Underutilization of Preventive Diabetes Care Among the Poor: Barriers and Consequences

Abstract

This paper focuses on type 2 diabetes amongst low-income individuals and families and their underutilization of preventive diabetes care, which includes both measures to prevent diabetes and to prevent a diagnosed individual from becoming insulin-dependent. I provide not only data about the higher incidence of type 2 diabetes in low-income families, but also data about the lack of resilience among low-income persons once they are diagnosed. Moreover, I discuss both the monetary and functional cost to individuals and society as the result of diabetes. I analyze the plausible causes of the lack of preventive care among low-income individuals by examining the interplay between personal responsibility and the social determinants of health and lifestyle. I also discuss the extent to which institutions are responsible for this preventive care. Furthermore, I examine current access to preventive services and offer policy recommendations in order to improve the quality of effective and accessible care for impoverished pre-diabetics and diabetics. I also offer policy recommendations to increase support of programs that seek to combat educational and cultural factors that encourage the habits that cause early onset diabetes. I use anecdotes and observations gained from my health-related volunteer experiences in Lexington, Virginia in order to provide realistic examples related to the literature and research cited to convey psychological, physical, social, and financial barriers to preventive health care among impoverished community members. [From Introduction]