Nature or Nurture: Why Do African Americans Have More Type 2 Diabetes?

African Americans are more prone to type 2 diabetes than white Americans: In 2008, the CDC reported that the rate of diagnosed diabetes in African Americans was 11.8 percent, nearly twice that of whites at 6.6 percent. But why? Is it all in their genes? Previous nationwide studies, which may have seemed to support this conclusion, did not account for socioeconomic and environmental differences between African American and white communities. According to a new study, however, when African Americans and whites live in the same community and have comparable incomes, their rates of diabetes are similar.

The “Exploring Health Disparities in Integrated Communities Southwest Baltimore” study was conducted in an integrated urban community where everyone, white and African American alike, had the same socioeconomic status and was exposed to the same environment. There, the prevalence of diabetes was similar between African Americans and whites.

According to the study leader, Thomas LaVeist, PhD, genes are but one factor in the complex web of causes that create type 2 diabetes. To implicate a purely genetic cause in African American rates of type 2 would require not only identifying a gene that only they have, but also proving that this gene is associated with diabetes. In contrast, Dr. LaViest noted in a press release from Johns Hopkins, implicating socioeconomic factors is a lot simpler. “There is overwhelming evidence that behavior, medical care, and the environment are huge drivers of race differences in health,” he said. “It seems more likely that the answer to health disparities will be found among these factors.”

Dr. LaVeist’s research and writing has focused on the social and behavioral factors that explain ethnic differences in health.  His recent report, created with other researchers at the Johns Hopkins Bloomberg School of Public Health, will appear in the October 2009 edition of the Journal of General Internal Medicine.

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Johns Hopkins Bloomberg School of Public Health

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