Major ethnic disparities in diabetes care were evident before the coronavirus pandemic hit, but the situation worsened exponentially as diabetes was discovered to be a major risk factor for severe COVID-19 outcomes. In an article entitled "The Impact of the COVID-19 Pandemic on Ethnic Minority Groups With Diabetes" in Diabetes Care, Eva Feldman, M.D., Ph.D., helped to author an article that looked at this issue.
Overall, ethnic minority populations have suffered disproportionate rates of COVID-19 hospitalization and mortality. Results from the limited number of studies of COVID-19 in ethnic minority populations with diabetes are mixed, but there is some suggestion that rates of hospitalization and mortality are higher than those in white populations. Reasons for the higher incidence and severity of COVID-19-related outcomes in minority ethnic groups are complex and have been shown to be due to differences in comorbid conditions (e.g., diabetes), exposure risk (e.g., overcrowded living conditions or essential worker jobs), and access to treatment (e.g., health insurance status and access to tertiary care medical centers, or higher-level specialized hospital care), which all relate to long-standing structural inequities that vary by ethnicity.
While guidelines and approaches for diabetes self-management and outpatient and inpatient care during the pandemic have been published, few have recommended addressing wider structural issues. As we now plan for the recovery and for improved surveillance and risk factor management, it is imperative that primary and specialist care services urgently address the disproportionate impact the pandemic has had on ethnic minority groups. This should include a focus on the larger structural barriers in society that put ethnic minorities with diabetes at potentially greater risk for poor COVID-19 outcomes.
“As a nation, we have to work systematically to improve quality of life issues that negatively impact the health and well-being especially of racial and ethnic minorities,” said Dr. Feldman. “We know what has to be done – adequate housing, food, education, employment opportunities and neighborhood resources. Those factors have a direct influence on medical outcomes. By prioritizing them, we can create a healthier and more equitable society.”