Critic of the paper says ‘health literacy is an even bigger problem’
“Structural racism” contributes to higher Type 2 diabetes rates in black Americans, according to a new paper from Emory University researchers.
The researchers used a framework that “consider[s] the domains of health behaviours and social norms, structural racism, access to high-quality care, economic development, and public awareness.”
“Structural racism play[s] a prominent role at all levels,” of these domains, the scholars wrote in The Lancet.
They list practices such as redlining and predatory lending from decades ago as part of their hypothesis of why black people today have higher rates of Type 2 diabetes than white citizens.
“Past policies, laws, and economies contribute to where people live, their access to sufficient and healthy food, and their access to health-care services,” the research team wrote.
“These factors, stemming largely from structural racism and discrimination, play an important role in driving racial and ethnic inequities in diabetes and diabetes-related complications,” they wrote.
The College Fix reached out twice via email to multiple researchers on the paper. After two weeks and a reminder, Dr. Saria Hassan responded on July 30 and said to “[p]lease discuss this request with our communications manager – Myra Patrick — who is copied on this email. In general an emailed list of questions is not the best way to communicate information.”
Patrick has yet to respond to that email.
The Fix asked for further information about how the team defined structural racism, how discriminatory practices of the 1950s and 1960s contribute to diabetes today, and how proposed “health equity plans” would help, if structural racism and historical factors are the cause of the disparities.
The Fix also asked why the paper used a study from 2006 to 2016, when developments such as the Affordable Care Act in those years might have made health care more accessible.
The academic paper called on healthcare professionals and policy makers to “recognize their role in health disparities both based on historical policy decisions as well as current ones to make necessary policy changes to reduce disparities [in diabetes].”
The former associate dean of the University of Pennsylvania’s medical school and a nephrologist by training criticized the claims of the paper.
“There is no question that the biggest cause of diabetes is obesity, and there is no question that a major component of obesity is diet,” Dr. Stanley Goldfarb, chairman of Do No Harm, told The Fix in a media statement. “If children are fed high sugar-containing foods, leading to childhood obesity, they are most likely to have adult obesity and develop diabetes, hypertension, and other medical issues.”
But, “a major problem in so-called food deserts is customer demand,” Goldfarb told The Fix, referencing a CNBC report. “That is to say that in low-income communities, there is no great demand for fresh produce and other foods that might help combat obesity.”
“Moreover, when stores like Trader Joe’s open in black neighborhoods, there is concern that this is a step towards gentrification and, in some instances, have been forced to close because of protests,” he told The Fix.
“The Lancet paper is just full of references that have nothing to do with the claims made in the paper,” he also said. “Moreover, the confusion of food insecurity with food deserts seems absurd. Either there’s too much food, or there isn’t enough food, but there can’t be both at the same time.”
He said while “healthcare access is a problem…health literacy is an even bigger problem.”
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