Time to Bridge the Gap, Demand Diabetes Care Equity

Access to breakthrough tech remains out of reach for many who stand to benefit most. Something has to change.

DIABETES CARE|Jan.19, 2021

Tracey D. Brown, who lives with type 2 diabetes, is CEO of the American Diabetes Association, the nation's largest voluntary health organization and a global authority on diabetes. Jared Watkin is Senior Vice President, Diabetes Care, at Abbott, a leading global health technology company. Their op-ed, republished here, originally appeared in the Boston Herald.

The United States is the world's largest engine for healthcare innovation. We generate nearly 60% of the world's new medicines, undertake roughly half of the world's medical research and development, and boast the largest medical device market of any country on Earth.

Despite that, many Americans can't get access to these advances. Low-income Americans and people of color of all incomes lag far behind white and wealthier Americans when it comes to access to medical technology and the latest innovations.

In America's historically underserved communities, barriers to basic medical care are high. Low-income Americans and people of color are more likely to live in areas with fewer hospitals. They often must travel further to see a doctor — something that can make regular care more challenging for those without transportation or the time off from work they need.

In the diabetes community, these health disparities are laid bare. Diabetes rates are inversely related to income. Americans of color are nearly twice as likely to be diagnosed with diabetes and other related chronic diseases as white Americans.

Because of the way diabetes disproportionately impacts those with the fewest resources, the condition is a bellwether for how the structural inequities that exist in our health care system manifest in poorer outcomes for so many vulnerable communities.

COVID-19 has vastly exacerbated this reality. Before the pandemic, people with diabetes in the U.S. spent two and a half times more on health care than those without the condition. With the unemployment rate for the diabetes community at one and a half times the national rate and a staggering 50% of Americans with diabetes having lost some or all income in the pandemic's wake, it's little wonder why one in four Americans with diabetes have turned to rationing insulin or other needed medications and supplies to afford their care during this unprecedented public health and economic crisis.

Technologies like insulin pumps and continuous glucose monitors have transformed the diabetes management landscape, making the condition easier to live and thrive with than ever before. But access to these breakthrough technologies remains out of reach for many of those who stand to benefit most.

Much like other medical advances, access to diabetes technologies often depends on your ZIP code, income bracket or skin color. Black children with type 1 diabetes are almost four times less likely to be using an insulin pump than their white peers. Considering all factors, it should come as no surprise that Black Americans die of diabetes at double the rate of white Americans.

Something has to change. That's why the American Diabetes Association recently launched Health Equity Now, a campaign to ensure that all people living with diabetes — and the millions of minority, low-income and medically underserved Americans at disproportionate risk — have access to these life-altering medical innovations.

Under that powerful umbrella, Abbott and other like-minded companies will be supporting the ADA's advocacy and community-driven initiatives to tear down barriers to care and medical technologies and therapies that seem to elude those Americans with fewer resources. This includes championing policy changes that address gaps in health equity and expand access to affordable technologies as well as building sustained community engagement through local programs to help improve diabetes-related health outcomes.

Abbott partners with organizations like the ADA to solve rising health challenges and is working to incorporate greater affordability into its health technologies from the start, to get them to as many people as possible who need them.

Together, we're urging other innovators, health advocacy groups and community leaders to join us to tackle health disparities through shifts in federal and state policies and the development of community programs to advance health equity for all people with diabetes in America today.

Ensuring that care and the latest advances in diabetes technology are widely accessible and affordable, regardless of circumstance, is a great first step, and we're proud to be building on that work today.