A Community-health care center's Diabetes Project: A strategy to reduce health disparities

OBJECTIVES: Diabetes is a serious chronic disease with prevalence rates that continue to rise in the 21st century. The rates of type 2 diabetes have now reached epidemic proportions. The evidence of health disparities is particularly significant in diabetes regarding both the health outcomes and quality of care for racial and ethnic minorities. This study examined a Diabetes Project implemented at a local community health care center, assisted by outreach workers, that serves predominantly low income African Americans. The objective was to evaluate the effectiveness of a community-based intervention that focuses on adopting a health care model more suited to treating chronic diseases as a tool to closing the gap in health disparities. METHODS: Archival data collected at the health care center was evaluated. There were 216 participants (147 females and 69 males) of mean age 53.56 (SD = 14.71) consisting of 143 (66.2%) African Americans, 55 (25.5%) Caucasians, and 18 (8.3%) Other. The HbA1c (blood glucose), blood pressure (BP) -- systolic and diastolic, LDL cholesterol, and body mass index (BMI) was measured at baseline and at the date of the last visit. RESULTS: Three of the five pairwise comparisons experienced significant reductions – HbA1c, and BP (systolic and diastolic). An unexpected finding was the significant improvements in self-management behaviors of patients. Self-management is an important component for controlling chronic diseases resulting in improved clinical outcomes, reduced health care costs as well as improved psychosocial outcomes for the patient. CONCLUSIONS: Overall, it appears that community health care centers that incorporate outreach workers and a health care model more appropriate for treating chronic diseases may be serving as a strategy to reduce health disparities.