Authors
Dr. Vasudevan S, Professor, Department of Urology, Medical College, Trivandrum; Associate Editor, Kerala Medical Journal
Abstract
Background: Diabetes is a devastating global disease affecting 415 million people, with significant morbidity, mortality, and economic burden. Despite solutions, disparities in care persist, impacting disease progression and outcomes. This article aims to analyze the reasons for these disparities, their impact, and the role of primary care providers in addressing them. The World Health Organization’s theme “Beat Diabetes” highlights the urgency of intervention.
Overview of Disparities: Healthcare disparities are defined as differences in disease incidence, prevalence, morbidity, mortality, and survival rates within subpopulations compared to the general population. In the US, racial and ethnic minorities exhibit disproportionately higher rates of diabetes and poorer care outcomes, including lower adherence to recommended annual services and higher amputation rates among specific groups.
Factors Contributing to Disparities: Disparities stem from a complex interplay of patient and provider factors. Patient factors include low health literacy, poor numeracy, and non-adherence to treatment. Provider factors involve unintentional biases, the ‘not me phenomenon,’ and differential communication influenced by time pressure, fatigue, or stress. Lack of cultural competency also contributes to these gaps.
Addressing Disparities: Strategies to reduce disparities include assessing patient health literacy, improving patient-centered communication, and providing cross-cultural training for providers. Organizational efforts, such as those by the American Diabetes Association, advocate for health equity through increased research, equitable access to insurance, funding for programs, and legislation to combat discrimination.
Conclusion: Disparities in diabetic care are prevalent despite advances in disease management. Healthcare providers are crucial in eliminating these disparities by understanding and addressing patient-specific factors like health literacy, fostering improved communication, and enhancing cultural competence in their practice.