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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.

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