Social Assessment
Many studies show that social determinants of health, ethnicity, and race significantly impact the health results for patients with diabetes. Therefore, a good understanding of the mechanisms of these associations or relationships would influence the design of economic and culturally tailored strategies for individuals living with diabetes. The present paper will focus social assessment of African-American people living in South Central Los Angeles which happens to be the seventh-largest Black population among the metropolitan areas of the United States of America. According to the United States Census Bureau, African Americans make up nearly 9.1 percent of total population of Los Angeles, an implication that this population is the smallest of the four major ethnic group in the county ("U.S. Census Bureau QuickFacts selected: Los Angeles County, California", 2017). Additionally, the data from the data from the Los Angeles County Health Survey of 2011 revealed that the prevalence of diabetes among the population of this county has been on the rise from the year 1997 to 2011 with the percentage of adult African-America standing at 9.9 percent has increased from 6.6 percent. However, the prevalence of diabetes among the African Americans was the highest since the report revealed that 12.4 percent of these population had diabetes.
Influence of Social Determinants of Health on Diabetes among African Americans in South Central Los Angeles
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Based on the sentiments expressed by Lucyk and McLaren(2017) social determinants of health are situations in which people are born, age, work and live. Increasingly, these conditions are being renowned for their association with the soaring occurrence of type 2 diabetes among the people of the United States of America plus the opportunities they reveal counter it. Although significant efforts have existed for an unprecedented period to eradicate health disparities, critical gaps remain evident precisely among the African-Americans who continuously suffer unreasonably due to poor health in comparison to another gender, ethnic and racial groups in the United States of America. Programs and research relating to African-Americans health often concentrate on personal health behaviors like increasing doctors’ visits, exercise and diet of the total African American population of the United States of America. However, the present study focused on determining the social determinants of health among the African Americans living in South Central Los Angeles which happens to be seventh-largest Black population among the metropolitan areas of the country. This can be attributed to the fact that African-Americans of South Central Los Angeles are exposed to many environmental and social conditions that have high chances of affecting their health status and make them vulnerable to cardiovascular diseases like diabetes. These social determinants of health include incarceration, racial discrimination, and socioeconomic status.
First, African-Americans of South Central Los Angeles are disproportionately influenced by low socioeconomic status (SES). According to the research by the Public Policy Institute of California (PPIC), 20.2 percent of African Americans living Los Angeles live below the poverty line which is three times the percentage of the white inhabitants in the same region ("Poverty in California - PPIC", 2017). Regarding the yearly median income, African Americans in Los Angeles earn less than 75 percent of the actual figure that their white counterparts earn. Regarding occupation, the study by PPIC revealed in a study that 9.5 percent of African Americans of South Central Los Angeles are not employed in comparison to about 4 percent of their white counterparts. Therefore, due to disproportionately low-income, African American people in this region are mostly located in economically disadvantaged areas with poor living conditions, environmental hazards and tend to live unhealthy lifestyles which make them vulnerable to acquiring diabetes. Similarly, the relationship between poor health and low SES is well documented. The study conducted by Menati, Baghbanian, Asadi-Lari, Moazen, Menati, Sohrabivafa, and Kassani (2017) and Sun, Chen, Johannesson, Kind, and Burström (2016) revealed that the conditions related to low SES result in stress, and it is stress that is the pathway connecting poor health outcomes and low SES.
Second, racial discrimination is another important aspect of life for African Americans in South Central Los Angeles must deal with as a social determinant of health. It is no secret that African Americans of South Central Los Angeles suffer from weighty disparities in the quality of education in comparison to white people. Additionally, Dumas (2013) and Lewis (2012) revealed in a study that blacks have high chances of attending the most segregated schools and it has been argued that schools policies in these schools play significant roles in disproportionate levels of placement among African American people. Additionally, studies also show that there are significant disparities in employment among African Americans and the white people. In the year 2014 and 2016, Mukerjee (2014) and Reed (2016) in their studies revealed that African Americans were less than half as likely to be considered by employers relative to the white people. At the same time, studies show that racial discrimination causes adverse health outcomes. Therefore, stress inherent in being part of a race-conscious community disadvantages and stigmatizes African Americans and lead to excessive mortality, morbidity and psychological deterioration among the African Americans.
Additionally, Incarceration is another social determinant of health for the majority of African Americans of South Central Los Angeles. Therefore, controlled access to SES and discrimination related to employment and education can leave the majority of African Americans with limited life options which makes them engage in crime leading to their arrests. In reality, evidence exists showing a relationship between health status and incarceration. As aforementioned, stress leads to the poor health status of people and considering that prisons are high-stress environments, it there follows that they have high chances of influencing the health situation of those imprisoned.
Epidemiologic Assessment
Demographic and Epidemiological Background
The 1990 and 2000 census of the United States of America showed that the non-Hispanic white people were emerging as the minority group in Los Angeles. Nevertheless, the census of 2010 in the United States of America showed that Latinos were approximately half of the entire population of Los Angeles growing for only 40 percent as per the census of the year 2000. Additionally, the cultural, ethnic and racial composition of Los Angeles with reference to 2005 to 2009 American community showed that Native Americans were 0.5 percent, African Americans standing at 9.8 percent. Additionally, the data indicate that Asian population stood at 10.7 percent, Non-Hispanic Whites being 29.4 percent, Hispanic standing at 47.5 percent, Native Hawaiian being 0.2 percent and other races being 25. 2 percent ("U.S. Census Bureau QuickFacts selected: Los Angeles County, California", 2017).
The 2011 study by the Los Angele County Health Survey revealed that prevalence of diabetes among the people of Los Angeles County has been on the rise since 1997 to the year 2011 with more than 685,000 people currently living with diabetes. Furthermore, the research revealed that the prevalence of diabetes in this region was highest among African Americans (12.4 percent) and Latinos (13.5 percent), but the white people has the lowest prevalence rate of diabetes with a mere 6.7 percent. Furthermore, the study by Los Angeles County Health Survey showed that the prevalence of diabetes among people living below the poverty line stood at 14 percent in comparison to 7.9 percent of people living at or above the poverty line ("LA County Public Health - Health Assessment - Home", 2011) . Again, according to the study, the prevalence of diabetes is higher among African American men (10.8 percent) than African American women (9.1 percent) ("LA County Public Health - Health Assessment - Home", 2011) . It is important to note that prevalence of diabetes is higher in the adult population of the people living in Los Angeles among who one in four people report to having being diagnosed with diabetes and the prevalence of diabetes was also observed among all income groups.
References
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Lewis, V. A. (2012). Social Energy and Racial Segregation in the University Context*. Social Science Quarterly (Wiley-Blackwell) , 93 (1), 270-290. doi:10.1111/j.1540-6237.2011.00548.x
Lucyk, K., & McLaren, L. (2017). Taking stock of the social determinants of health: A scoping review. Plos ONE , 12 (5), 1-24. doi:10.1371/journal.pone.0177306
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Mukerjee, S. (2014). Job Satisfaction in the United States: Are Blacks Still More Satisfied?. Review Of Black Political Economy , 41 (1), 61-81. doi:10.1007/s12114-013-9174-6
Poverty in California - PPIC . (2017). PPIC . Retrieved 18 September 2017, from http://www.ppic.org/publication/poverty-in-california/
Reed, A. (2016). The Black-Labor-Left Alliance in the Neoliberal Age. New Labor Forum (Sage Publications Inc.) , 25 (2), 28-34. doi:10.1177/1095796016639281
Sun, S., Chen, J., Johannesson, M., Kind, P., & Burström, K. (2016). Subjective Well-Being and Its Association with Subjective Health Status, Age, Sex, Region, and Socioeconomic Characteristics in a Chinese Population Study. Journal Of Happiness Studies , 17 (2), 833-873. doi:10.1007/s10902-014-9611-7
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