Advancing Health Equity in Diabetes Prevention and Management in the District of Columbia - Diabetes is the 8th leading cause of death in the District and is a leading risk factor for many chronic diseases and debilitating conditions such as heart disease, stroke, kidney failure, vision loss, and lower limb amputations. Approximately 90% of prediabetes and type 2 diabetes cases are preventable with lifestyle changes, largely influenced by the social and structural environments in which individuals live, work, and play. Healthcare providers, community leaders, and government agencies play a vital role in improving health outcomes of District residents. In the District, nearly 43,000 adult residents have diabetes and almost 50,000 have prediabetes, which reflects an 8% and 11% prevalence rate, respectively (DC Health, 2021). While the prevalence of diabetes in the District is lower than the national average (8.2% vs 9.6% age-adjusted) (BRFSS, 2021), mortality rates are significantly higher. The diabetes mortality rate in the District in 2020 was one and half times higher than the national rate (138.6 per 100,000 individuals vs. 93.6 per 100,000 individuals). Additionally, disparities persist across District populations, disproportionately affecting residents by geographic area, age, race, and socioeconomic status. Specifically, the diabetes mortality rate among Black/African American residents is nearly seven times higher than White residents (213.5 vs 29.9 per 100,000 individuals). Socioeconomic factors such as income, health literacy, quality preventive care utilization, and access to evidence-based lifestyle change, and self-management support programs contribute in part to the disproportionate burden of diabetes in the District. The goal of DC Health’s Chronic Disease Division (CDD) is to reduce the prevalence, morbidity and mortality from diabetes, heart disease, stroke, and other chronic conditions in the District by reducing the most common risk factors. The CDD aims to address these disparate outcomes by implementing strategies to prevent and manage chronic conditions and reduce risk factors, ultimately to advance health, wellness and equity across the District. Our team of chronic disease experts collaborate with health systems, federally qualified health centers, community-based organizations, government agencies and other key partners to ensure that data-driven, evidence-based and sustainable approaches are utilized across the District to improve diabetes and other chronic disease outcomes among our residents. Under the previous funding cycle, The Chronic Disease Division’s work focused on addressing gaps in availability, access, coverage and participation in diabetes evidence-based programs. The Division increased access to self-management programs, improved health systems’ capacity and advanced/expanded community-clinical linkages to improve the prevention and management of pre-diabetes and diabetes among high burden populations. Key to the work under this funding was the convening of The DC Million Hearts Learning Collaborative. Under Component A of the NOFO, DC Health, located at 899 North Capitol Street NE, Washington, DC 20002, intends to build on successes and lessons learned under the previous funding cycle to achieve statewide adoption of diabetes prevention and management strategies. The District aims to increase utilization of risk reduction strategies by; 1) engaging multisectoral partners, 2) strengthening the diabetes workforce, 3) reducing system/provider/individual barriers to evidence-based interventions, 4) promoting policy changes, 5) improving organizational and individual health literacy, and 6) implementing media and awareness campaigns. Strategies within this proposal prioritize high burden populations, Black/African American and Hispanic residents ages 45 and older living in Wards 4, 5, 7 and 8.
