The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #69314

Kimi Watkins-Tartt¹, Mia Luluquisen, DrPH, MPH, RN², Sandra M Witt, DrPH², Neena Murgai, PhD, MPH², Brenda Rueda-Yamashita¹, Angie Orante, MPH¹, and Mark Woo, MPA¹. (1) Community Health Services, Alameda County Public Health Department, 1000 Broadway, Suite 500, Oakland, CA 94607, 510-268-5902, kwtartt@co.alameda.ca.us, (2) Community Assessment Planning and Education Unit, Alameda County Public Health Department, 1000 Broadway, Suite 500, Oakland, CA 94607

In Alameda County, the racial and ethnic differences in diabetes death rates were pronounced in 2000. Age-adjusted death rates among African Americans were 49.3 per 100,000, nearly three times higher than for Asians and Whites. Rates for Latinos were 34.6 per 100,000, two times higher than for Asians and Whites. The literature has identified a complex set of factors contributing to health disparities, including social structure; personal behaviors shaped by knowledge, attitudes, and cultural beliefs; and healthcare-related issues including access, services utilization, and quality of care. However, translating knowledge about health disparities and factors that contribute to them into concrete interventions is very challenging. This paper describes a pilot project in Alameda County that aims to reduce disparities related to diabetes and the challenges to developing and implementing a complex set of interventions that include prevention, diagnosis and treatment of African American and Latino residents of Oakland and Hayward. The foci of interventions are 1) individual (diabetes case management and diabetes self-care education), 2) community (capacity building and social marketing) and 3) policy and systems changes (increasing food access). We discuss the development of an ecological framework for addressing health disparities and the implementation of related objectives and activities. We examine strategies necessary to improve diabetes management behaviors, increase provider knowledge of diabetes-related disparities in prevention, increase community awareness of and response to diabetes and the necessary social and cultural considerations for creating culturally appropriate interventions with African Americans and Latino Americans.

Learning Objectives:

1)Describe the health diparities in diabetes mortality among African Americans and Latino Americans in Alameda County, California
• Describe Alameda County Public Health Department's pilot project and its framework on eliminating health disparities in diabetes
• Identify the set of interventions with African Americans and Latino Americans
• Describe the challenges in health disparities program planning, implementation and evaluation.

Keywords: Health Disparities, Cultural Competency

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Alameda County Public Health Department; The California Endowment; South Hayward Community Collaborative; CDC
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employee of Alameda County Public Health Department that is the recipient of grant funds from The California Endowment