Diabetes kills more African Americans than other groups in Tulare County. What’s being done?

More African Americans are dying from diabetes in Tulare County than any other group — a death rate that’s so high, some community leaders call it alarming.

The diabetes death rate for blacks in Tulare County is 227.9 deaths for every 100,000 people. That’s compared to 104.2 deaths among whites for every 100,000 residents, and 119 deaths for every 100,000 county residents in general, according to key findings in a Tulare County Department of Public Health report.

California’s rate is 77.9 diabetes deaths for every 100,000 residents among all groups statewide. That means the rate of Tulare County diabetes deaths for African Americans is nearly three times the state average.

Yet, African Americans represent only 1.2% of the overall population in Tulare County, according to data from the county’s demographics. The county’s total population is nearly half a million, according to the U.S. Census.

The health disparities among the African Americans specifically were first made known in the county’s Public Health Branch 2017-22 Strategic Plan.

African Americans in the county were also found to have higher cancer diagnosis than any other group and a higher rate of low birth weight babies. For example, the cancer diagnosis rate for African Americans is 917.8 diagnoses for every 100,000 blacks, compared to 388.3 diagnoses for every 100,000 county residents in general.

Sounding the alarm

Focus groups were formed last year in Tulare County for African Americans, Native Americans and Hispanics to try to identify barriers preventing these groups from seeking care, leading to health inequity.

Crystal Jackson, president for the National Association for the Advancement of Colored People (NAACP) in Tulare and Kings counties, wasn’t aware of the findings.

She was taken aback upon hearing the findings. “That’s an alarming percentage,”she said. “That is cause for concern.”

The county released the focus groups’ findings last month.

African American participants largely blamed unhealthy foods for the significantly high diabetes rates.

Lack of education and transportation to medical appointments, as well as not having access to prescription medication were also common reasons cited by the focus group participants.

Some participants also believe stress from racism plays a role, and there have been past examples of such incidents. For example, black students in Visalia recently alleged facing racial hostility – and the ACLU subsequently filed a complaint on their behalf.

Some of the focus groups’ recommendations to start tackling the diabetes problem among the African American community include determining if intensive intervention can take place in concentrated areas where African Americans reside or gather.

The need to strengthen partnerships with organizations and cultural centers that service the African American community was also suggested.

Another recommendation considered using barber shops and beauty salons to provide education, plus providing outreach through churches.

No concrete action has been taken on any of the recommendations. Tammie Weyker-Adkins, spokeswoman for the Tulare County Health and Human Services Agency, said it will take time to implement the recommendations correctly.

“The concrete steps taken are based in relationship and taken very carefully as we are aware that the best steps towards tearing down barriers are made in concert with the populations experiencing the barriers,” she wrote in an email.

Sharon Minnick, an epidemiologist at the Tulare County Department of Public Health, said higher diabetes rates among African Americans is not unique to Tulare County. “That’s something that’s even seen at the national level,” she said.

Staci Chastain, deputy director at the Tulare County Public Health Department, said there have been ongoing efforts to try to improve access to care overall in the county. “We are going to be bringing this topic to our existing coalitions,” she said.

Alma Torres-Nguyen, a community outreach coordinator for the Kaweah Delta Medical Center, listed a number of existing programs aimed at preventing or managing diabetes in Tulare County.

Torres-Nguyen acknowledged the majority of those efforts target the Hispanic community as they represent a larger percentage of the county’s population. Hispanics make up a 66 percent of Tulare County’s population, according to data of the county’s demographics.

The African American community is also harder to reach as the majority of them are concentrated in the city of Tulare, where there are less health resources compared to other areas. “That’s an area that we definitely need to focus on, and work a little bit more,” she said.

Torres-Nguyen said Adventist Health Tulare, which is the newest hospital in Tulare County, is located in the city of Tulare, and could be a good partner in helping address the diabetes problem among the African American community.

Rebecca Russell, community wellness director at Adventist Health Tulare, said hospital staff understand diabetes is a “major health issue” among African Americans, and the hospital is partnering with the county to address the “very important topic.”

“Because we know that this is something we cannot fix by ourselves, we welcome the opportunity to partner with local agencies and encourage them to reach out to us,” she said via email.

Torres-Nguyen said using barber shops and beauty salons to zero-in into the African American community could be effective. But the model that has been used with the Hispanic population, such as a diabetes project in Lindsay, where various partners work very closely with the community, could also work with African Americans.

“But it takes a lot of resources and time,” she said.

Karen Elliot, director of the Tulare County Department of Public Health, said it will take effort from various entities in the community to work together to reverse the dismal diabetes death statistics among African Americans in the county.

“We are sort of the lead agency to bring everyone together to work toward that outcome that we all want,” she said. “The public health department can never do everything on its own.”

Since a decade ago, ethnic minorities in the Central Valley as a whole, were up to twice more likely to die from diabetes and its complications, compared to whites, an analysis done by The Bee at that time found.

This story was originally published June 5, 2019 at 3:12 PM.