The Growing Problem of Diabetes in Latinos - Essay Example

? The Growing Problem of Diabetes in Latinos and Number: Submitted: Diabetes is a significant problem in the United States with more than 25 million Americans affected by the health problem in 2010 alone (Centers for Disease Control and Prevention, 2011). The disease is a prevalent problem that disproportionally affects Latinos, with people of Latino ethnicity having approximately two-thirds greater chance of having diabetes than non-Latino whites (National Diabetes Education Program, n.d.). Diabetes is prevalent throughout the world, and people with the disease lack the ability to either produce or use insulin depending on the type of diabetes that they have. In addition to this, patients with diabetes also has an increased risk of complications during the progression of the disease (Hartnett et al., 2000), and are more likely to have a vascular condition as a result (Pennathur and Heinecke 2004). Latinos suffer significantly from diabetes, not only due to their increased likelihood of having the disease, but also because a large proportion lack the means or ability to effectively manage their diabetes. For example, one important aspect of diabetes management is glucose control, and diabetics who do not effectively do this can have significant health consequences. There are many factors that affect this, a large number of which are more common in Latinos than other ethnic groups, such as a low level of health literacy, few economic resources and language barriers (Herrera et al., 2011). As such, diabetes is a prevalent disease among Latinos that has a strong negative health impact and can lead to complications. Houston Texas is the state which has the second-highest amount of Latinos out of any state within America. Because of this, it is an area where the prevalence of diabetes is a significant problem. There are also 16 areas within the state that are considered to be ‘medically underserved areas’, where people receive limited medical care, which often does not meet their needs (City of Houston, 2005). Latinos have higher levels of mortality from diabetes than the white population, and also experience lower access to preventative healthcare services. The amount of people that die from diabetes is approximately 90% higher for Latinos than for whites (Houston Health and Human Services, 2008). Diabetes in Latinos is a problem that is only beginning to be addressed as a specific need, however, there are current resources and services available that are focused on providing assistance to this group. One of these resources that is available for Latinos with diabetes at a nationwide level is an online information base that provides documents about diabetes, statistics and methods of managing diabetes, with many articles provided in the Spanish language. However, this database is not widely known, and its availability is not communicated to the relevant people (National Diabetes Information Clearinghouse, 2012). Another resource is the Junior Diabetes Relief Fund (JDRF), which plays a large role in community events, fundraising and research. The large number of public events that JDRF is involved in, means that it is recognized throughout the United States (JDRF, 2012). Within Houston itself, one resource that is available to diabetic Latinos is a small clinic opened in Denver Harbor, which served 9,000 patients in 2007. The community approach that this clinic has, has helped it to gain recognition, and its existence was communicated through a news article, as well as through word-of-mouth (Berger, 2007). A final resource is the American Diabetes Association, which has a local office in Houston, and offers a wide range of support, including contact information to local support groups, and a range of upcoming events. This resource is advertised primarily through its events, which reach large numbers of people (American Diabetes Association, 2012). There are many barriers that influence the ability of Latinos with diabetes to receive help for their disease and to effectively care for themselves. Services need to address the particular problems that are present within the Latino population, and to provide them with increased information and encouragement about methods of treating their disease, such as monitoring glucose levels and self-management in general. The primary type of services that are needed are ones that improve health education and information that is accessible and understandable to diabetic Latinos and those who are at risk for diabetes. The second important type of services is those that increase the level of communication between Latinos with diabetes and health providers, as this also plays a role in increasing their knowledge and their ability to obtain feedback from an actual person that understands their disease. Research has shown that Latinos with diabetes are frequently unaware of the recommended approaches to treatment and monitoring for their disease (Chin et al., 2000). Access to health care and information can be a significant problem for Latinos, many of whom are low income, and do not health insurance or the finances to obtain effective medical treatment (Herrera et al., 2011). In Houston and other parts of the country, Latinos often have low access due to frequently being present in areas that are medically underserved. These two factors make it difficult for Latinos to access health services or to communicate with health practitioners. In addition, Latinos are faced with two simultaneous communication challenges with accessing diabetes information and services. The first of these is health literacy, which describes the level of knowledge and understanding that the individual has of health topics. A low level of health literacy means that a person may not be able to understand health instructions that they are given, and because of this may not be able to accurately follow them (Hernandez, 2009). The second communication issue is that many Latinos are not fluent in English, and cannot understand or information given to them (Herrera et al., 2011). These two problems make it difficult for Latinos to incorporate and act on health information and to care for their diabetes. From the political and regulatory perspective, there has been considerable focus on decreasing the issues that limit health disparity between minority groups and other ethnic groups, although some issues still remain. One approach has been the development of health information technology, which attempts to decrease some of the disparities. This approach was introduced into legislation with the 2009 HITECH (Health Information Technology for Economic and Clinical Health) Act, which focuses on increasing the introduction and adoption of information technology for health (NORC, 2010). Nevertheless, health policies and initiatives tend to focus primarily on addressing the needs of the majority of the population, and minority groups are often excluded due to the differences in their needs. Delivery and care from single agencies is not an effective way of approaching the problems of diabetes in Latinos. Instead, the use of inter-agency approaches is crucial, in order to increase the number of Latinos who are effectively served, and the level of care. It can sometimes be difficult for agencies to operate collaboratively, as their interests may conflict, such as for obtaining funding or reimbursement. An additional problem for the Latino population is that there is often not many agencies available that can collaborate with one another, and these may be overworked. This limits how effective inter-agency delivery and care is for Latino diabetics. The medical system in the United States is already under considerable strain, with cutbacks having to be made in some areas in order to accommodate expansions in others. Developing a comprehensive, targeted approach to a minority population, especially for a single disease, is difficult in light of this economic climate. However, finding a solution for the issues surrounding diabetes in Latinos is an important strategic approach due to issues of population and human impact. Latinos currently consist of about 15% of the population of the United States, with estimates projecting that they will grow substantially by 2050 (Livingston, Minushkin & Cohn, 2008). With the increase in the Latino population, developing an effective approach to managing diabetes within this group is crucial. Solving this community health problem involves several groups of major stakeholders. The first is the government, which plays an important role in the development of policy and also is strongly involved in the funding of healthcare within the community. The second major stakeholder is healthcare institutions, which includes public and private institutions both profit based and those that are not-for-profit. The third group of stakeholders is the consumers, who directly gain from any intervention that promotes better healthcare. A minor group of stakeholders is pharmaceutical companies and industry which are often strongly involved in the development of treatment, as well as organizations that make devices such as glucose meters. Although there are many potential avenues for conflicting agendas between these stakeholders, the most prominent is the struggle between profit, healthcare costs and healthcare outcomes. In addition, there are many agencies that potentially offer the same services, which could lead to crossovers in service provision. On the basis of this analysis, the first recommendation that I would make would be to increase the use of a form of health information technology known as electronic health records (EHRs). This form of technology has the potential to increase the ability of healthcare agencies to care for their patients and letting them access the information of patients faster. It is also a low cost technology (Office of the National Coordinator, 2011). The second recommendation would be to focus on the creation of organizations and teams that focus on providing the needs of other the diabetic Latino population specifically and also has a strong emphasis on diabetes. There are currently organizations that focus on increasing service to Latino groups, such as HIMSS Latino Community, and these have played many roles in increasing healthcare to Latino groups. However, these organizations have not focused specifically on diabetes, so the need for this remains prevalent. It is only when a group is focused specifically on this group that they will effectively be able to focus on the unique problems that are present and find solutions (HIMSS Latino Community, 2012). My final recommendation would be the investigation and implementation of other forms of health technology, such as programs that make use of mobile phones that focus on the Latino diabetic community. This approach could help to bridge the gap, providing customized care for Latinos, while being economically viable (Schroeder et al., 2011). References American Diabetes Association. (2012). In My Community. Retrieved from http://www.diabetes.org/in-my-community/local-offices/houston-texas/ Berger, E. (2007). Houston Clinic on Mission to aid Latino Health. Retrieved from http://www.chron.com/news/houston-texas/article/Houston-clinic-on-mission-to-aid-Latino-health-1807377.php Centers for Disease Control and Prevention. (2011). 2011 National Diabetes Fact Sheet. Retrieved from http://www.cdc.gov/diabetes/pubs/factsheet11.htm. Chin, M.H., Auerbach, S.B., Cook, S.C., Harrison, J.F., Koppert, J., Karrison, T.G.,… McNabb, W.L. (2000). Quality of diabetes care in community health centers. American Journal of Public Health, 90(3), 431-434. City of Houston. (2005). Community Profiles. Retrieved from http://www.houstontx.gov/health/AIM/CommunityProfiles.html Hartnett, M. E., Stratton, R. D., Browne, R. W., Rosner, B. A., Lanham, R. J. and Armstrong, D. (2000). Serum markets of oxidative stress and severity of diabetic retinopathy. Diabetes Care, 23: 234-240. Hernandez , L. M. (2009). Health literacy, ehealth, and communication: putting the consumer first: Workshop summary. Institute of Medicine of the National Academies. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK36296/pdf/TOC.pdf Herrera, A.P., Smith, M.L., Ory, M.G., Rodriguez, H.P., Warre, R., Thompson … Romero, J.A. (2011). The provision of diabetes care monitoring exams to older Latinos. Journal of Aging & Health, 23(7), 1075 - 1100. HIMSS Latino Community. (2012). HIMSS Latino Community. Retrieved from http://www.himss.org/ASP/latino_community_home.asp Houston Department of Health and Human Services. (2008). The City of Houston Health Disparities Data Report. Retrieved from www.houstontx.gov/health/disparity.pdf JDRF. (2012). JDRF: Improving Lives, Curing Type 1 Diabetes. Retrieved from http://www.jdrf.org Livingston, G., Minushkin, S. and Cohn, D. (2008). Access, information and knowledge: Hispanic and health care in the United States. Pew Research Center. Retrieved from http://www.pewhispanic.org/files/reports/91.pdf National Diabetes Information Clearinghouse (NDIC). (2012). Diabetes in Hispanics/Latinos. NORC at the University of Chicago. (2010). Understanding the Impact of Health IT in Underserved Communities and those with Health Disparities. Briefing paper, presented to the United States Department of Health and Human Services. Retrieved from http://www.healthit.gov/sites/default/files/pdf/hit-underserved-communities-health-disparities.pdf Pennathur, S. & Heinecke, J. W. (2004). Mechanisms of oxidative stress in diabetes: implications for the pathogenesis of vascular disease and antioxidant therapy. Frontiers in Bioscience, 9, 565-574. Schroeder, D.G., Hix, B., Dean, D., and Fiordelisi, V. (2011). Improving the health of Hispanics using mobile technology. Hola Doctor and Interactive mHealth Solutions The Office of the National Coordinator for Health Information Technology.(2011). Health IT Home. Retrieved from http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__home/1204 Read More