Lack of Diabetes Prevention Efforts in Underserved Communities
- Sarayu Bongale
- Feb 16
- 5 min read
Approximately 830 million people worldwide have diabetes (World Health Organization, 2025). In the United States alone, 40.1 million people live with diagnosed or undiagnosed diabetes, and nearly 115.2 million adults are prediabetic (Centers for Disease Control and Prevention, 2024b). While the United States has preventive and accessible treatment options for diabetic individuals, many underserved communities do not have the same accessibility. This has caused certain communities to remain critically overlooked in diabetes prevention efforts, which leads to disproportionately high rates of disease and long-term complications.
Diabetes is classified into several types which each have different causes. Type 1 diabetes is an autoimmune condition in which the body attacks insulin-producing cells in the pancreas, leading to little or no insulin production. Type 2 diabetes, the most common form, develops when the body becomes resistant to insulin or cannot produce enough of it, often influenced by lifestyle factors such as diet, physical inactivity, and obesity. Gestational diabetes occurs during pregnancy and can increase the risk of developing type 2 diabetes later in life for both mother and child. Other, less common forms of diabetes can result from genetic mutations or certain medical conditions.
Disparities in Risk and Access
Communities with limited economic resources, predominantly minority populations, and rural areas face challenges that increase diabetes risk. A literature review conducted by Esadi et. al. (2023) of 59 peer-reviewed articles shows that the prevalence of diabetes in underserved communities has been attributed to consumption of unhealthy diets. For example, many low-income neighborhoods are considered “food deserts,” areas with few grocery stores offering fresh fruits, vegetables, or whole grains, resulting in limited access to affordable, nutritious foods and higher rates of diet-related conditions like type 2 diabetes (Ziso et al., 2022) Residents may be forced to rely on inexpensive, calorie-dense, nutrient-poor processed foods that contribute to obesity and insulin resistance, which is a major risk factor for type 2 diabetes.
Healthcare access is another critical barrier. Preventive care, such as regular screenings, nutrition counseling, and education about lifestyle modifications, is often unavailable or underutilized in underserved communities. Even when these services are available, underserved communities may lack sufficient funds to manage the adverse effects of diabetes (Eseadi et al., 2023). Barriers such as lack of insurance coverage and limited access to healthcare providers prevent people from seeking care until complications arise. As a result, diabetes is diagnosed after irreversible damage has already been done to organs like the kidneys, heart, and eyes.
Insufficient Public Health Initiatives
Despite the growing burden of diabetes in these populations, public health interventions frequently fail to reach the communities most at risk. National campaigns often rely on generalized messaging that does not account for the unique socioeconomic, cultural, and environmental challenges faced by underserved groups (Khatri et al., 2024). For instance, the Centers for Disease Control and Prevention’s nationwide campaign “Do I Have Prediabetes?” provides broad recommendations about diet and exercise, but its materials are primarily in English and assume easy access to fresh produce and safe spaces for physical activity — resources that may be limited in low-income or rural communities (Centers for Disease Control and Prevention, 2024a). Additionally, community-based programs tailored to local needs are underfunded, leaving gaps in lifestyle education.
Studies show that culturally adapted interventions, such as programs delivered in native languages, peer-led education, or cooking classes using affordable, locally available ingredients, can significantly improve outcomes (Khatri et al., 2024). For example, PrevenganT2 was a program designed to teach lifestyle interventions to prevent type 2 diabetes in Hispanic and Latino individuals (Franklin et al., 2025). However, a limitation of PrevenganT2 was that it required significant time engaging with communities and understanding their unique needs (Franklin et al., 2025). These limitations make these programs scarce, highlighting a systemic failure to invest in prevention rather than reactive treatment.
The lack of diabetes prevention in underserved communities has both individual and societal consequences. On an individual level, residents face higher rates of diabetes complications, including cardiovascular disease, neuropathy, and vision loss (World Health Organization, 2025). On a broader scale, these disparities contribute to rising healthcare costs and increased burden on public health systems. The cycle of disease and poverty perpetuates itself, as chronic illness limits work capacity, income potential, and access to resources, thus limiting treatment funding and effective disease management.
Future Implications
If diabetes prevention efforts continue to neglect underserved communities, existing health disparities will further widen. Rising rates of diabetes and associated complications will place increasing strain on already overburdened healthcare systems, particularly in safety-net hospitals and community clinics. Long-term complications such as kidney failure, cardiovascular disease, and amputations require costly treatments, including dialysis and surgical interventions, which are far more expensive than preventive care (World Health Organization, 2025). As a result, healthcare spending will continue to rise without meaningful improvements in population health.
However, targeted investment in prevention could significantly alter these trajectories. Expanding access to affordable, healthy foods and cultural and community-based prevention programs can reduce diabetes incidence and improve long-term outcomes (AuYoung et al.,
2019). Without these interventions, diabetes will remain a preventable disease that continues to harm underserved populations disproportionately.
References
AuYoung, M., Moin, T., Richardson, C. R., & Damschroder, L. J. (2019). The Diabetes Prevention Program for Underserved Populations: A Brief Review of Strategies in the Real World. Diabetes Spectrum, 32(4), 312–317. https://doi.org/10.2337/ds19-0007
Centers for Disease Control and Prevention. (2024a, February 29). About CDC’s First National Prediabetes Awareness Campaign. Diabetes.
Centers for Disease Control and Prevention. (2024b, May 15). National diabetes statistics report. Centers for Disease Control and Prevention.
Eseadi, C., Amedu, A. N., Ilechukwu, L. C., Ngwu, M. O., & Ossai, O. V. (2023). Accessibility and Utilization of Healthcare Services among Diabetic patients: Is Diabetes a Poor Man’s ailment? World Journal of Diabetes, 14(10), 1493–1501. https://doi.org/10.4239/wjd.v14.i10.1493
Franklin, B. E., Meulenberg, B. L., Beaulieu, E. Z., Cisneros-Macias, J., Cao, Y., Carbajal-Salisbury, S., Villalta, J., Flores, N., Fuentes, V., Hernandez, M. C., Parry-Alba, D., Rodriguez, C., Rodriguez, Y., Zavala Orozco, V. S., Asnaani, A., Sanchez-Birkhead, A., & Baucom, K. J. W. (2025). "PrevenganT2," a Culturally Responsive Family-Based Diabetes Prevention Intervention for Hispanic or Latino Adults at High Risk for Type 2 Diabetes: Protocol for a Proof-of-Concept Evaluation. JMIR research protocols, 14, e66317. https://doi.org/10.2196/66317
Khatri, R. B., Endalamaw, A., Erku, D., Wolka, E., Nigatu, F., Zewdie, A., & Assefa, Y. (2024). Enablers and barriers of community health programs for improved equity and universal coverage of primary health care services: A scoping review. BMC Primary Care, 25(1). https://doi.org/10.1186/s12875-024-02629-5
World Health Organization. (2025). Diabetes. World Health Organization; World Health Organization. https://www.who.int/healthtopics/diabetes#tab=tab_1
Ziso, D., Chun, O. K., & Puglisi, M. J. (2022). Increasing access to healthy foods through improving food environment: A review of mixed methods intervention studies with residents of low-income communities. Nutrients, 14(11), 2278. https://doi.org/10.3390/nu14112278
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