Undiagnosed and Overlooked: Socioeconomic and Healthcare Inequality in Caribbean Diabetes – A Cross-Sectional Study

Diabetes mellitus is a major public health in the Caribbean, where economic instability, food insecurity, and healthcare inequities drive high mortality. Barriers to diagnosis, healthcare access, and financial security contribute to widespread undiagnosed diabetes, yet regional analyses remain limited. This study examines diabetes prevalence, mortality, and cases across 12 Caribbean nations, integrating economic and social indicators to identify causes of disease disparities.

Research Design and Methods

Publicly available data from the WHO, International Diabetes Federation, World Bank, and regional reports were compiled, prioritizing 2021 estimates. Data analysis included Pearson correlation to assess associations between economic and health variables, PCA for dimensionality reduction, and hierarchical clustering to identify country-level patterns.

Results

Our data found that diabetes prevalence and mortality were higher in the Caribbean (12.14% and 6.41%) than in the USA (10.70% and 3.50%), respectively. Next, we examined socioeconomic factors and found that food insecurity and unemployment were higher in the Caribbean (29.8% and 14.8%) than in the USA (9.1% and 3.7%), respectively. We then investigated economic disparities and found GDP per capita was inversely associated with undiagnosed diabetes (r = -0.94), with lower-income countries having more undiagnosed cases. Wealth inequality, measured by the GINI coefficient, was greater in The Bahamas (57.18) than in the USA (39.8). Lastly, PCA analysis showed Caribbean nations clustered separately from the USA based on healthcare rather than lifestyle factors.

Conclusions

Diabetes and obesity in the Caribbean stem from economic instability, food insecurity, and healthcare limitations rather than individual lifestyle choices. High undiagnosed diabetes rates reflect broader socioeconomic struggles where healthcare access competes with basic survival. This is the most recent examination of diabetes trends in the Bahamas. Addressing these issues requires healthcare expansion, wage reforms, and food security policies to ensure economic growth translates into better public health.