How To Get A Better Health Care Package For A Black Person

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1 Incidence of Type 2 Diabetes in Hispanics as Compared to the General Population in Massachusetts By Isabelle Pierre Krystal Amaral, and Ardrianna Howard, 2014 SEP Participants 1

2 TYPE 2 DIABETES MELLITUS Definition: A metabolic disease in which the body s inability to properly use insulin causes elevated levels of glucose in the blood Contrary to type 1 diabetes mellitus where the body is unable to produce insulin 2

3 WHAT IS A HEALTH DISPARITY? The NIH defines a health disparity as: The differences in the incidence, prevalence, mortality, and burden of disease and other adverse health conditions that exist among specific population groups compared to a larger group. Health disparities limit continued improvement in overall quality of care and population health and result in unnecessary costs. 3

4 Hispanic Population in Massachusetts Asian 5.01% Hispanic 8.21% Black 6.21% American Indian 0.20% The Massachusetts population is 8% Hispanic White 80.38% Black American Indian White Asian Hispanic CDC National Center for Health,

5 Hispanic vs. General Population 16 Prevalence of Diabetes: Prevalence (%) Hispanic White Black Year Source data: Massachusetts BRFSS 1.6 times more likely to have diabetes than Non-Hispanic Whites 1.5 times more likely to die from diabetes compared to Non-Hispanic Whites 5

6 Leading Causes Diabetes is the 4th leading cause of death in Hispanics Genetics Inequalities in Income and Education Lifestyle Patterns Access and Quality of Healthcare 6

7 Genetics Strong link to family history and lineage Mutations of one gene increase the risks for developing Type 2 diabetes SLC16A11 variation accounts for about 20 percent of Hispanics' increased risk of Type 2 diabetes 7

8 Lifestyle Patterns 2011 BRFSS Routine Doctor Visits o Hispanic adults less likely to have visited doctor in the last year (78.6% versus 85.7%) than Non-Hispanic White adults o Less likely to have early detection Diet and Nutrition o Higher prevalence of poor diet Obesity and Overweight o Hispanic adults are 50% more likely to be obese than Non-Hispanic Whites. o 2010 MA Department of Public Health Family History 9

9 Physical Activity 85% Physical Activity in the Past Month 80% 75% Percentage 70% 65% 60% 55% 50% Hispanic Black White 45% 40% Year Source data: Massachusetts BRFSS 49% of Hispanic students spend three or more hours watching TV daily compared to 46% of Black students and 27% of Non-Hispanic White students 2007 MA Youth Risk Behavior Survey 10

10 Inequalities in Income and Education 43% of Hispanics in Massachusetts do not complete high school compared to 13% of Non- Hispanic Whites 44% Hispanics reported receiving diabetes education compared to 59% of Whites Individuals with less income and less education have higher rates of diabetes. Percentage Below Poverty (%) 35% 30% 25% 20% 15% 10% 5% 0% Individuals in Massachusetts Under 100% Poverty 29% 22% 20% 15% 10% 7% White Black Asian Hispanic AI/AN Massachusetts Race 8 Source: US Census Bureau, American Community Survey 3- Year Estimates,

11 Access and Quality of Healthcare 2011 MA FRBSS Uninsured Hispanic adults dropped from 19% to 11% following health care reform Three times as many uninsured Hispanic adult residents compared to Non- Hispanic Whites. 20% of Hispanic adults without a personal health care provider 2010 MA Department of Public Health 70% Adults Without Personal Health Care Provider Percent 60% 50% 40% 30% 20% 10% 0% Hispanic Massachusetts White Year Source: MDPH BRFSS

12 Current News: Project REACH Racial and Ethnic Approaches to Community Health Goals: Project is based in the Greater Lawrence Family Health Center Work to raise awareness of diabetes and its complications in the Hispanic population of Massachusetts. 12

13 The Lawrence Latino Diabetes Prevention Project (LLDPP) Goals: Collaboration with UMass Lowell and UMass Medical School Inexpensive, culturally sensitive intervention program to improve the incidence of diabetes in the Latino population of Lawrence. 13

14 The Lawrence Latino Diabetes Prevention Project (LLDPP) 80 Diabetes Care for Latino Residents Treated at the Greater Lawrence Family Health Center 70 Percentage (%) Source: REACH Latino Health Project 14

15 Narrowing The Gap Culturally tailored interventions Preventative Care Recognizing the symptoms Self- Management Less-costly alternative Nutrition Education Better dietary choices Active Living Increased insulin sensitivity Decrease total calories to lose weight 15

16 Conclusion Incidence of Type 2 Diabetes is higher in Hispanics than in the general population Socioeconomic factors contribute to disparity Awareness campaigns such as Project REACH help raise awareness and lower the prevalence of diabetes within high risk communities together we can put an end to diabetes 16

17 Questions? 17

18 References 1. Ockene I. S., Tellez T. L., Rosal, M. C.,Reed, G. W., Mordes J., Merriam, P. A., Olendzki,B. C., Handelman, G., Nicolosi, R., and Ma, Y Outcomes of a Latino Community-Based Intervention for the Prevention of Diabetes: The Lawrence Latino Diabetes Prevention Project. American Journal of Public Health 2. Rosal M. C., Ockene I. S., Restrepo A., White M. J., Borg A., Olendzki B., Scavron J., Candib L., Welch G., and Reed G Randomized Trial of a Literacy-Sensitive, Culturally Tailored Diabetes Self-Management Intervention for Low-Income Latinos. Diabetes Care 34: Welch G., Allen N. A, Zagarins S. E., Stamp K. D, Bursell S-E. and Kedziora R. J Comprehensive Diabetes Management Program for Poorly Controlled Hispanic Type 2 Patients at a Community Health Center. The Diabetes Educator 35(7): Bhargava A., Wartak S. A, Friderici J and Rothberg M.B The Impact of Hispanic Ethnicity on Knowledge and Behavior Among Patients With Diabetes. The Diabetes Educator 40(3): Welch G, Schwartz C, Santiago-Kelly P Diabetes- related Emotional Distress of Hispanic and Non- Hispanic Type Two Diabetes Patients. Ethnicity & Disease. 17: Massachusetts Department of Public Health. Health of Massachusetts. Boston, MA; April Connor, A., Baumgartner, R., Baumgartner K., et al Associations between TCF7L2 polymorphisms and risk of breast cancer among Hispanic and non-hispanic White women: the Breast Cancer Health Disparities Study. Breast Cancer Res Treat 136(2):