Removing barriers, reducing diabetes risk for African Americans in Baltimore

By John Hopkins Medicine and University of Maryland Medical Center According to the Centers for Disease Control and Prevention, diabetes in the U.S. is more prevalent than ever, with Type […]

Removing barriers, reducing diabetes risk for African Americans in Baltimore

By John Hopkins Medicine and University of Maryland Medical Center According to the Centers for Disease Control and Prevention, diabetes in the U.S. is more prevalent than ever, with Type 2 diabetes affecting 90-95 percent of Americans with diabetes. And in the African-American community, its impact is even more pronounced.  In 2018, Black adults were 60 percent more likely to be diagnosed with diabetes and twice as likely to die from the disease.

Over the past several decades, this noticeable disparity has been getting wider. Here in Baltimore, statistics tell a similar story of diabetes being disproportionate in African-American populations. The prevalence and increasing rate of the disease demonstrate that 'better medicine' alone is not the sole answer to preventing, helping people manage, or reducing serious health risks of Type 2 diabetes.

We know that genetics, insulin resistance, and the prevalence of obesity (African American women in the U.S. have the highest rates of obesity or being overweight compared to other groups) are a few contributors to African Americans being at greater risk of Type 2 diabetes and experiencing serious complications from it. In addition, social determinants of health, including socioeconomic status, food apartheid, access to healthcare, physical environment and racism, work to further increase disparities.

By disrupting the cycle of poverty that perpetuates poor diet and obesity, hesitancy to seek professional healthcare, stigma, lack of transportation, and insufficient education, we can remove significant barriers driving our current Type 2 diabetes epidemic. A unique partnership between Johns Hopkins Medicine (JHM) and University of Maryland Medical Center (UMMC) brings two world-class health organizations together to remove the barriers that have created an ever-growing equity gap in diabetes care for African Americans. Through the expansion of the diabetes prevention and management programs, JHM and UMMC are seeking to establish clear, accessible pathways to healthier living in communities where they can be accessed by those most at risk.

Here are a few ways JHM and UMMC are working to close the gap and support Black members of our community in overcoming the challenges of Type 2 diabetes.  Population with increased risk for diabetes A solution lies in supporting populations with specific resources and support that take into consideration their culture, history, and ability to access proper care. Replace myths and stereotypes with facts and understanding Some common misconceptions are that people with Type 2 diabetes 'simply' need to lose weight, lower their sugar intake, and don't have a 'serious' disease. In fact, Type 2 diabetes is a complex disease with many underlying factors.

Left untreated, it can lead to nerve damage, kidney and heart disease, vision loss, and foot and toe amputations. Stereotyping a person with diabetes can be a form of 'shaming' and deter them from getting the care and support they need. This is why JHM and UMMC's work educates people on factors they can control to prevent or manage diabetes, connects them with resources including peer support, and teaches them self-care activities to empower them in managing their disease.

Increasing access to healthy food Having a diet that consistently includes fresh, healthy options and avoids foods that are processed and high in sugar can help a person prevent and manage Type 2 diabetes. Unfortunately, nearly 25 percent of Baltimore residents live in food apartheid and have challenges accessing and affording the right foods. Moreover, across the U.S., one out of every five Black households is located in a food apartheid.

JHM and UMMC are working to implement strategies that make healthy food more affordable and accessible to populations in need.  Increasing timely access to and financial support for quality care A recent community health assessment by the Baltimore City Health Department revealed that nearly 40 percent of residents consider lack of transportation a barrier to care. While agencies work to improve public transportation and make it more affordable, other individuals and groups can bridge the gap by helping people get to medical appointments, screenings, and disease management programs. In addition, with more than 236,000 African Americans in Maryland living below the poverty line, ensuring affordable care is also critical.

This is why JHM and UMMC work to help eligible patients access available financial assistance programs for buying medicine and covering copays. The key is addressing inequities by removing various barriers to healthcare—including lack of transportation, limited education, low access to healthy food, and others—so that, as we teach people how to eat properly, they can easily put that knowledge into action. With these roadblocks cleared, open paths emerge for African Americans and all people, to prevent or successfully manage Type 2 diabetes through a lifestyle that is more convenient and easier than ever.

Johns Hopkins Medicine (JHM) aims to bring together physicians and scientists within the Johns Hopkins University School of Medicine community with the 'organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System,' according to information released by JHM. Johns Hopkins Medicine has six academic and community hospitals, four suburban health care and surgery centers, over 40 patient care locations, a home care group and an international division, and it offers an array of healthcare services.  The University of Maryland Medical Center (UMMC) has two hospital campuses located in the Baltimore area that together offer roughly 1,000 beds for care. Both locations are teaching hospitals that look to improve and deliver care through research and innovation.

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