Tracey D. Brown, CEO of the ADA, on how the pandemic has worsened inequities in our health system
Diabetes is a rising epidemic in American society: More than 122 million Americans are living with diabetes or prediabetes. Maintaining the disease requires consistent checkups, a balance of healthy nutrition, daily physical activity; add Covid-19 into the mix and you have another layer of tailored care. Per one study, in the U.S., diabetes was noted as an underlying condition in four out of 10 Covid-19 deaths.
Enter Tracey D. Brown, the CEO of the American Diabetes Association, the leading global authority on diabetes. “What the Covid-19 pandemic has done is just really shine a bright light on an old, existing problem,” Brown told us. Below, Brown elaborates on the risks diabetes poses right now, the stark inequities in our health care system exposed by the pandemic, and the resources the American Diabetes Association® (ADA) and Walmart have to help out those in need.
What are the risks of having diabetes in the time of Covid-19? And how can people mitigate those risks?
I, myself, have been living with diabetes for 17 years. I want to make sure people know that diabetes has nothing to do with your risk factor of getting infected with Covid-19. It’s that if you do get infected, your risk factors increase. When you look at the data, people with underlying conditions, like diabetes are six more times likely to be hospitalized, and 12 times more likely to die than other people with no underlying conditions. So, people with diabetes need to be extremely cautious and do everything within their power not to get infected. That means, adhering to the guidelines set by the CDC. We need to all wear masks, socially and physically distance, and make sure we’re washing our hands. I tell people, if they have to go into work because they cannot work from home, just be safe and follow the precautions. I also urge people to manage their stress, their sleeping habits, and their food and drink intake, because all of those things affect your blood sugar.
The pandemic has truly altered life as we know it. With mass unemployment, how has the pandemic worsened any inequality that already existed pre-Covid-19?
Even before this, the financial burden on people living with diabetes was high. A person living with diabetes has medical expense costs that are about two and a half times those who don’t. When you look at what has happened with Covid-19 and the number of people who have lost their jobs, you see that unemployment has also disproportionately affected people with diabetes: They are unemployed at a rate that’s 50% higher than the national average.
When you are unemployed, in addition to the financial burden, you’ve also likely lost your health insurance. When you’ve lost your health insurance, your ability to pay for your diabetes prescription drugs — whether it’s insulin or oral medications, your supplies, whether that’s insulin pumps, or your ability to get quality routine checks, getting your feet checked, getting your eyes checked — all of this becomes complicated. When you stop doing those things, that is when your risk for complications increases.
What populations with diabetes have been hit the hardest by these burdens?
You see a high number of people of color being affected by the burdens of this pandemic and diabetes. Not only has Covid-19 has shined a bright light on the preexisting problem of diabetes, but it has spotlighted the social and racial unrest that erupted around the murders of George Floyd and Breonna Taylor, and the health inequities that exist in this country. Groups lack access to healthy foods, affordable prescription drugs, quality care.
If we want to change what’s happening in terms of diabetes rates, and in turn, the hospitalizations and deaths from Covid-19, these inequities will need to be dismantled in the future.
What are some ways we can begin to address these inequities right now, as a second wave of the pandemic rages across the U.S.?
The data suggests testing places for Covid-19 are more likely to be placed in more affluent white neighborhoods. We recently worked with Congressman Bobby Rush on a piece of legislation addressing testing, tracing and bringing Covid-19 testing into communities that need it.
How are the high costs of prescription drugs like insulin affecting people right now? What needs to change?
The cost of insulin and other drugs have continued to skyrocket. And we at the ADA are continuing to lean into getting people affordable insulin and prescription drugs so that people can manage their diabetes and thrive.
Here’s the deal: No one should have to choose whether they spend their money to get the drugs that they need to live and thrive, versus putting food on their table. That’s a decision that Americans shouldn’t have to make. During this pandemic, we’ve worked with Congresswoman Maxine Waters to drop a piece of legislation around zero-copay insulin, and we’ve been working with all of the state governors around zero copay and capping insulin. Currently we have 13 states with co-pay caps ranging from $35-$100. We won’t stop until all 50 states have signed co-pay cap bills into law.
What tools do you recommend for people who are struggling to monitor their health right now? What resources do the ADA and Walmart have to offer?
I encourage everyone to go to our www.diabetes.org. If you’ve been newly diagnosed with diabetes, we have a series of information to help you understand what living with the disease means and the steps that you take in your own life, because it’s often quite overwhelming. We have some info there around the key areas of thriving, like nutrition, exercise, mental health and sleep. If you are having issues getting your insulin please go insulinhelp.org.
We encourage people to know their rights and know their numbers. For example, Walmart has a series of quarterly Wellness Days where people can get free health screenings in most of their pharmacies. Often, we talk to people and they don’t know what their blood sugar numbers look like, so we encourage people to get their numbers checked! Your pharmacist can be an extension of your care team!
Additionally, I am thriving while living with diabetes, and one of the reasons is that I manage my food and nutrition quite well: I can buy everything I need from a Walmart store from a dietary perspective to help me thrive. And I believe I was told that 90% of the country has a Walmart within a 10-mile radius of them, so everyone can get there. I never want people living with diabetes to feel like they’re alone. If people are feeling that way, I want to encourage them to call our call center at 1-800-DIABETES.