The US population is vulnerable to the highest risk of developing chronic conditions as the government agencies strive for healthcare reforms. These reforms aim to improve and coordinate medical care through innovative arrangements and new insurance coverage. According to Sai Ambati, El-Gayar, and Nawar (2019, p. 12), challenges associated with chronic conditions are managed when government health care agencies oversee social determinants that create disproportionate development of chronic diseases. There exist new clinical interventions that strive to improve and manage chronic conditions such as Type 2 diabetes based on social determinants of health. Housing, nutritious food access, income, and education contribute to health disparities for patients with diabetes condition.
As the government agencies strive to provide interventions to curb health disparities among diabetes, data accuracy and policies are vital. The policies and intervention help in capturing social determinants of health and intersect health practice and principles that promote a link between health care service delivery and social factors (McGill et al., 2019, p. 42). Diabetes, especially Type 2 diabetes, has multi-factorial complexity, and thus additional targeted activities are required to manage and prevent chronic conditions. This paper aims to discuss health outcomes of the Asian race suffering from diabetes in the United States with a reflection on how policies improve public health regarding race, gender, and class.
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Diabetes, a Public health Issue
Type II diabetes is a common condition as ninety-five percent of twenty-five million patients in the United States suffers from the condition, and seventy-nine million individuals estimated to be pre-diabetic. Since 2007, the US government has exhibited an annual increased economic burden of diabetes, spending one hundred and sixteen billion dollars on medical expenditures and fifty-eight billion on low productivity (Moonesinghe, Beckles, Liu & Khoury, 2018, p. 1160). According to Dong et al. (2019, p. 39), the US health care system has had increased cases of diabetes for a long time as the medical expenses for diabetes patients nearly twice as high as those patients with different medical issues. However, minority races and ethnicities are vulnerable to Type 2 diabetes, with 9 percent of Asian race risk high infection.
High increase of diabetes cases are attributed to behavioral influences and biological traits, which are constituents of social factors that have raised public health concern in the United States. Family history, age, use of statins or atypical antipsychotics and testosterone are genetic predispositions established as biological factors like cardiovascular disease, kidney failure, hypertension, stroke and blindness part of comorbid behavioral influences that creates complexity to diabetes treatment (Kinney et al., 2020, p. 20). Thus, diabetes requires government intervention since it is a serious and costly issue as physics diagnose approximately two million new cases annually.
Race and Ethnicity
Valdez & Golash-Boza (2017) state, " ethnicity is a complex multidimensional construct reflecting the confluence of biological factors and geographical origins, culture, economic, political and legal factors, and racism" ( p. 2258 ). Understanding health care disparities require knowledge of the roles of race and ethnicity in society. Disparities in diabetes are defined in terms of a specific ethnic groups or race, where Native American, non-Hispanic black, Hispanic American, non-Hispanic white, and Asian American are part of races or ethnic groups in the US. The ethnic groups, such as Asian and Hispanic populations, are arbitrary with various characteristics ( McGill et al., 2019, p. 48 ). Reflecting on the Asian American race, they have a prevalence rate of 9%, and thus those with diabetes cases in this ethnic group are affected disproportionally compared to other races in the U.S.
The Center for Disease Control and Prevention (CDC) shows that nine percent of Asian origin in the U.S., aged 20 years and above, are diagnosed with diabetes, and this is due to the poor state of life exhibited by minority populations. Asians experience more diabetes-related complications compared to other United States' ethnic groups, thus they are subjected to higher mortality rates. However, the diabetes prevalence rates among Asian Americans differ depending on the countries of origin. For instance, Asian Indians have a 14.2% prevalence rate, while Asian Americans from Japan and Korea have 4.9% and 4% prevalence rates, respectively. The high prevalence rates for diabetes have increased the economic, medical burden as71% of Asian origin diagnosed with high blood pressure, non-traumatic limb amputation, high cholesterol, stroke, cardiovascular disease, and heart attack ( Moonesinghe, Beckles, Liu & Khoury, 2018, p. 1163 ). Thus, race, gender, and status are determinants of how prevalent diabetes is on health due to behavioral and socioeconomic factors.
Social Factors to Diabetes
Minorities live in an inferior environment and exhibit poor access to healthy food, limited social cohesion and increased psychosocial stressors that define poor health outcomes ( Sai Ambati, El-Gayar & Nawar, 2019, p. 20 ). People of Asian origin in the United States are considered minorities since they are vulnerable to problems of accessing health care facilities; thus are subjected to a higher risk of Type two diabetes. They are part of ethnic groups that live in inferior neighborhoods and thus exposed to physical inactivity, smoking, and poor environmental conditions that contribute to the development of diabetes and associated complications.
Social factors to diabetes are divided into two groups, namely biological factors and behavioral influences. Family history, age, use of statins, or atypical antipsychotics and testosterone are genetic predispositions established as biological factors like cardiovascular disease, kidney failure, hypertension, stroke, and blindness part of comorbid behavioral influences that creates complexity to diabetes treatment. Social factors also involve political and cultural drivers. However, there exists a relationship between diabetes risk outcomes and social determinant of health. For instance, an increased risk of diabetes is a result of low socioeconomic status where most people in the United States, especially Asians with less education (high school), are subjected to higher diabetes-related mortality rates (Dong et al., 2019, p. 52). Additionally, it is a challenge for minority groups with less education to manage and control their diabetes as compared to those with higher education.
Government Interventions
The United States government has derived strategies to eliminate and reduce ethnic disparities through quality and improved health care access. However, the strategies have failed to reflect on the impact and roles of social factors as far as ethnic disparities and diabetes treatments are concerned. CDD defines social factors as general status in which people live and work, are born, their age, and surrounding healthcare system ( Fayfman & Haw, 2017, p. 242 ). Thus, any intervention to curb diabetes conditions has to take into consideration socioeconomic status, surrounding environment, psychosocial factors as well as political, economic, and cultural drivers. As per Kinney et al. (2020, p. 26) , there is a framework guideline created by the World Health Organization based on the effect of social factors patients with diabetes. These social factors are shaped by economic, political, and cultural drivers through socioeconomic influence and thus predetermining the state of the psychosocial and biological factors as well as material circumstances.
In the United States, government intervention adopts and implements national policies such as the Healthy people Initiatives to identify, eliminate, and reduce inequalities in health care. Additionally, national policies promote equal health care service delivery to everyone living in the United States. For instance, there is a standardized medical care for diabetes patients established by the American Diabetes Association, especially for ABCs of diabetes. Through US government intervention ABCs for diabetes suggest that all ethnic group access blood pressure freely (BP) <140/90 mmHg, a glycosylated hemoglobin A1C (HbA1c) <7% and low-density lipoprotein cholesterol (LDL-C) <100 mg/dL (2.6mmol/L) ( Grier & Schaller, 2020, p. 33 ). However, it has remained a challenge for minority populations such as Asians who still live under the low poverty index.
There are great disparities in health for minority populations due to fundamental health status and inequalities factors, which impact the determinants of health. However, social policies that intend to shape the health helps individual from minority populations in the United States to mitigate such inequalities ( Jones, Weaver, Panahi & Kamimura, 2018, p. 3 ). The government intervention aims to warrant equitable and comprehensive health policies that improve health care and marginalization of minority populations such as Asians in the United States. The department of Health and Human Services-Office of Minority Health strives to improve the health outcomes for minorities such as Asians through equal health care service delivery. The HHS is a US-based health care organization that ensures all American citizens can afford healthy meals, recieve good education, nutritious food, better health services, affordable and reliable infrastructure, decent and safe housing, clean water, and non-polluted air as well as culturally sensitive health care provision. Through government intervention and effort of HHS, social factors that lead to diabetes are eliminated as minority groups in the United States, such as Asians, can control both biological and behavioral influences defining health determinants ( Fayfman & Haw, 2017, p. 248 ).
Sociologist indicates that the United States' minority groups experience health issues due to their religion, gender, mental health, age, and socioeconomic, among other social factors. Health exclusion leads to health care vulnerabilities; thus, the rates of diseases, chronic conditions, death, and other demographic factors should be taken into consideration to compel the rate of diabetes, which affects the economic state of the United States.
Policy Implications
The government needs to strengthen the health information infrastructure to monitor and measure disparities based on race and class. Despite a policy by the institutes of medicine on eliminating acute illnesses in the U.S., the government should readdress the infrastructure of measuring health conditions since both federal and state levels have failed to do so. For instance, there is limited accuracy, detail, and completeness on the analysis of racial disparities, despite claims from Medicare and Medicaid in the United States ( Jones, Weaver, Panahi & Kamimura, 2018, p. 4 ). The policy has to consider coding socioeconomic status data rather than only recording insurance coverage status.
Policymakers can monitor the effect of policies on health disparities if the US strengthens and improve the measure of data infrastructure regarding race/ethnicity and class/socioeconomic status in the United States. Additionally, prospective institutions should be in place to check and validate the impact of health equity assessment for proper retrospective evaluation. Institutions such as HHS and CDD needs to come up with a program that reduces racial disparities and segregate neighborhoods to harmonize status quo and correct biasness in terms of health care service delivery ( Grier & Schaller, 2020, p. 39 ). There is a health status gap between average White Americans and African Americans, leading to disproportionate health provision and thus require policies that will close this gap.
Health equity with proper assessment ensures that all achievement meets the threshold of racial disparity with minority groups exposed to better living standards rather than being disadvantaged in a status quo. A program that applies to health-sector policy proposals with consumer-driven health plans and health savings accounts stressed as well as social policies on social security reform is ideal as it closes the gap for class and race-based health disparities. However, political, ideological, and historical are challenges that affect how people or governments perceive the race and class with the perception that they are determinants of disparities ( Malika, Arthur & Belliard, 2019, p. 9 ).
Conclusion
The paper discusses health outcomes of the Asian race suffering from diabetes in the United States with a reflection on how the government interventions improve health outcomes in terms of gender, race, and class. Social factors and race/ethnicity challenge patients suffering from diabetes in the nation. Hence, understanding the two aspects can help the government to come up with proper intervention and policies to improve health in general . People of Asian origin in the United States are considered minorities since they are vulnerable to poor access to health care facilities with a high mortality rate and thus subjected to a high risk of Type 2 diabetes. They are among Americans living in inferior neighborhoods and thus exposed to physical inactivity, smoking, and poor environmental conditions that contribute to the development of diabetes and associated complications. Some of the social factors affecting them include f amily history, age, use of statins or atypical antipsychotics and testosterone which are genetic predispositions established as biological factors as well as cardiovascular disease, kidney failure, hypertension, stroke and blindness part of comorbid, which establish behavioral influences that create complexity to diabetes treatment.
Through government intervention with a better understanding of pathways and mechanisms to curb race, gender, and class disparities in the health care system will improve the development of culturally tailored and cost-effective programs for patients with diabetes. Assessment of social factors for health requires skilled health care professionals with clinical care knowhow. Any government intervention with positive impacts on the improvement of minority health has to reflect beyond the traditional view of clinical care by taking into account social and cultural context through health education.
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