September 14, 2011
jjîortlanh (Dbseruer
Page 7
Diabetes Remain High with Health Disparities
Key is early
diagnosis and
management
of disease
by M indy C ooper
T he P ortland O bserver
More than 241,000 Oregon residents are
living with diabetes, and the numbers are on
the rise.
Although the chronic disease effects
people from all walks of life, the risk of diabe
tes are higher for Hispanic Americans, Asian
Americans, Native Americans and— espe
cially African Americans.
In an effort to eliminate the disparities,
Lifeworks NW and the Multnomah County
Health Department developed ACHIEVE, a
community planning process to address root
causes of inequities in chronic diseases.
Rachael Banks, program supervisor at
Multnomah County’s Community Wellness
and Prevention department, said the pro
gram was created in 2009 to help people make
healthy choices.
“The goal was to get together a policy
action team to look at the policies we have
within our community, identify the gaps and
then make a plan of action,” said Banks.
“When we came together three years ago, we
asked what we wanted our legacy to be, and
someone said, ‘I don’t want my grandchild to
have diabetes.’”
Although the program is a nationwide
effort, Banks explained Multnomah County
was one of just two communities that fo
cused on a specific population to address
health disparities.
Diabetes, one of the leading causes of
death and disability in the country, is defined
as a group of diseases marked by high levels
of blood glucose resulting from defects in
insulin production, insulin action, or both.
Insulin, a hormone produced by the pan
creas, helps the body absorb excess sugar
from the bloodstream, but in a person with
diabetes, blood sugar levels are not ad
equately controlled by insulin.
Although there is a common misconcep
tion that diabetes mostly develops from eat
ing too much sugar, experts say our bodies
are predisposed with genetic factors— es
pecially in type II diabetes, which affects 90
percent of those with the disease.
Although the chronic condition can cause
photo by M indy C ooper /T he P ortland O bserver
Michael Crocker, clinical nurse supervisor for Multnomah County's Northeast Health Center on Martin Luther King Boulevard,
speaks out about the high-sugar content in certain foods products, helping patients manage diabetes and other health conditions.
serious complications in an individual’s
health and quality of life, people with diabe
tes can take steps to control the disease and
lower the risk if diagnosed early and man
aged in a proper way.
According to Bruce Gutelius, the deputy
state epidemiologist for the Heath Author
ity, because diabetes is a long-term chronic
disease, for which there is not necessarily a
cure, management over a life span is neces
sary.
“The environment is a huge contributor to
people developing and managing diabetes,”
he said. “We also know people developing
and managing diabetes may not have what
they need to have access to healthy food and
physical activity in their surrounding area,”
he said.
Environmental disparities, Dukes said, is
one of the reasons the department chose to
focus specifically on African American popu
lations. “We can and we should focus on
strategies that work for the whole popula
tion, and focus on those who have the high
est risk and burden,” he said.
Poverty, discrimination, oppression, and
a lack of political power are some of the most
common root factors in health inequities.
The social environment can dictate the level
of medical services received and the behav
ior of individuals.
According to Bev Bromfield, a regional
program manager for the American Diabetes
Association, healthcare costs can also range
two to three times higher for people with
diabetes than those without because of the
high management costs of the disease.
“Typically, they are on one or two medi
cations or more,” said Bromfield.
Another issue is the marketing and avail
able of unhealthy foods in Portland’s low-
income neighborhoods.
ACHIEVE works to create policies and
environments where people have better ac
cess to healthy foods, along with regular
physical activities,.
Several programs have also made it their
goal to delay and manage an individual’s
health conditions as a means to prevent
complications and improve quality of life.
A Living Well with Chronic Conditions
program, for example, is a six week workshop
series, where anyone with a chronic condi
tion can meet once a week, including those
suffering from diabetes, high blood pressure
and/or arthritis.
Although there are participant costs for
the program, some local organizations work
with individuals who can’t afford to pay.
Banks said ACHIEVE runs health clinics
to increase care and focus on management.
“Ultimately, we want to stop people from
getting diabetes in the first place. Often times
it is a preventable condition,” she said. “But
one of the things the program wants to focus
on is prevention.”
Although the level of diabetes is on the
rise. Banks said, “I have high hopes for the
future.”
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