207698 Addressing diabetes disparities through sub-county analysis of multiple data sources

Monday, November 9, 2009: 5:30 PM

William Livingood, PhD , Institute for Health, Policy and Evaluation Research & Pediatrics Department, Duval County Health Department & University of Florida COM-Jax, Jacksonville, FL
Luminita Razaila, MS , Institute for Health, Policy and Evaluation Research, Duval County Health Department, Jacksonville, FL
Elena Reuter, MPH , Institute for Health, Policy & Evaluation Research, Duval County Health Department, Jacksonville, FL
Rebecca Filipowicz, MPH, MS, CHES , Institute for Health, Policy and Evaluation Research, Duval County Health Department, Jacksonville, FL
Katryne Lukens-Bull, MPH , Center for Health Equity & Quality research, University of Florida College of Medicine-Jacksonville, Jacksonville, FL
Carlos Palacio, MD, MPH , Internal Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL
David L. Wood, MD, MPH , Department of Pediatrics, University of Florida, College of Medicine-Jacksonville, Jacksonville, FL
Diabetes continues to be a persistent source of health disparities in the US. These disparities are unevenly distributed throughout the US, within individual states and within local communities. Multiple sources of data provide insights into the impact of diabetes at the local level, including death certificate, clinical and survey data. Expanded sampling of BRFSS in the local community and adaptation of CDC weighting formulas for sub-county analysis facilitated the use of BRFSS for this analysis. Acquisition of Hospital Discharge, Emergency room utilization and vital statistics data also facilitated analyses supporting planning and policy development. Results of the analyses of the multiple sources of data including relative risk analysis and GIS mapping showed high minority areas of the community had approximately twice the relative risk of other areas of the community for mortality and self-reported prevalence. However, the same areas had four times the relative risk for hospital use and emergency room use for diabetic conditions. These analyses show that the burden of these disparities not only falls on the individuals and their families, but also on the community that is burdened with extensively disproportionate utilization and cost of care resulting from these disparities. This approach to local analysis applied in Jacksonville, Florida has profound implications for planning and policy development at the local level. These analyses illustrate how effectively addressing disparities will require informed policy development and comprehensive planning supported by analysis of data at the local level. Beyond planning and policy development, questions also emerged concerning BRFSS survey methods.

Learning Objectives:
Describe an effective approach to sub-county analysis, Identify sources of data on morbidity and mortality and methods of analysis, Discuss the implications of documenting the prevalence and cost of diabetes disparities for local communities.

Keywords: Community Health Planning, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Direct Univerity and local health department research center and institute, published in many public health, medical and health promotion journals, earned PhD
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.