Community Health Centers Work to Find Effective Treatments

Minorities suffer higher rates of diabetes than most Americans and, in many cases, are not getting the care they need to treat the disease, a trend that Community Health Centers are working hard to reverse.  Approximately 17 million Americans have diabetes, a disease that kills more people every year than breast cancer or AIDS.  Roughly one million people age 20 and older become diabetic every year, and the number of people with diabetes in the U.S. rose by nearly 50 percent during the past decade.  But a larger proportion of minorities have diabetes because they are not getting the preventive care they need.             

According to recent data:

·        2.8 million, or 13 percent of African Americans have diabetes.

·        2 million or just over 10 percent of Latino or Hispanic Americans have diabetes.

            Unity Health Care, a nonprofit organization that serves the uninsured and medically underserved through several health care sites located in the District of Columbia, is diligently working to beat these odds with the launch of a Diabetes Collaborative at its Upper Cardozo Clinic, where a large population of Latinos live and work. The Diabetes Collaborative is part of a national effort to reduce the health disparities and improve treatment outcomes for different minority and low-income populations who suffer from chronic diseases.  The collaborative brings together strategic partners to change the way health care organizations deliver care (for more information click on to www.healthdisparities.net).       

            "What we're focusing on is teaching patients about their disease so they can take better care of themselves," said Dr. Aviva Zyskind, M.D., of Unity Health Care.  "The goal of the collaborative is to improve outcomes for diabetic patients and to design health care systems so that the patients can be better educated about the disease.  The exciting thing is that we're helping diabetics improve their quality of life.  We focusing on the patients and improving our services to them."

            A case in point is a series of diabetes education classes at Unity's Upper Cardozo clinic, where many of the patients are Central American.   The weekly classes, taught in both Spanish and English, help diabetics learn how to control their blood sugar with good meal choices, carbohydrate counting, and eating from the right food groups.  Diabetics also learn how to monitor their glucose by using a glucometer, a device that measures glucose levels in blood.  

At the first nutrition class, Usha Kalro, a nutritionist from the University of the District of Columbia, introduced the class, many of them newly diagnosed diabetics, to the ABCs of diabetes; the signs and symptoms of hypoglycemia, and how to eat smaller portions of carbohydrates to control their blood sugar.  Rae Johnson, a Registered Nurse with the Upper Cardozo Clinic, provided a full translation for Spanish-speaking patients.

            "A lot of these patients would not have access to this kind of information that helps them manage their disease,” said Ms. Kalro.  "They're supposed to monitor themselves once or twice daily.  But many of the diabetics we see are on a fixed income and cannot afford the glucose strips used to test their blood sugar, which cost about 50 cents to a dollar each.  As a result, they do not test themselves as often as they should.  So it's important to teach them how to eat well, to eat fruits and vegetables, avoid fatty foods, and focus on what they can do proactively to control their diabetes."

            “Diabetes is one disease that the patients can do something about to prevent long-term problems, such as losing a limb or going blind or renal failure,” said Rae Johnson, RN.  “Of all the chronic diseases that a collaborative program targets, diabetes is one which you can control, or even change the outcome, by setting up self-management goals, such as exercise, or eating a better diet.   We help our diabetic patients form self-management goals that work for them.”

            Diabetes can result in long-term complications, particularly if left untreated.  At least 65 percent of people with diabetes die from heart disease or stroke, yet only one in four of Hispanic and Latino Americans know they are at risk for heart disease.  Diabetes can also result in kidney failure, premature heart attacks, strokes, limb amputations, blindness or death.  Diabetes is the sixth leading cause of death in the United States.  

            The National Association of  Community Health Centers (NACHC) is a strategic partner in Health Disparities Collaborative.   Over 300 community health centers around the country are participating in a diabetes collaborative to better understand and treat the disease in medically underserved populations.