forcement variable in health maintenance efforts (e.g., control weight gain) might be worth future investigation.
No one will deny that the health status of African-American women is poor, and a contributing factor is diabetes mellitus and its complications (e.g., blindness, amputation and end-stage renal disease) associated with poor health management and health practices. Epidemiological evidence clearly indicates that obesity, which is perpetuated by a "poverty diet" high in fats and sweets and low in vegetables and fruits, and a health care industry/social structure, which is riddled with racial discrimination and racism, both contribute to stress, lowering one's bodily defenses, and thus assuring poor health outcomes.
Furthermore, the impact on the health status of African-American women by those who are insensitive to cultural differences and the level of access they have to the health care industry/services will continue to increase health care cost with little or no return in healthy lifestyle. Heretofore, we have relied heavily on the health care industry to help alleviate the health ills of African-American women who suffer with diabetes. Efforts in diabetes health education have been designed to meet most of the physical health needs of African-American women. However, they need to be able to trust the system in order to feel comfortable in availing themselves of their services. These diabetic education programs have been designed most often within a medical or health behavioral model approach. Varying degrees of success have been noted in this chapter and in the literature. However, health educators must consider the impact of, and take a closer look at, how to utilize the spirituality of African-American women in program design. With the ever-increasing number of African-American women being diagnosed with NIDDM, both the traditional health education approach and the not so traditional (e.g., the church/spirituality) approach should be given serious consideration.
American Diabetes Association ( 1990). Diabetes facts (information fact sheet).
Beardsley Edward ( 1990). Race as a factor in health. In Rima Apple, ed., Women, Health and Medicine in America: A Historical Handbook. New York: Garland.
Black church diabetes program gets underway in Los Angeles. ( 1994). Los Angeles Sentinel, September 22.