public Health. 95. (9), pp 1552-1560.