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Vital Signs

D is for Diabetes--and Disparities

Diabetes is the focus of another recently released major study on the health status of women in the United States. But while its topic is more specific than that of the wide-ranging Women’s Health Data Book, the underlying message is the same: Women of color are hit harder by this potentially deadly disease than their white counterparts but are less likely to have access to high-quality diabetes care.

According to Diabetes & Women’s Health Across the Life Stages: A Public Health Perspective, a monograph published by the diabetes program at the Centers for Disease Control and Prevention (CDC), more than half (8.1 million) of the 15.7 million people with diabetes in this country are women. However, the prevalence of type 2 (adult-onset) diabetes is at least two to four times higher among black, Hispanic, American Indian and Asian/Pacific Islander women than among white women.

The 200-page publication examines the impact of diabetes on the lives of white and minority women across four different stages of their life cycles: the adolescent years (10-17), the reproductive years (18-44), the middle years (45-64) and the elder years (65 and over). Here are some of the key findings relating to women of color in each age group:

• Although 92% of girls younger than 20 who have type 1 (juvenile-onset) diabetes are white, the incidence of type 2 diabetes appears to be increasing among both girls and boys, particularly in some racial and ethnic minority groups.
• In the reproductive years, American Indian women have considerably higher rates of gestational diabetes than the national average.
• By middle age, type 2 diabetes is at least twice as common among women of color than among white women. For women aged 50-59 years, the prevalence is 24% for Mexican Americans, 23% for African Americans and 9.7% for whites.
• Seventy percent of Pima Indian women aged 45-64 have diabetes. So do 41% of Navajo women in this same age group.
• Elderly black women have twice the rate of death from diabetes as their white counterparts, and elderly Mexican American women have almost four times the rate.

The Diabetes & Women’s Health study does more than just present exhaustive data about women’s diabetes risk factors, prevalence and death rates, complications risks and the gap in health outcomes between white women and women of color. It also discusses the public health implications of these statistics and offers recommendations in the areas of assessment, research, policy development and improved delivery of diabetes care services.

“The monograph has become much more than a ‘report’ by CDC,” explains Frank Vinicor, MD, MPH, director of the agency’s diabetes program. “We (at CDC), along with many partners, have the opportunity to convert the ideas in this monograph into concrete action. . . In the next 12 months, CDC and its primary cosponsors, the American Diabetes Association, the Association of State and Territorial Health Officials and the American Public Health Association, will convene a national call-to-action meeting to develop and then implement the National Public Health Action Plan for Diabetes and Women.”

For more information, or to order copies of the book, contact the CDC at (877) CDC-DIAB (232-3422), email diabetes@cdc.gov, or visit www.cdc.gov/diabetes.