On June 19, 2022, I woke up to the devastating news that my grandmother had passed away, her life tragically cut short by complications from diabetes. Her passing marked the end of a long, exhausting battle that my family had fought alongside her — one defined by relentless physical and emotional challenges.
Caring for my grandmother as she struggled with diabetes consumed nearly every aspect of our lives. The constant vigilance required to manage her condition became an unending reality: monitoring her blood glucose levels, ensuring she took her medications on time, and watching for signs of delayed wound healing that never seemed to fully resolve.
The effects of autonomic neuropathy added another layer of complexity, with her body unpredictably betraying her and making everyday activities difficult. For our family, the toll extended far beyond the logistics of care; it was the emotional weight of witnessing someone we cherished frustration as she lost parts of her independence.
In Ramsey County, this is the case for many families, especially African American families, who are disproportionately affected by diabetes and other chronic diseases. While this population makes up only 13% of diabetes patients in the county, a 4% increase in less than a decade, their risk of developing severe complications like heart disease, vision loss, and amputations is far higher than for other groups. This disparity reflects deeply entrenched inequities, from limited access to quality health care to food insecurity and living conditions that do not allow them to get in the physical activity needed to keep them healthy and thriving.
Barriers beyond biology
After life returned to a regular pace following the COVID-19 pandemic, many people resumed their busy routines. However, for many African Americans, the events of the past few years have made it difficult for families to access quality food at every meal. Numerous neighborhoods in Ramsey County are food deserts, lacking healthy, affordable and culturally appropriate food options. As a result, patients with chronic illnesses often have no choice but to rely on processed and sugary foods, which worsens their health outcomes.
Diabetes is a condition that can impact nearly every part of the body and its functions. Effectively managing diabetes requires a multifaceted approach to achieve good blood sugar control and to prevent life-threatening complications.
Many African Americans in Ramsey County rely on Minnesota Health Care Programs (MHCP) to manage their diabetes. However, these programs often do not provide comprehensive care, resulting in high out-of-pocket expenses for patients.
Copayments for diabetes medications range from $35 to $55 each, which can discourage consistent treatment adherence and lead to worsening health issues. Furthermore, these financial challenges are often made worse by food insecurity.
The weight of history
Historical injustices have significantly contributed to ongoing health disparities in Minnesota. In the Twin Cities, racial covenants and redlining policies systematically excluded African Americans from well-resourced neighborhoods, confining them to areas plagued by substandard housing and limited economic opportunities.
A poignant example of this is the destruction of the Rondo neighborhood, a once-thriving African American community in St. Paul, which was razed to make way for the construction of Interstate 94. This displacement not only shattered a close-knit community but also forced many families into segregated, under-resourced areas, perpetuating cycles of poverty and health disparities that have persisted across generations.
A call to action
Addressing the growing diabetes epidemic among African Americans in Ramsey County requires bold and urgent action. For many affected families, diabetes is not only a medical condition but also a financial and emotional burden.
One effective solution is to expand Minnesota Health Care Programs to include specialized diabetes care and to reduce medication copayments. Lowering these costs would make life-saving treatments more accessible to low-income families, encouraging better medication adherence and helping to reduce the long-term complications associated with diabetes.
States like California and Maryland have already demonstrated that lowering cost sharing improves health outcomes and decreases overall health care expenditures incurred in emergency room visits and hospitalizations. In addition to providing health care coverage, it is essential to address food insecurity and promote physical activity to achieve long-term health equity. Investing in grocery stores and community programs to improve access to nutritious food can empower residents to make healthier choices.
Similarly, creating safe and accessible spaces for exercise — such as parks and community centers in predominantly African American neighborhoods — would encourage physical activity and support diabetes management.
These interventions require collaboration among public health officials, urban planners, and local government, as their impact on community health could be transformative. The urgency of addressing this crisis cannot be overstated. In Ramsey County, systemic inequities — both historical and ongoing — continue to create significant barriers that disproportionately affect African Americans.
Immediate action is needed to ensure that every Minnesotan has the opportunity to lead a healthy life, including African Americans in Ramsey County. Through bold legislative measures, Minnesota can transform lives and demonstrate that health equity is not just an ideal but a tangible and achievable reality.
