Black people face a higher risk of death from diabetes than white people or any other racial group in every single one of the 30 largest cities in the United States, according to a new study published in the journal Diabetes Research and Clinical Practice.
The researchers used a variety of data sources to compare the burden of diabetes, including deaths related to the condition, in the 30 largest U.S. cities. The main outcomes they were interested in were overall deaths from diabetes, as well as the difference in this death rate between Black and white Americans. These two outcomes were given the simplified terms “mortality” and “inequity,” and each of the 30 cities was ranked based on them.
As noted in a press release on the study from DePaul University, mortality due to diabetes ranged widely across the 30 cities, with more than twice the rate of diabetes-related deaths in some cities than in others. San Francisco had the lowest rate of diabetes-related deaths (about 13 per 100,000 people), while El Paso had the highest rate (about 36 per 100,000 people). Overall, 22 of the 30 cities had a higher diabetes mortality rate than the U.S. average of about 21 deaths per 100,000 people.
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Diabetes mortality and inequity linked to race
When it came to inequity, the greatest disparity in diabetes mortality between Black and white residents was seen in Washington, DC, where Black people were almost seven times as likely to die of diabetes-related causes. The level of inequity was seen to be growing over several years in Chicago, Los Angeles and Oklahoma City, while the gap between Black and white residents was shrinking in Louisville and Phoenix.
The researchers also plotted the results of each city for both mortality and inequity on a graph, showing whether they had high or low results for each outcome and how they compared with each other. Only three cities had low levels of both mortality and inequity — Boston, Dallas and Denver. In contrast, 13 cities had high levels of both mortality and inequity — Fort Worth, Houston, Indianapolis, Jacksonville, Las Vegas, Los Angeles, Memphis, Nashville, Oklahoma City, Phoenix, Portland, San Antonio and San Jose.
Study author Joanna Buscemi, PhD, an assistant professor of psychology at DePaul, explained in the press release that there are most likely a variety of factors that explain the racial gap in diabetes-related deaths, from access to affordable insulin to social determinants of health like access to nutritious food and safe spaces to exercise. This means that to close the racial gap in diabetes-related deaths — as well as to lower the overall rate of these deaths — a variety of policies could be helpful, from capping the cost of insulin to making healthcare more affordable and designing cities with more outdoor recreational spaces.
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