The Defunding of Diabetes Education: A Public Health Crime That’s To Blame For Thousands Of COVID Deaths


The South Bronx is the lowest-income urban congressional district in the country and was home to New York’s highest COVID infection rate. It’s also home to one of the highest rates of residents diagnosed with diabetes (16%) in the country. Statistics show that when people with type 2 diabetes and high blood sugar levels become infected with the novel coronavirus, they are more at risk for developing severe symptoms, including death. 

Both Republicans and Democrats To Blame For Preventable Coronavirus Deaths

Chris Norwood is the executive director of Health People, a community health agency based in the South Bronx that uses several educational tools to empower program participants to lead healthier lives. 

In a scathing editorial, Norwood blames the federal government and the New York State Department of Health for defunding Health People’s “successful” diabetes self-management program. This even as it became apparent in the beginning weeks of the pandemic that “the ignored diabetes epidemic was accelerating rampant COVID sickness and death,” she writes. 

Prior to the organization’s defunding, Health People had reached approximately 2,000 Medicaid patients with Type 2 diabetes, educating them with a 6-session course designed to help them reduce blood sugar and reduce their risk for other diabetes-linked complications. Diabetes-associated complications such as heart disease and kidney disease contribute to severe and fatal COVID symptoms. 

Norwood assigns blame to both sides of the political aisle for failing to do anything to prevent COVID deaths among those with type 2 diabetes. She describes President Trump and New York Governor Andrew Cuomo as having opposite public profiles in the COVID epidemic, with the former considered to have utterly failed in leadership and the latter widely praised for stepping forward. But both executive’s administrations “felt free to brutally cut off self-care education that was urgent for people with diabetes.”

Moreover, Norwoods claims that not a single prominent figure or politician has made reforming diabetes care and prevention a real cause. 

More Focus On Funding Diabetes Prevention, Less Focus On Defunding The Police? 

Norwood also suggests that activists who fight for progressive causes, whom she calls, “the usual American forces of reform and change” are absent in addressing the diabetes epidemic. 

“They do not, in any way, protest its mass carnage of unnecessary death and disability. If Black Lives Matter, why doesn’t diabetes matter as it so heavily hurts Black populations that African Americans have triple the diabetes-related lower limb amputation rate of others?” Norwood asks.

Norwood criticizes the “woke” age. She also questions why, considering that social justice foundations are investing multi-millions in causes such as defunding the police and eviction moratoriums, “Why hasn’t one major foundation invested in promoting serious reform in diabetes prevention and care?”

Defunding Diabetes Education Proves Deadly 

Was the defunding of Health People culpable in Covid deaths? Norwood certainly thinks so. “The Bronx was entirely stripped of reliable community access to diabetes self-management education. Already subject to the state’s highest diabetes death rate, the Bronx suffer[ed] the state’s highest COVID death rate,” says Norwood, a community health advocate who also authored the first book on women and HIV, “Advice for Life: A Woman’s Guide to AIDS.

Norwood quotes the diabetes education program coordinator, Evelyn Rivas: “I really couldn’t understand it … people wanted this so badly—and needed it. We took it everywhere, all over the community.” Norwood describes the defunding as “a public health crime,” given the evidence shows that for diabetics with well controlled blood sugar, COVID outcomes are not significantly worse than for COVID patients who don’t have diabetes.

South Bronx: Diabetes Epicenter, But The Ripples Extend Nationwide

The Bronx is not alone is suffering very high diabetes rates. Norwood calls the highly-preventable chronic disease “the nation’s most widespread, costly and debilitating epidemic” for which there “has been no coherent national effort to improve diabetes care, outcomes and prevention,” she describews. 

Diabetes outcomes, Norwood suggests, are far worse than two decades ago. Certainly, the statistics she points to suggest that it’s more deleterious than a decade ago; there has been a 50% increase in diabetes related lower-limb amputations since 2009.

If premature death from type-2 diabetes is highly-preventable, Norwood says that public health authorities have knowingly left millions with diabetes to face an even greater risk of preventable death.

The only benefactor of soaring rates of diabetes that afflict lower income communities, Norwood suggests, are privately-run dialysis centers. 

Nothing Learned From Former Coronaviruses

Are public health officials guilty of intentionally neglecting lower-income, minority populations? That’s another assertion made by Norwood, who writes, “Public health officials knew that COVID was almost bound to strike heavily at diabetics.” 

Norwood references a Reuters article that demonstrates how coronaviruses have hit people with diabetes especially hard. For instance, during another coronavirus outbreak, which transpired in 2003, and was known as SARS, or Severe Acute Respiratory Syndrome, more than 20% of people who died had diabetes. Fast-forward a decade to 2013’s MERS (Middle East Respiratory Syndrome) epidemic, where approximately 60% of patients who ended up in intensive care or died had diabetes.

Diabetes: A Collision Of The Medical Industrial Complex

For all the feel-good social justice talk about COVID disparities, and how the pandemic has disproportionately affected low-income, minority communities, Norwood says that while diabetes remains rampantly unaddressed, “We can never have anything approaching health in the United States. 

True reform, Norwood writes, “requires a sharp look at a range of challenges. Diabetes, above all, presents a stunning collision—as destructive as it is instructive—of race and class with the powers of the medical industrial complex,” of which Norwood describes as the nation’s largest industry.

Norwood provides statistics which lend credence to her assertion of big pharma’s economic might. Diabetes generates $237 billion a year in direct medical costs. However, both Medicaid and Medicare block prevention and wellness by refusing to pay for or reimbursing for community-provided self-care education, Norwood laments. 

A Prescription To Lower Rates Of Diabetes

For her part, Norwrood would like to see more local peer educators who would be able to reach as many people with diabetes as possible. Achieving this alone, Norwood asserts, would serve as the catalyst for diabetes reversal. In addition, to put the brakes on what is truly a national epidemic, Norwood says there needs to be more focus on teaching people with diabetes about plant-based nutrition. 

Unfortunately, Norwood says that the failure of public health and political powers to turn to prevention and wellness—and overcome the grip of the medical industrial complex has prevents these goals from being realized. 

Adapted from a longer article that appears here.


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