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The latest data from the U.S Department of Health and Human Services Office of Minority Health lays bare a disturbing reality: diabetes is hitting Black Americans harder than any other group in the United States.
Behind these numbers is a story of systemic inequity, biological risks, and an evolving conversation about how best to care for the people most affected.
In 2023, 12.9% of non-Hispanic Black adults were diagnosed with diabetes, compared to just 8.9% of non-Hispanic white adults. Even when adjusted for age, the gap persisted, 11.5% among Black adults, versus 7.2% among white adults.
But diagnosis is only part of the picture. In 2020, Black adults were hospitalized for uncontrolled diabetes nearly four times more often than white adults, 102 vs. 26.8 admissions per 100,000.
The same year, the risk of end-stage kidney disease linked to diabetes was over three times higher in Black adults than in white adults (434.4 vs. 121.1 cases per million). In 2021, Black Americans were 40% more likely to die from diabetes.
The complications continue.
Diabetes-related amputations were more than double among Black adults compared to whites, 71.1 vs. 27.8 per 100,000. Even vision problems caused by diabetes showed a disparity, 28.5% for Black adults compared to 26.3% for whites.
The disparities in diabetes outcomes among Black Americans reflect more than just biology.
Factors such as unequal access to healthcare, cultural barriers, and social inequality contribute significantly, according to the Office of Minority Health data.
What’s causing this?
To understand why Black Americans are more likely to develop type 2 diabetes and suffer more from its effects, a 30-year study led by Dr. Mercedes R. Carnethon at Northwestern University Feinberg School of Medicine examined more than 4,200 participants from Birmingham, Chicago, Minneapolis, and Oakland.
The study, backed by the National Heart, Lung, and Blood Institute, found a major gap in diabetes incidence, especially between Black and white women. While a mix of factors played a role, biological risks like body mass index, waist size, glucose levels, and blood pressure were the biggest contributors.
“Obesity is driving these differences. The findings surprised us because, for the past 20 years, there was a narrative that there must be something we haven’t found that was causing this higher rate. We now know there is no mystery to these higher rates. Our efforts to control the traditional risk factors can work to reduce the disparities we observe in diabetes incidence,” Dr. Carnethon stated.
Social and behavioral factors, such as education, job security, and neighborhood environment, also played a role, but to a lesser extent than the biological indicators. The study emphasized that addressing traditional risk factors like obesity, high blood sugar, and poor nutrition can go a long way in closing the racial gap in diabetes outcomes.
Traditional medicine’s role in the fight against diabetes
Before modern medicine, as we know it existed, traditional medicine was the backbone of healthcare for many communities, including African American and Indigenous populations. These systems of healing focused on balancing the body, mind, and emotions, and today, those traditions still offer wisdom that can be useful in managing chronic diseases like diabetes.
Modern healthcare is increasingly exploring how to integrate traditional healing with Western medicine.
Studies show that blending approaches, carefully balancing medications with natural remedies and lifestyle changes, can improve outcomes in diabetes care.
“The care of a person with diabetes in the modern environment involves a comprehensive, holistic approach focusing not only on the diagnosis and management of hyperglycemia but also on controlling these and other concurrent conditions,” noted the Research Invention Journal of Biological and Applied Sciences on ‘Integrating Traditional and Modern Medicine: A Holistic Approach to Diabetes Care.’
However, combining both approaches require care. Practitioners need to be aware of potential drug interactions, respect cultural preferences and include patients in treatment decisions. The report stresses that whether a patient chooses traditional, modern, or both forms of medicine depends on means, access, habit, and especially culture.
Integration in action: What’s working?
Across the U.S. and Canada, some healthcare systems are proving that traditional and modern medicine can work side by side. On the Wind River Arapaho Reservation in Wyoming and in rural Alberta, integrated diabetes care programs have successfully brought together community healers and clinical doctors.
In these communities, patients are receiving support that respects their culture while also using evidence-based medical practices. Programs include spiritual counseling, herbal treatments, diet modifications, and insulin therapy, combined in a way that reflects the lived experience of each patient.
These cases are being closely studied. As the report points out: “These stories challenge the frequently heard claim that ‘modern’ healthcare practitioners or patients will not accept traditional healthcare models and approaches.”
What makes integration work?
Healthcare providers working in integrative systems recommend open communication between traditional healers and doctors. They also stress the importance of understanding different healing philosophies, educating patients, getting informed consent, and involving interdisciplinary teams, including nutritionists, spiritual leaders, and mental health professionals.
Guidelines also call for ethical practice and ongoing research to make sure integrative treatments are safe and effective.
“It is envisaged that this document will be a valuable guide to healthcare providers who are considering implementing an integrative care approach to their practice,” the recommendations state.
Challenges remain
While promising, integration is not without obstacles. Misinformation, stigma, and lack of regulation in traditional medicine can be barriers. Some practitioners worry about the credibility of traditional healers, while others are concerned about spiritual practices being misrepresented or misunderstood.
Despite these concerns, the desire for integration is growing. Patients, especially those in underserved communities, are asking for care that reflects their beliefs and traditions.
What is the way forward?
Experts believe the next step is research. Long-term studies that follow patients using both systems, traditional and modern, could offer insight into how best to manage diabetes in diverse communities.
There’s also a call to include traditional healers in public health education, develop joint treatment protocols, and use digital tools to improve access. While current studies focus mostly on type 1 diabetes, more data is needed for type 2 diabetes, which affects the majority of Black adults.
“By combining the holistic, culturally rooted practices of traditional medicine with the evidence-based approaches of modern medicine, healthcare systems can provide more comprehensive and patient-centered care,” the report concluded.
Diabetes in the Black community is a public health crisis but it’s also a call to action. The solution is not just about more medicine or better hospitals. It’s about addressing the root causes of inequality, recognizing cultural strengths, and making space for multiple paths to healing.
By: Joshua Narh