For centuries, immigrants have sought refuge in America for its bountiful promise of freedom; whether that be in a political, economical, or social sense. America’s vibrant ethnic diversity has always appealed to those searching for a niche within the Western world. Of the various migrant groups, Caribbean immigrants have a distinguished legacy in the States. Although America is widely regarded as the “Land of Opportunity,” being a foreigner is latent with stigmas and adversity in its own right. While the Caribbean Diaspora faces a plethora of issues, Diabetes Mellitus poses an urgent threat to this transnational community.

 

Image of a diabetic patient testing their blood glucose levels via blood gauge.

Diabetes is a chronic disease that has serious implications on an individual’s health and wellness. In recent years, the prevalence of this non-communicable disease has drastically increased. In 2014, it was estimated that 422 million adults were diagnosed worldwide. If mismanaged, elevated levels of blood sugar cause by this disease over time lead to hypertension, obesity, heart disease, kidney disease, blindness, amputations, amongst other health related problems. Diabetes can be classified into two categories: type 1 and 2. Type 1 ensues when the pancreas does not produce enough insulin, meanwhile type 2 characterizes the body’s ineffective use of insulin. Type 1, also known as Juvenile diabetes, is caused by a unpreventable hereditary disposition and accounts for a small percentage worldwide. Unlike type 1, type 2 is preventable and is a product of an unbalanced diet, sedentary lifestyle, as well as a genetic predisposition. Type 2 diabetes accounts for 90 % of all cases, and is therefore the root of the diabetic epidemic. For islands such as Barbados, St. Kitts and Nevis, Montserrat, Dominica, and Jamaica diabetes is one of the leading causes of death. For instance, in Trinidad, Tobago, and the British Virgin Islands, at least 14 % of the population is living with diabetes. Similarly, in Dominica, one out of every five persons in a clinic suffers from diabetes. Diabetes has not only seriously affected native Caribbean populations, but also those in the States. “Island of Flatbush,” is recognized as the “largest concentration of West Indian people anywhere in the United States that is outside the Caribbean.” According to NCCHE, a community-base health organization, this Caribbean community in Brooklyn is one such population that is heavily affected by the onset of diabetes. Over time the mistreatment of this chronic illness can provoke serious detriments in a population.

Dr. David Johnson, chief medical officer of Dominica, spreading diabetic awareness.

Diabetes is a major public health challenge for the Caribbean community at home and abroad in the twenty-first century. It is no surprise that health disparities in different neighborhoods, rapid urbanization, and various genetic dispositions (that vary with ethnic origins) are huge factors in the diabetic epidemic. Those afflicted with diabetes have medical expenses 2.3 times greater than non-diabetics. According to the American Diabetes Association, “70% of the cost of diabetes is due to the mismanagement and non-compliance of the patient.” A recent paper on diabetes and hypertension in Jamaica and Trinidad and Tobago found that the annual cost of diabetes in 2001 was 221 million and 467 million USD, respectively. This in turn translates to 2.66% and 5.21% of the national GDP in these respective countries. For lower income individuals 48% of their income goes to the treatment of diabetes which takes money away from the local economy. More and more people are dying premature deaths as a result of being unable to afford expensive blood testing strips or insulin. Those who mismanage the disease are not able to garner economic mobility, as their money is being used in treatment. With great urgency, Caribbean diasporic media depicts the harrowing conditions that surround this chronic disease.  

Diabetes is treated as an imperative issue in Caribbean media. Headlines in online Caribbean news outlets refer to diabetes as a persistent crisis. News outlets such as Dominica News Online, St.Lucia Star, Caribbean News Now, and Caribbean Life News, have given me great insight on transnational relations. They all call for action within their respective communities. Headlines that address the diabetes epidemic include rhetoric such as “Experts call for stronger, more resilient health systems to mitigate future health crises,” “Prevention urged to reduce diabetes and associated blindness,” and “ Caribbean Diabetes Is Not News!” all of which echo the outrage and urgency over this pandemic. In some articles diabetes is referred to as “a national security crisis.” Oftentimes, articles refer to the idea that the Caribbean population need to “wage warfare against (diabetes).” The health minister of Barbados, John Boyce, even voiced his concern over the “widespread unregulated advertising and marketing” of unhealthy foods to children. To counter this sort of destructive media, the ministry of health is working with partners in information technology to combat obesity in younger generations. Caribbean news outlets demonstrate severity of the situation through the public outcry for health reform. These online platforms of diasporic media make it feasible to reach a large audience of Caribbeans, at home and abroad. Better still, this the diabetic crisis is not one solely faced by Caribbean migrants.


All immigrant groups are drastically influenced by American gastronomy. It can be said that American diet is notoriously malnutritious in comparison with traditional lifestyles. In fact, over the last fifty years, the American obesity has tripled, and diabetes has increased sevenfold. A growing body of mortality research shows that the longer immigrants live in America, the worse their risk of heart disease, high blood pressure, and diabetes. Typically, migrant children end up losing taste for healthier traditional foods and acclimate to processed American foods. Generally, an immigrant’s health declines as they adopt American behaviors such as smoking, drinking, high-calories diets and sedentary lifestyle. Hispanic and Asian migrant groups are not exempt from the grasp of diabetes. For example, in the immigrant Hispanic population, nearly twice as many Hispanic adults as non-Hispanic white adults have diabetes. Later generation immigrants of Hispanic background in the US have a diabetes rate of 12.8% while the overall US prevalence is 9.3%. Likewise, the rate of diabetes is almost 3 times higher for Asian Americans living in New York City. South Asian immigrants are 7 times more likely to have type 2 diabetes than the general population. On a grand scale the movement from a homeland to America with its abundance of fast food and drastically different gastronomy and seemingly prevalent sedentary lifestyle lends itself to foster this diabetic epidemic.

Although these statistics and facts are seemingly bleak, there has been a large push for healthcare reform in the Caribbean community to combat the prevalence of diabetes. In St. Lucia, the Tenacia Global Initiative made piloted a project set to attack the diabetes epidemic in the Caribbean. Similarly, Jamaica’s health minister, Dr. Christopher Tufton says the Caribbean island is implementing a 10 year strategic plan to “improve health and attain its vision of health and stable population.” The plan calls for improvements in the health service delivery, the health workforce, and health information and governance. Likewise, the Montserrat Diabetes Association introduced a diabetic self management course. This 4 month course strives to improve the knowledge and coping skills of diabetics, to strengthen daily self management skills, and to use a team approach in diabetes management. Even here in the States, Caribbean diaspora populations have taken precautions to fight diabetes. Guyanese community leader, John Williams, who spearheaded the initiated the “New Creation Community Health Empowerment Corporation,” launched the “Island of Flatbush Diabetes Task Force.” This task force is comprised of 300 churches, Islamic centers, community centers and community-based organizations who work to provide direct resources and educational information on the disease. Their ultimate goal is to reduce diabetes by 20 % by year 2020.” According to Caribbean governments, “the response to the very real threat of diabetes must be a coordinated effort both at the individual ‘high risk’ level and population level. It is this fierce initiative of the diasporic community that fuels the present efforts for diabetic education and treatment.

In spite of America’s limitless promises, migrant groups endure many tribulations in their journey. One of the most destructive challenges facing the Caribbean diaspora movement today is Diabetes. The prevalence of this chronic illness is a pressing issue in native as well as migrant communities. The stigma, misinformation, and ignorance that surrounds diabetes inhibits the effective change needed to combat it. In recent times, however, diasporic media outlets have addressed this public health emergency. The Caribbean diasporic community has made great strides to confront this growing epidemic and will hopefully see improvement in the near future.

Sources:

  1. http://www.caribbeanlifenews.com/stories/2016/12/2016-12-23-nk-diabetes-task-force-cl.html
  2. http://www.caribbeanlifenews.com/stories/2016/12/2016-12-02-nk-flatbush-diabetes-expo-cl.html
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  4. http://www.caribbeanlifenews.com/stories/2016/11/2016-11-18-nk-prevent-diabetes-blindness-cl.html
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  6. http://www.caribbeanlifenews.com/stories/2016/10/2016-10-14-azad-roundup-cl.html
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  14. http://dominicanewsonline.com/news/homepage/news/health/dominica-records-high-rates-of-hypertension-obesity-and-diabetes/
  15. http://jamaica-gleaner.com/article/health/20160406/diabetes-killer-can-be-stopped
  16. http://www.trinidadexpress.com/20151115/news/swrha-head-14-per-cent-of-citizens-have-diabetes
  17. https://www.nytimes.com/2017/01/25/opinion/if-sugar-is-harmless-prove-it.html
  18. http://www.migrationpolicy.org/article/caribbean-immigrants-united-states
  19. http://www.ghjournal.org/immigrant-health-and-the-intersection-of-type-2-diabetes-and-non-endemic-infectious-diseases-in-the-united-states/
  20. http://www.med.nyu.edu/asian-health/research/dream/diabetes-and-south-asian-communities
  21. http://www.nytimes.com/2013/05/19/health/the-health-toll-of-immigration.html