Content area
Full text
Abstract: Diabetes is the fourth leading cause of death among African American women. One in four black women (23.4 percent) older than age 55 has diabetes. In evaluating the experience of black women with diabetes, an understanding of their social context is essential. Resulting from historical and sociocultural factors, black women have relatively lower income and education levels and consequently, poorer health and restricted access to quality health care. In a sense, being black, female, elderly, and chronically ill places this group in quadruple jeopardy. Tackling the problem of diabetes among African American women is a public health priority and requires a multilevel approach.
Key words: Diabetes, obesity, African American, women, elderly, sociocultural factors.
In the past decade there has been a growing recognition of the health disparities between older black women and their white counterparts. Diabetes, which was relatively uncommon at the turn of the century, is now the fourth leading cause of death among African American women.' The rate is almost epidemic-one in four black women (23.4 percent) older than age 55 has diabetes; this is double the rate among white women.2 Furthermore, between 1980 and 1987, diabetes increased by 24 percent among black women, resulting primarily from the doubling of diagnosed diabetes cases in the 75 years and older age-group. Compared with white women, black women have a higher prevalence of risk factors for diabetes including obesity, hypertension, and family history of diabetes. Complications of the illness (blindness, amputation, end-stage renal disease, and heart disease) are also more prevalent among African Americans.2
Despite these observations, little attention has been paid to the social, cultural, and economic factors that both increase the risk for the illness and exacerbate its management. Resulting from historical and sociocultural factors, black women have relatively lower income and education levels and, consequently, poorer health status. Elderly black women with diabetes are at particular risk because both the prevalence and the complications of the illness increase with the duration of the illness. Furthermore, black women live longer than black men, which results in problems relating to social isolation and the absence of a primary caregiver.4 In a sense, being black, female, elderly, and chronically ill puts this group in quadruple jeopardy.
Evaluating the experience of black women with...