Why 7 Deadly Diseases Strike Blacks Most
Health care disparities heighten disease differences between African-Americans and white Americans.
The Forgotten Killer
There is, indeed, evidence that African-Americans may have a genetic
susceptibility to diabetes. Even so, Nelson says, the real problem is
empowering patients to keep their diabetes under control.
"Patients often have the sense that they are not as much in charge of
managing their diabetes as their doctor," Nelson says. "Where I work,
in various settings, there is an emphasis on patients. We say this is what your
blood sugar is; this is what influences your blood sugar; you have to remember
to take your meds. So as a diabetes educator I know there has to be an emphasis
on patients putting out more effort to manage their own health."
It's easy to say people with diabetes should learn how to control their
disease. But the tools for this kind of self-empowerment often aren't available
in black neighborhoods, says Elizabeth D. Carlson, DSN, RN, MPH. Carlson, a
postdoctoral fellow in the division of cancer prevention and education at the
University of Texas M. D. Anderson Cancer Center in Houston, studies the social
determinants of health.
"I go to this black neighborhood 20 minutes from my house in a white
neighborhood, and the health education they get in school is much worse than
the health education my kids get," Carlson tells WebMD. "It is not just
formal education, but everyday things. It's being afraid to go out and exercise
because you live in a high-crime neighborhood. It's not having transportation
to your health care provider. It's not having decent fresh fruits and
vegetables in the local grocery."
Black Americans and Sickle Cell Anemia
It's no surprise that sickle cell anemia affects African-Americans far more
than it does white Americans.
This, clearly, is a genetic disease that has little to do with the
environment. Yet even here -- with a killer disease -- social and political
issues come into play.
Graham notes that the cause of sickle cell anemia has been known since the
1950s. But for many generations, he says, sickle cell anemia has not had the
funding and research attention it deserves.
"If you look at the time and attention devoted to sickle cell anemia, it
pales when compared to cystic fibrosis and other genetic diseases," Graham
says. "There are actually more Americans with sickle cell disease than with
cystic fibrosis -- 65,000 to 80,000 versus 35,000 to 40,000 -- but the amount
of money spent on cystic fibrosis research outstrips sickle cell anemia by many
fold. This is a shame on the medical research arm of our nation."
To its credit, Graham says, the National Institutes of Health is changing
this situation. One reason for this change -- as research into lung disease,
heart disease, and diabetes shows -- is the growing realization that the health
of black Americans isn't a racial issue but a human issue.