Hands drawing blood for glucose test

Diabetics use lancets to prick their fingers to get blood to test their glucose levels.

More than 30 million Americans have diabetes, a chronic illness that affects the body’s ability to produce or use insulin and convert food into energy, according to the Centers for Disease Control and Prevention. Its prevalence has tripled in the U.S. over the past two decades and has become the seventh-leading cause of death, as well as the costliest illness in the country.

A 2017 economic report by the American Diabetes Association estimated the disease cost the U.S. $327 billion that year, including $90 billion in reduced productivity. The association estimated it cost Virginia $8.4 billion in 2017.

The chronic illness, which has common and severe complications, including kidney failure, lower-limb amputations and blindness, also affects African-Americans at about twice the rate of white people.

“There is a growing gap in how commonly [chronic illnesses] occur and how bad they get depending on race and socioeconomic status,” said Dr. Steven Woolf, a professor with Virginia Commonwealth University’s Center on Society and Health.

The primary causes are differences in living conditions, including access to healthy food, physical activity, health care and education, Woolf said.

Type 2 diabetes, which is linked to diet and physical activity and accounts for 90 percent of cases, has risen along with trends in obesity since fast food and processed food became more prevalent in the American diet, Woolf added. He said unhealthy food options are often less expensive and more easily available to low-income people and to those working long hours.

“Over the years, we’ve come to a much better understanding of how our abilities are shaped by environment,” Woolf said. “[Health] depends — not only on personal choice — but on whether we have access to healthy options.”

Dr. M. Norman Oliver, the Virginia health commissioner who studied health disparities as a University of Virginia professor, said one of the Virginia Department of Health’s priorities is to address social and environmental inequalities that contribute to poor health in low-income and minority populations. He said local health departments are spearheading efforts to reach out to high-risk communities, but that obesity is still on the rise.

“I believe that we’re not really going to move the needle on these things unless we start doing something about the social conditions that underlie the [health] conditions,” Oliver said.

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