Strategies to Reduce Diabetes Disparities: An Update
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PSYCHOSOCIAL ASPECTS (K HOOD, SECTION EDITOR)
Strategies to Reduce Diabetes Disparities: An Update Joseph R. Betancourt & Jason V. Duong & Matthew R. Bondaryk
Published online: 14 September 2012 # Springer Science+Business Media, LLC 2012
Abstract Racial and ethnic minorities in the US have a higher prevalence, as well as suffer from more complications, lower quality care, and poorer outcomes for diabetes than their counterparts. Given the US health care system is in the midst of drastic transformation, with the passage of health care reform, and efforts in payment reform, and value-based purchasing, there is now support to provide more intensive, team-based care for those conditions that are complex, costly, and highly prevalent. Addressing and improving diabetes disparities, given they are prevalent and costly, will be an important area of focus in the years to come. The latest research demonstrates that community-based efforts, multifactorial approaches, and the deployment of health information technology can be successful in addressing diabetes disparities, and require support, attention, resources, and continued evaluation. Ultimately, these efforts should improve the quality of care for all persons with diabetes, especially those who are most vulnerable. Keywords Disparities . Diabetes . Community health workers . Health information technology . Promotora . Cultural competence . Diabetes management . Telemedicine . Multifactorial approaches . Treatment algorithms . Diabetes education . Nurse case management J. R. Betancourt (*) : J. V. Duong : M. R. Bondaryk The Disparities Solutions Center, Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford Street, Suite 901, Boston, MA 02114, USA e-mail: [email protected] J. R. Betancourt Harvard Medical School, Boston, MA, USA
Introduction Diabetes continues to march ahead as a major public health challenge, with data suggesting that as many as 1 in 3 adults will suffer from this condition by 2050 if current trends continue [1]. In fact, from 1990 to 2010, the annual number of new cases of diagnosed diabetes almost tripled [1]. Currently, diabetes affects 8.3 % of the US population—about 25.8 million people [2]. Although all patients with diabetes face challenges to controlling their disease through proper nutrition, adequate exercise, glucose monitoring, and medication adherence, minority patients may face additional challenges due to language barriers, cultural and socioeconomic factors, and poorer access to high quality care. Research consistently demonstrates that diabetes disproportionately impacts minority populations—with minorities not only having diabetes at greater rates than their counterparts, but also suffering higher morbidity, mortality, and overall poorer health outcomes. For example, in 2010, the age-adjusted incidence of diagnosed diabetes was 13.0 per 1,000 in Blacks, 12.9 per 1000 in Hispanics, and 7.7 per 1000 in s (Fig. 1) [3]. Along the same lines, in a 2007–2009 survey from the Centers for Disease Control, amon
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