How diabetes collides public health
More than 34 million Americans, or 13 percent of all adults, have diabetes, a pernicious disease that hobbles the body's ability to control blood sugar and wreaks havoc on circulation, kidney function and other vital organs. A chronic condition that disproportionately affects the poor and people of color, diabetes robs the country of more than one in four health care dollars spent.
A public health approach to diabetes encompasses the medical issues as well as lifestyle, family, psychosocial and cultural concerns. These must be addressed to maximize the impact of any public policy on the issue, according to a 1988 call from the Institute of Medicine's committee on diabetes.
Community outreach workers like Betty Angeles, 59, who helps Spanish-speaking low-wage laborers in Santa Barbara manage their diabetes at Sansum Diabetes Research Institute, have been an important part of the institute's success. Their community roots have helped them build trusting relationships with clients and make easy-to-understand information about the disease accessible to a population that is often ill-informed about its many complexities.
Developing and supporting public health programs that tackle the root causes of diabetes is a complex and challenging task. These efforts require commitment from multiple individuals within a health system, and must often be implemented with limited resources.
Despite the pandemic's grim toll, researchers and experts say that a public health approach to diabetes is as necessary now as it was when the IOM called for it nearly two decades ago. They are hoping that the disease's disproportionate burden and death among the poor will finally bring policymakers to focus on its crisis, and the critical role it plays in America's economy.