Healthy People 2020 and Diabetes Advocacy Partnership Highlights Opportunities to Eliminate Health Disparities in Diabetes

This National Diabetes Month, Healthy People 2020 (HP2020) is highlighting its strategic partnership with the Diabetes Advocacy Alliance (DAA) to achieve the HP2020 Diabetes objectives over the decade. The objectives relate to preventing diabetes among those at risk and improving glycemic control among people with diabetes. Currently, 30.3 million people in the United States have diabetes — this includes both diagnosed and undiagnosed cases. Nearly 84 million adults have prediabetes, putting them at high risk for developing diabetes.

The partnership began on November 19, 2012, and is heading into its sixth year. In 2017 and 2018, our partnership with the DAA focused on new opportunities to reach underserved populations and eliminate persisting disparities through education and changing Medicare rules.

Our Work over the Past 12 Months

In October of 2017, we jointly hosted a HP2020 Diabetes Workgroup meeting to discuss the prevention and treatment of diabetes in rural populations, which are disproportionately affected by the disease. Rural residents experience a 17% higher rate of type 2 diabetes than urban residents. This is because people have more risk factors in rural communities, and they may lack access to a variety of services.

The conversation focused on identifying barriers in specific areas of diabetes prevention and treatment and recommending strategies for eliminating those barriers. The meeting included presentations from the Federal Office of Rural Health Policy (FORHP) at the Health Resources and Services Administration (HRSA) and the Division of Diabetes Treatment and Prevention at the Indian Health Service (IHS).

FORHP discussed their numerous resources designed to help people with diabetes access care. IHS also shared its current prevention efforts and best practices in Indian Country. The meeting also focused on how to increase access to the Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program (NDPP) in rural areas. Finally, we discussed solutions for improving the delivery and utilization of Diabetes Self-Management Education and Support (DSME/S). Proposed solutions ranged from developing policies to increase telehealth reimbursement to ensuring that research and evidence on DSME/S is widely disseminated.

Many partners were very interested in continuing to identify ways to improve access to care and diabetes education in underserved and rural communities. A smaller group met in June of 2018 to learn more. Experts from CDC, the Academy of Nutrition and Dietetics, the American Association of Diabetes Educators, and the American Diabetes Association presented data on key challenges and barriers that could help generate collaborative action. The HP2020 diabetes stakeholders and DAA member organizations will meet again this month to continue to define action steps to increase the use of DSME/S.

Webinar on Promoting Diabetes Prevention Programs and New Payment Options

In June of 2018, HP2020 and the DAA hosted a webinar on the NDPP and new payment options, including the new coverage (as of April 2018) provided to Medicare beneficiaries by the Medicare Diabetes Prevention Program (MDPP). Over 1,000 public and clinical health care professionals and other interested parties participated in the webinar. Representatives from CDC and the Centers for Medicare and Medicaid Services (CMS) presented information on the prevention programs, their benefits, and the new coverage options.

Presenters from the DAA included the Y-USA, Dow Chemical, and the American Medical Association (AMA), who talked about their innovative efforts to deliver diabetes prevention programs and promoting awareness to the public and health care providers. The Y-USA is one of the few organizations that is working with Ys across the country to implement the NDPP. Dow Chemical, using HP2020 as part of its Total Worker Health framework, provides diabetes prevention programs to its employees. AMA presenters shared their work educating physicians on the availability of diabetes education and management programs for their patients. Visit the DAA’s website to find a recording of the webinar, the presenters’ PowerPoint slides, and a list of questions received during the webinar.

Our partnership with the DAA, and the continued work of its members and other HHS agencies, is working to prevent diabetes and improve treatment. Prior to the current HP2020 tracking period, we saw increases in the incidence of diagnosed diabetes from 1997–1999 to 2006–2008. During the HP2020 tracking period, the rate of new cases of diagnosed diabetes decreased from 8 new cases per 1,000 in 2006–2008 to 6.6 new cases per 1,000 individuals in 2014–2016, meeting the HP2020 target.

We look forward to continuing our joint efforts in support of diabetes prevention and care.