Overview. Although Minnesota has better health status and care delivery systems relative to other states, we have unacceptable disparities in diabetic health status and outcomes across populations. For all people in Minnesota, diabetes ranks as the 8th leading cause of death. In contrast, it is the 4th leading cause for American Indian and Alaska Natives and 5th leading cause for Black, African American and Asian American Minnesotans. Social determinants of health (SDOH), such as socioeconomic status, contribute to unfair and avoidable differences in health status. This can result in disproportionately higher rates of diabetes in some communities and population groups.
Applicant. To address inequities in diabetes outcomes, the Minnesota Department of Health (MDH) is applying for Component A of 23-0020 A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes with the intention of serving the 87 counties and 11 Tribes throughout the state of Minnesota. MDH has the capacity to serve all populations and communities within the state. The department is physically located at 625 Robert St. N., St. Paul, MN 55164-0975.
Purpose. Working with community partners, MDH will support strategies to decrease the risk for type 2 diabetes among adults with prediabetes and improve self-care practices, quality of care, early detection of complications among people with diabetes, and an evidence-based childhood obesity intervention for populations disproportionately impacted.
Strategies and Priority Populations. MDH will implement strategies #1, #3, #5, #7, #8 and #13. For this application, MDH is defining priority populations as Medicaid members in urban, suburban, and rural communities as well as American Indian; Black, African, and African American; Hispanic or Latino; and Asian or Asian American populations that are disproportionately impacted by diabetes.
Outcomes. The long-term outcomes for this proposal are: 1) decreased proportion of people with diabetes with A1C>9%; 2) increased number of program completers served by the CDC recognized National DPP delivery organizations who reduce their risk for type 2 diabetes; and 3) decreased percentage of the 95th percentile body mass index (BMI) and percent of median BMI in children, improvement in pediatric quality of life, and decreased BMI among caregivers. Intermediate outcomes include: 1) increased participation in evidence-based community behavioral change programs; 2) improved self-management of chronic diseases; 3) increased patient contact with CHWs or health care extenders; and 4) increased proportion of the population receiving the health care services they need and want. Short terms outcomes include: 1) increased number of organizations implementing evidence-based community behavioral change programs; 2) increased adaptation/tailoring of effective programs for priority populations; 3) increased number of patients screened and referred to community resources (i.e., health/mental health resources); and 4) increased SDOH screenings in clinical settings.
MDH has the capability to serve all populations in Minnesota by building on existing statewide DSMES and National DPP infrastructure and collaborating with new and existing partners who are reflective of priority populations, prioritize uplifting community voices, and who are well-versed in SDOH and quality care.