Building cultural competency for improved diabetes care: Introduction and Overview

Diabetes affects about 7% of the US population with more than 90% of cases being type 2 diabetes mellitus. In 2005, this translated into nearly 21 million Americans with diabetes. Whereas Americans from all ethnic and cultural groups are affected, minority populations are disproportionately affected. In fact, diabetes prevalence is 2 to 6 times higher among Latino Americans, African Americans, Native Americans (American Indians and Native Alaskans), and Asian Americans than among white Americans. The National Institutes of Health reports that American Indians and Native Alaskans are 2.2 times more likely to have the disease than are non-Hispanic whites. Furthermore, studies using glycosylated hemoglobin (A1C) as a marker have shown that Latino Americans, African Americans, and Asian Americans have poorer control of their diabetes. In a study by Brown and colleagues, mean A1C levels were higher among Latino Americans, African Americans, and Asian Americans/Pacific Islanders than among white Americans.