There has been increased prevalence of Diabetes among African Americans 18 years and older in the United States between 2002 -2010. There are a variety of key determinants that factor into this diabetes epidemic on many levels. Biological determinants include race, gender, physical activity, and previous health-related problems such as obesity and hypertension. Social and Cultural factors are things such as ethnicity, socioeconomic status, group norms (soul food, curvy women), daily lifestyle habits (working multiple jobs, not enough time to cook), education (being aware of healthier options), media influence, and social support. In addition to these are environmental determinants such as the distance to grocery stores, access to gyms, and quality of neighborhoods. Economic factors include the price of foods, medication costs, and employment status. There are also political determinants such as access to healthcare/quality of healthcare and even medication costs.
To analyze these determinants and see how much they contributed to the development of diabetes, many studies were done. The Food, Identity, and African-American Women With Type 2 Diabetes: An Anthropological Perspective analyzed the importance of food in African American culture and relationships, predominantly among women. They found that food was sort of a way to welcome others, and to show gratitude those who the food was given too felt they had to eat plenty. One interviewee stated that, “The old people that I work around, they show me they love me and really care for me, they feed me. They feed me a lot. They feed me like five times a day, not thinking, well, this child needs a balanced nutrition meal so he won’t get fat.” Other research was done on another basis as noted in Social determinants of health among African Americans in a rural community in the Deep South: an ecological exploration. Researchers interviewed African Americans in a systematic way which included questions from several different categories of ecological levels such as individual, relational, and environmental. As a result of these interview responses, they put together possible determinants of health. This included lack of social capital, political cronyism, poverty, racism, and local economy. Although this study does not particularly identify diabetes determinants, they can also be applied to this disease. Another study, Healthy Eating and Exercising to Reduce Diabetes: Exploring the Potential of Social Determinants of Health Frameworks Within the Context of Community-Based Participatory Diabetes Prevention, focused on diabetes in the population of African Americans in Detroit, Michigan. Something they found was that the city had a higher rate of mortality from the disease than the state itself, (note: Detroit is predominantly African American). They also identified that African American women were the least active and the most overweight among many groups and bridged a link between this and the development of type 2 diabetes. The researchers suggest that race-based residential segregation is one of the overarching issues that have a trickling effect down to the health disparities seen in the US.
There are many key determinants that contribute to the prevalence of diabetes among the African American community. I intend to identify those that relate to my problem definition through more research.
Liburd, Leandris C. "Diabetes Spectrum." Food, Identity, and African-American Women With Type 2 Diabetes: An Anthropological Perspective. American Diabetes Association, n.d. Web. 01 Apr. 2013.
Scott AJ, Wilson RF. Social determinants of health among African Americans in a rural community in the Deep South: an ecological exploration. Rural and Remote Health 11: 1634. (Online) 2011.
Schulz, Amy J., Shannon Zenk, and Angela Odoms-Young. "Healthy Eating and Exercising to Reduce Diabetes: Exploring the Potential of Social Determinants of Health Frameworks Within the Context of Community-Based Participatory Diabetes Prevention." PMC. American Journal of Public Health, Apr. 2005. Web. 01 Apr. 2013.