Focus Policy Blog


Diabetes Burden Higher Among Ethnic Minorities; Taking Toll on California Health System

According to the Centers of Disease Control and Prevention, diabetes incidence and prevalence have been a growing epidemic, with the number of diabetic patients tripling since 1980. There are approximately 21 million Americans living with diabetes, with 2.1 million living in California. This has implications not only for individual health, but contributes to the cost burden of the US healthcare system.

A new policy brief from the University of California, Los Angeles’ Health Policy Center reported that among hospitalized Californians’ aged 35 and older, 31% of hospitalized patients were diabetic. Though these patients were not admitted for a diabetic diagnosis, diabetes can exacerbate conditions that lead to hospitalizations. In relation to health costs, 33% of hospital healthcare costs ($11.6 billion out of $35 billion) in California (excluding Kaiser hospitals) was spent paying for hospitalized patients living with diabetes, regardless of whether the hospitalization was the primary reason for the visit.  If one were to include Kaiser health costs and assume that Kaiser hospitalization costs were comparable to other hospitals, the amount of hospital healthcare costs in California spent on hospitalized patients living with diabetes would be $17.3 billion. On an individual level, the average cost of a hospital stay for diabetic patients is $2,200 more than patients not living with diabetes ($18,691 and $16,492 respectively). The majority of hospitalizations for diabetic patients in California are covered by public insurance.

Hospitalizations for ethnic minority patients living with diabetes was higher compared to non-Hispanic white patients. While the percentage of hospitalizations for diabetic non-Hispanic white patients is 27.5% in California, percentages were higher for Asian Americans (38.7%), African-Americans (39.3%), American Indian/Alaska Natives (40.3%), and Latino/as (43.2%).

Report recommendations include:

  • Promoting appropriate diabetes management through diabetes care guidelines, healthcare provider oversight, and self-management education.
  • Promoting access to quality primary and specialty healthcare through continuous health coverage and stable medical home.
  • Creating and promoting environments that encourage healthy behaviors to prevent and/or manage diabetes (i.e. healthy eating)
  • Promoting built environments that encourage regular physical activity.

Joanne Chan, Joint Center Graduate Scholar, Harvard School of Public Health