Diabetes is a growing burden in the United States, affecting the health and quality of life of millions of Americans. Local health departments (LHDs) across the country work with their communities to raise awareness about diabetes and its risk factors and to develop programs and policies that support diabetes prevention and control.
November is American Diabetes Month, an important time for LHDs to highlight their role in helping their constituents prevent, screen for, and effectively manage diabetes. “Eat Well, America!” is the theme of this year’s awareness month, sponsored by the American Diabetes Association. The theme highlights the important role diet and nutrition play in preventing and managing diabetes.
The Compounding Cost of Diabetes
According to the 2014 National Diabetes Statistics Report, more than 27 million Americans had type 2 diabetes in 2012. An additional 79 million adults are at risk of developing diabetes. Diabetes was the seventh leading cause of death in the United States in 2010; it is a major risk factor in the development of heart disease, stroke, kidney failure, non-traumatic lower-limb amputations, and blindness.
The American Diabetes Association estimates that the total cost of diagnosed diabetes in 2012 was $245 billion: $176 billion in direct medical costs and $69 billion in reduced productivity. One in every 10 healthcare dollars is spent treating diabetes and its complications.
What Local Health Departments Can Do
The Community Preventive Services Task Force recommends programs that jointly promote healthy changes in diet and increased physical activity for people at increased risk of type 2 diabetes. Many LHDs, including my own, have partnered with community-based organizations to implement diabetes prevention and management programs. My health department partnered with the YMCA of Central Florida to hold community events that provided free diabetes screening, education, and information.
During Food Day Week in October 2014, my health department’s School Health program collaborated with local stakeholders to develop the Pick of the Pantry cookbook. The cookbook showcases easy, healthy recipes that can be fixed with items obtained from a food pantry or farmers market. An informational booth with food samples from the recipe book were shared throughout the entire week.
Fellow LHDs have successfully implemented the Stanford University Patient Education Research Center’s Diabetes Self-Management Program and the Centers for Disease Control and Prevention’s National Diabetes Prevention Program.
This year, Panhandle Public Health District in Nebraska won a NACCHO Model Practice Award for its implementation of the National Diabetes Prevention Program. The effort aimed to recruit and train individuals within partner organizations to deliver the evidence-based lifestyle change intervention; raise awareness about diabetes risk factors and the availability of the program; facilitate relationships between partner organizations delivering the program and referring clinical partners; and develop a healthcare provider protocol or algorithm to facilitate referrals into the program. The program was successful in several ways; perhaps most notably, every dollar the health district spent on the program in the startup phase and the first year resulted in $28 in benefits.
The Nassau County (NY) Department of Health also won a 2015 Model Practice Award for its efforts to promote better nutrition by developing and distributing a cookbook with healthy recipes. The cookbook contained recipes that used fresh ingredients and minimal salt, fat, and sugar. The health department also worked with a local community farmers market to promote the recipes and offer samples.
NACCHO has also developed a toolkit to help LHDs bill for and sustain diabetes self-management programs. The toolkit highlights the North Carolina Diabetes Education Recognition Program and shows how Wilkes County Health Department, one of the LHDs involved in the program, established a billing program. It also contains resources that LHDs can use to develop reimbursement models and better understand how the Affordable Care Act impacts diabetes services.
LHDs can also advocate for policies that address the root causes of diabetes. NACCHO has several relevant policy positions that LHDs can adapt on issues such as healthy community design, comprehensive obesity prevention, healthy food access, and menu labeling.
NACCHO encourages LHDs to use American Diabetes Month as an opportunity to raise awareness and continue the innovative, effective programs that are addressing the burden in their communities. Together, we can successfully reduce the incidence and impact of diabetes.
NACCHO Toolkit: Billing and Reimbursement for Diabetes Self-Management: A Local Perspective
NACCHO Policy Positions
Local Health Departments’ Capacity to Prevent and Control Diabetes in Priority Populations (research brief)
NACCHO Supports Local Health Departments Funded by the CDC’s State and Local Public Health Actions to Prevent Obesity, Diabetes, and Heart Disease and Stroke Program (fact sheet)
Chronic Disease Model Practices Case Study: Jefferson County Health Department Successes in Diabetes Prevention (case study)
NACCHO Exchange: Chronic Disease (Summer 2015)
American Diabetes Association Facts
American Diabetes Association – Diabetes Fast Facts
American Diabetes Month resources