Promising Programs in Racial and Ethnic Disparities in Health and Health Care Addressing... researched and compiled by Sarah McCloskey, Erin Kennedy, and Michele Sloan December 2004 and updated November 2007
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California | Illinois | New York | North Carolina | South Carolina | Wisconsin
Background
Although diabetes is the sixth leading cause of death in the U.S., many people
are unaware that they have the disease until they develop the potentially lifethreatening
complications it can cause. These can include kidney damage or
failure, blindness, nerve damage leading to amputations, or cardiovascular
disease, which is the leading cause of death among diabetes patients. Annually,
diabetes care totals $132 billion, or 11 percent of national healthcare
expenditures. In 2005, almost 21 million people in the U.S. were suffering from
diabetes, however it is estimated that about 6 million of these cases are
undiagnosed. All minority groups are at greater risk of developing diabetes.
African Americans and Hispanics are twice as likely to develop diabetes as
whites, with the disease affecting 25 percent and 10.2 percent of each group,
respectively. Native Americans are 2.6 times more likely to develop diabetes,
and 15.1 percent of that population is diabetic. Among ethnic and racial
minorities, children are also at high risk for developing diabetes. In 2002,
diabetes mortality rates in Delaware for whites were 25 per 100,000 compared
to 48 per 100,000 for African Americans.*
*Data provided by the Kaiser Family Foundation State Health Facts Online. www.statehealthfacts.org
State Programs
On the national and state level, efforts have been made to educate people about
diabetes and diabetes prevention. Many programs exist to ensure that diabetes
Promising Programs to Eliminate Racial and Ethnic Health Disparities 14
patients receive proper care, treatment, and medication. As of 2002, 46 states
had laws requiring some insurance coverage for diabetes patients.
CaliforniaViva la Vida! (Live Your Life!) San Francisco, Calif. – A local program developed by a non-profit organization, Lumetra, Vida la Vida! increases awareness of diabetes among Hispanic Medicare beneficiaries through coordination with community groups and local healthcare providers. The program includes distribution of bi-lingual educational materials, fact sheets, and media campaigns that reach an estimated 10,000 people annually. This is an APHA Statistics to Solutions program example. For more information, contact Ana Perez at 415-677-2142. www.lumetra.com/diabetesandlatinos
IllinoisChicago Southeast Diabetes Community Action Coalition – This coalition is comprised of health and human service providers and Chicago Southeast residents who have come together with the main goal of reducing diabetes prevalence and diabetes complications of African Americans and Latinos in the area. Established in 1999 with CDC funding, this coalition has created community self-care centers where people can participate in education programs, attend support group meetings, and receive information. Currently, they are undergoing a telephone survey in order to compile more accurate information on the health status of minorities in the community. www.uic.edu/jaddams/csdcac
New YorkNew York Diabetes Prevention and Control Program (DPCP) – Currently, 18 communities and three universities participate to improve access to diabetes care for African-American and Hispanic patients. The program aims to overcome socioeconomic, cultural, and linguistic barriers to care and emphasizes monitoring diabetes through controlling glucose levels. DPCP also assists schools and daycares with diabetic pupils, advises the Department of Motor Vehicles about issues for diabetic drivers, and establishes relationships with insurance companies regarding insurance coverage for diabetes. www.cdc.gov/diabetes/states/ny.htm
North CarolinaProject DIRECT (Diabetes Intervention Reaching and Educating Communities Together) – The program targets the African-American community of southeast Raleigh through community-based interventions focused on decreasing disparities in diabetes prevention and care. Collaboration occurs among the CDC, North Carolina Department of Health, and county and community organizations. The project focuses on improving the quality of care and self-management, diagnosing diabetes, and maintaining access to care for diabetics. Prevention is promoted through reducing risk factors, specifically through encouraging more physical activity and better nutrition. www.ncdiabetes.org/ProjectDirect
South CarolinaBringing Together Community Partners to Improve Diabetes Care and Control for African Americans – The Charleston and Georgetown Diabetes Coalition goal is to improve diabetes care and control for more than 12,000 African Americans. More than 40 organizations reach out to African-American communities where they live, worship, work, play, and seek health care. The plan links people to necessary services and medical supplies, creates learning environments where health professionals and people with diabetes can talk about the disease, and establishes walk-and-talk groups. This program has been evaluated and has already shown that disparities in diagnostic and annual testing have decreased. More African Americans are undergoing annual A1c tests, annual kidney tests, referral for dilated eye examinations, and blood pressure control. www.musc.edu/diabetes/reach
WisconsinThe Wisconsin Collaborative Diabetes Quality Improvement Project – In cooperation with Wisconsin’s Diabetes Prevention and Control Program, this project coordinates efforts among public health departments, minority groups, insurance organizations, and academic centers to share resources, strategies, and best practices in diabetes education, treatment, and prevention. Through Promising Programs to Eliminate Racial and Ethnic Health Disparities 15 emphasizing lifestyle changes, the project implements population-based interventions to target groups that are at high risk for developing diabetes. Efforts are also made to evaluate the implementation of Wisconsin’s Essential Diabetes Mellitus Care Guidelines and collect data on the effectiveness of diabetes control and prevention programs. www.pophealth.wisc.edu/UWPHI/publications/issue_briefs/issue_brief_v03n03.htm
For more information, contact Eric Jacobson (302-831-1711).
photo on this page courtesy of the Administration on Aging
