How health care organizations can address disparities in diabetes care for minorities

Gaps in care among people from disadvantaged or historically oppressed groups have become front and center over the past few years, as minorities within the U.S. continue to be disproportionately affected by certain diseases. Despite diabetes being a protected disability under federal law, the chronic health condition remains one of the top health concerns that plague minorities. Estimates indicate that rates of diabetes are almost 1.5 times higher among minority ethnic groups, while other studies have found medical costs and lost wages of people with diabetes contribute to $327 billion annually, further blocking access to those of lower socioeconomic status.

These disparities in diabetes care for minorities are the result of a combination of limited access to health care services, a lack of affordable medications, cultural and linguistic differences and little educational resources around the health condition. Health care organizations, both providers and suppliers, have the responsibility to understand, address and break down these barriers to ensure underserved populations have access to comprehensive diabetes care for better health outcomes.

Understanding the current challenges limiting access to diabetes care

A prominent barrier that is plaguing minorities from receiving diabetes care is the medical costs associated with the condition. Spending on insulin has tripled in the past 10 years – increasing from $8 billion in 2012 to $22.3 billion in 2022 – with findings showing that Black Americans with diabetes pay the most in direct health expenditures. This increase in costs for minorities with diabetes stems from poor insurance plans. Many practitioners in the U.S. are limited to only serving patients whose insurance covers specific procedures and medicine, and in most minority populations, insurance coverage does not cover all expenses needed to receive care. Access to diabetes-related technology is also disproportionate for minorities, with studies showing that racial disparities in diabetes technology use have actually widened over the last decade. It was found that Black patients with T1 Diabetes are half as likely to receive a continuous glucose monitor despite them having an increased risk of hospitalizations with Diabetic ketoacidosis and hypoglycemia.

In addition to monetary hurdles, the location of minorities and being able to physically access endocrinologists and diabetes specialists in person is also a large challenge. Compared to urban populations, those in rural regions have a 16% higher prevalence of Type 2 diabetes and a 20% higher Type 2 diabetes-related hospital mortality rate. This is resulting from the lack of transportation options available for residents to get to and from doctor appointments in these regions, along with there being a limited concentration of medical practices for diabetes, and most medical care, in these areas to begin with.

It’s important to remember that, unlike other medical conditions, diabetes relies heavily on self-care practices to manage properly. Understanding blood sugar levels, when to see a doctor for exams and check-ups and how different diets and exercise can impact your health are crucial for individuals living with diabetes. Studies show that diabetes education is directly linked to improved self-care practices and outcomes, yet the Centers of Disease Control and Prevention (CDC) found that only half (52%) of American adults with diabetes have received education, also known as the diabetes self-management education and support (DSMES) program. What’s more, the study concluded that participation in diabetes education was lowest among Hispanic or Latino people and people who were living in a rural county, or had less than a high school education.

How health care organizations can improve outcomes for minorities

Health care companies and organizations have the power of influence when it comes to closing gaps in care, regardless of the condition. These companies can push payers and policymakers to expand coverage to include more affordable insurance plans. They can also influence insurance payers to improve coverage criteria, allowing for more health conditions to be covered by insurance at earlier time frames before they become larger issues. Health care organizations also have the power to work with payers on reimbursement rates for procedures and medical devices to ensure patients are able to receive the treatment and products needed for the best health outcome, regardless of their condition.

Looking towards technology to provide a more personalized and integrated approach to health care can also help break down barriers. For providers, offering patients telehealth services so they can speak to their doctors if they cannot meet in-person, creating better operational efficiencies like electronic health records, and having more resources online that discuss where and how to find certain medications and devices can help alleviate many of the gaps that minorities face. From a supplier standpoint, providing home delivery of supplies and resources, along with proactive communication and education around how to use devices properly and ensuring they receive their supplies in a timely manner can also improve health outcomes for minorities with diabetes.

Related: Employees are paying more to manage their diabetes: How employers can help

Health care organizations must also begin understanding the cultural and linguistic differences between different populations, and implement culturally competent care practices that reflect the communities they serve. Taking it a step further, companies can also foster partnerships with local community organizations to better understand the specific limitations that are contributing to the disparities in diabetes care. Failure to learn and engage with minority populations will only result in more barriers and less access to care.

In hindsight, we can expect disparities to continue in diabetes care if barriers to access are left unaddressed. Working with payers and insurance professionals, along with implementing new technology and encouraging education are all practices that health care organizations can pursue to help diabetes patients receive care regardless of location or socioeconomic status. Doctors, health care systems, providers, public health experts and community leaders will all need to work together to create a new model of equitable diabetes care.

Carson Moore, Director of Aeroflow Diabetes