In 1996, hip-hop trio A Tribe Called Quest released Emphasized Out, the narrative of a black human looking to remain optimistic while dealing with the repercussions of his criminal record, trying to provide for his family, and doing his best to not be a victim of neighborhood violence. For many African-American men, this narrativewhether in part or in fullis gospel. Environmental fears maintain African-American men in a perpetual country of fight-or-flight, and studies show that this chronic stress has led to health disparities, with diabetes represent one of the most insidious.
Theres substantial proof to demonstrate the environment “were living in” has direct impacts on our health, says Rebecca Hasson, training exercises physiologist and director of the Childhood Disparities Research Laboratory at the University of Michigan.
About 13 percent of African-Americans age 20 and older have been diagnosed with diabetes, in agreement with the American Diabetes Association. About 9 percentage of all Americans are diabetic, in agreement with the Centre for Disease Control and Prevention. African-American men are 1.7 times more likely than white non-Hispanic humen to have diabetes.
When Protective Hormones Harm
Hassons findings point to cortisol, a steroid hormone produced by the adrenal glands, as a contributing factor in stress-related onsets of diabetes. Cortisol temporarily increases energy production required for immediate survivallike running from a bear, or escaping a house fire. For the average person, cortisol levels begin high in the morning and taper off as the day progresses, fluctuating appropriately. In African-American men living in socioeconomically depressed communities, cortisol levels start and remain highthe bear is always chasing; the smoke alarm always screeching.
Debra J. Barksdale, professor and associate dean of academic programs at Virginia Commonwealth Universitys School of Nursing, has been examining stress in African-American men for three decades. Like Hasson, she quotes cortisol and its role in chronic stress, stating that its like having your stressors turned on all the time.
The fight-or-flight reaction is more of an acute reaction, she says. Whether its related to the pressures from society, increased the opportunities of being stopped by the authorities, trying to provide for their families or trying to find a job or sustain a job, when a stressor results, there are physiological processes that occur in the brain that trigger the release of cortisol. What we have found was in certain people who are constantly emphasized, cortisol levels do not go down throughout the day. It will remain high.
The Broken Thermostat
When cortisol levels remain high without the presence of imminent peril or without some physical activity to offset the effects of chronic stress, Type 2 diabetes is a possibility the consequence. According to the American Diabetes Association, higher cortisol outcomes in higher insulin resistance, forcing the pancreas to produce more insulin to get a response. With ongoing insulin resistance, the insulin-producing beta cells wear down, causing Type 2 diabetes.
Think of stress like a hot summertime day. Your thermostat has to keep working harder and harder to keep your house cool. Eventually, it cant get the temperature back down to where you want it anymore; it cant get back down to 68 degrees. It can only get down to 69 degrees,( because) the system is worn out. Sixty-nine degrees is not bad, but then it maintains creeping up and eventually the body isnt able to respond because its chronically activated. Those are the folks who are going to be more likely to progress to diabetes, she says.
Mezuk partners with the YMCA of Greater Richmonds diabetes control and diabetes prevention programs. The diabetes control program helps adults living with Type 2 by providing education, support and care management. The diabetes prevention program is for those at risk for Type 2 diabetes. They learn how to construct lifestyle changes to reduce their chances of developing the disease.
Know Your Status
Learning to identify and manage stress positively is the first step to a healthier outcome. That can be exercising, playing in mens sports leagues, practising yoga, or seeking talk therapy. If no change pass, African-American men run the risk of epidemic levels of diabetes diagnoses5 0 percentby 2050, according to the diabetes association.
Caroline Fornshell, a registered dietitian and diabetes fitness and nutrition expert in Williamsburg, calls the individuals who catch the disease before its onset the luck ones.
They are the ones that got the warn. So often, people are walking around with undiagnosed full-fledged diabetes, and so it is really an exciting opportunity for individuals who find out they have pre-diabetes to take control, she says.
Pre-diabetics can exercise more and evaluate their diet. They also should reduce stress, get the proper quantities of sleep and seek out subsistences, whether its through a program or even some sort of wellness buddy, says Fornshell.
Mezuk fosters African-Americans who think theyre at risk due to family history or who live with chronic stress to consult a physician. Many humen dont know that they have the disease and when left untreated, it can lead to a host of other health problems, including hypertension, heart disease and kidney failurethree more conditions that African-American humen suffer at higher rates than their white and Latino counterparts.
Its really scary to go to the doctor[ and find out that you have] diabetes. People call it denialabetes for a reason. People dont want to believe that theyre sick, says Mezuk. But there is good news. We can take what we are learning about how stress and depression affect the body and actually turn that into improved health for people in terms of managing this condition better and hopefully being able to prevent this condition better.
Originally published in Richmond Magazine