Washington State Department of Health (DOH) proposes to design, test, and evaluate novel approaches to address evidence-based strategies to address diabetes and cardiovascular disease (CVD) in response to DP18-1817, Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke. We request $3,000,000 for the first year of this five-year project to reduce risks, complications, and barriers to prevention and control of diabetes and CVD in lower-income, high-burden populations in Washington. This work builds upon the accomplishments and outcomes produced through our implementation of the CDC’s DP13-1305, “State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health” and DP14-1422, “State and Local Public Health Actions to Prevent Obesity, Diabetes, and Heart Disease and Stroke.”
In WA heart disease, stroke, and diabetes are leading causes of morbidity, disability, and death. The health and social impacts of these diseases are not evenly distributed in the adult population; marked disparities in prevalence and outcomes are noted between populations based on age, geography, socioeconomic status, race, ethnicity, and other factors. Our target populations are adults ages 18 and older who are at or below 200% of the Federal Poverty Level (FPL). In Washington, this population includes the following groups: African American or Black, American Indian or Alaska Native, Asian, Hispanic or Latino, Native Hawaiian or Other Pacific Islander adults; those living in rural or urban geography; older adults; and adults with disabilities. The target populations identified for this opportunity experiences significantly higher prevalence of diabetes, heart disease, and stroke than other groups in WA.
This proposal includes innovative activities that advance technological and methodological solutions to improve health under 6 selected strategies in Category A, Diabetes Management and Type 2 Diabetes; and 7 selected strategies in Category B, CVD Prevention and Management strategies. DOH will design, test and evaluate 4 key synergistic approaches among more than 900,000 adults in high burden populations, especially in rural communities, and work with non-traditional partners located in non-traditional settings. These approaches: 1) Build and advance new partnerships; 2) Explore emerging outreach methods to engage previously overlooked populations; 3) Test new methods of engagement between providers, health care teams, community health workers, organizations, and patients; and 4) Use new technology to expand the reach/impact of public health in chronic disease prevention and management.
Diabetes and CVD in WA continue to be serious, common, and costly conditions. DOH’s work in diabetes and cardiovascular health over the past 39 years aligns with Healthy People objectives, and with the Million Hearts® 2022 Initiative, as they relate to improving health for WA citizens at greatest risk. The activities proposed to improve diabetes and CVD-related health are built on evidence and promising practice, while creatively using strengths of our internal capacity and longstanding partnerships.
WA is nationally known for resourcefully supporting DPP, Medicaid coverage for Diabetes Self-Management Education, using Community Health Workers to support Self-Monitoring of Blood Pressure, and using technology to support providers and patients in managing chronic health conditions. Our proposal builds on the lessons learned and DOH intendeds to maximize federal investments in the work of state and local departments of health. The strategies selected are anticipated to lead to improvements in immediate and long-term health outcomes for our target populations.