NR 503 CUCN Week 2 Healthy People 2020 LGTBQ Community Paper
NR 503 CUCN Week 2 Healthy People 2020 LGTBQ Community Paper
Diabetes is a growing healthcare concern in adults. Diabetes is a chronic disease characterized by increased blood glucose levels caused by a reduced ability of the body to utilize or secrete insulin. It is an important public health issue since it is associated with increased healthcare costs and a higher risk of health complications, such as cardiovascular diseases, stroke, vision loss, kidney failure, and nerve damage (Pippitt et al., 2018). The risk of premature death for diabetic adults is 60% higher. Therefore, diabetes needs to be effectively addressed to lower its associated complications and healthcare costs. The purpose of this paper is to discuss diabetes in Illinois, including statistics and epidemiology, and population-based health education interventions.
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Overview, Background, and Significance of the Problem
Approximately 34.2 million people in the U.S. have diabetes. Of this population, type 2 diabetes (T2DM) accounts for 90 – 95% of all diabetes cases (CDC, 2020). In Illinois, an estimated 1.3 million adults have diabetes. However, about 341,000 of these adults are not aware they have diabetes. Of the estimated 88 million Americans with prediabetes, 3.6 million are Illinois residents. Diabetes is the seventh leading cause of mortality nationally and in Illinois (IDPH, 2021). The number of adults in Illinois ever diagnosed with diabetes escalated from 9.7% to 11.3% between 2011 and 2019.
The incidence of prediabetes in Illinois and the U.S. is also increasing. An additional 88 million individuals in the U.S. have prediabetes. According to the Illinois 2021 diabetes reports, the prevalence of diabetes among adults aged 18-44 was 2.0%, while the overall U.S. was 3.2% (IDPH, 2021). Adults aged 45-64 years had a prevalence of 14.8%, and 65 years and older had 22.6, whereas the overall U.S. prevalence was 114.6 for 45-64 years and 22.5% for 65 years and above (CDC, 2020). Males had a slightly higher prevalence of diabetes than females, with 11.3% in males and 9.9% in females. Based on race and ethnicity, African Americans had the highest rate with 16.6%, followed by Whites with 10.4%, and Hispanics had the least prevalence with 8.5%.
Epidemiological Analysis of the Problem
Diabetes was more prevalent among adults aged 65 years and above than in other age groups. Between 2015 and 2019, diabetes in Illinois was higher among adults living in rural areas, mostly in southeast Illinois, compared to other counties. Rural counties mostly have higher rates than the state’s average. The disparity is attributed to fewer diabetes-related health care services and limited access to diabetes self-management education programs than urban areas (IDPH, 2021). The incidence of diabetes was considerably higher among adults with less than a high school education level. Besides, adults with an annual household income below $15,000 have the highest diabetes prevalence, whereas those with an income of $75,000 or above had the lowest rate.
Obesity is a significant risk factor for diabetes in Illinois, and obese/overweight adults are considered an at-risk population. The prevalence of overweight/obesity among diabetic adults in Illinois in 2019 was considerably higher than among under/normal-weight adults (IDPH, 2021). According to Healthy People 2020 (H.P. 2020), disparities in diabetes risk are evident in minority populations. Individuals from minority ethnic/racial groups are more likely to develop T2DM. Minority groups account for 25% of adults with diabetes in the U.S. and constitute the majority of pediatrics with T2DM. For instance, African Americans, American Indians, Hispanic/Latino Americans, Asian Americans, and Native Hawaiians/Pacific Islanders are significantly more likely to develop T2DM.
Application of H.P. 2020
The H.P. 2020 goal related to diabetes is: To alleviate the disease burden of diabetes and improve the quality of life for all individuals who have or are at risk of diabetes. The objectives are to: Decrease the number of new cases yearly of diagnosed diabetes; Reduce mortality among people with diabetes; Lower the rate of lower-limb amputations in diabetics; Improve glycemic control; Increase the number of diabetics who receive the needed medical follow-up and diabetes education; Increase the number of individuals with diabetes whose have been diagnosed; Improve prevention practice in people with prediabetes (Healthy People 2020, n.d.).
The American Diabetes Association (ADA) developed the guidelines for diabetes referred to as The Standards of Medical Care in Diabetes. It includes current clinical practice recommendations. It is aimed to offer the components of diabetes care, treatment goals and guidelines, and tools to assess the quality of care. Hemoglobin A1c (HbA1c) test is one of the screening methods for diabetes (Pippitt et al., 2018). Diabetes is diagnosed based on an A1C level of 6.5% or more. The test approximates the average blood glucose levels over two to three months. It can be used by anyone, including all age groups and ethnicity/racial groups. However, some limitations occur in A1C testing, and an incomplete association between A1C level and average glucose level in some people (Pippitt et al., 2018). For instance, acute blood loss and hemolytic anemia can falsely reduce A1C levels, while previous splenectomy and aplastic anemia can falsely increase A1C levels since they increase erythrocyte age.
Population-Level Planning Interventions
Genomics is being carried out at the population health level to prevent and promote health in diabetes at the national level. It entails using family health history genetic tests to guide clinical and public health interventions. Genetics is one of the risk factors for diabetes. Genetic tests are used to identify an individual’s risk of developing diabetes and guide health education on lifestyle practices to lower this risk (Healthy People 2020, n.d.). At the state level, the Illinois Department of Public Health (IDPH), with its partners, focuses on the prevention and management of diabetes through collaboration with the CDC.
Evidence-based interventions are being executed through partnerships, with a key focus on populations vulnerable to diabetes, such as older adults, Hispanic and non-Hispanic Black populations, and people living in rural areas (IDPH, 2021). For example, IDPH and its partners are exploring new and innovative approaches to provide virtual programs promoting the prevention and self-management of diabetes in central and southern Illinois. The programs include Diabetes Self-Management Program, Chronic Disease Self-Management Program, and the National Diabetes Prevention Program (CDC, 2020). The outcomes being tracked related to the genomic intervention include the number of adults at risk of diabetes who are genetically tested and initiated lifestyle interventions to reduce the risk of developing diabetes. Besides, outcomes at the state level are being tracked by evaluating the number of people who access diabetes prevention and self-management education programs.
Conclusion
Diabetes is a prevalent chronic condition in Illinois and the U.S. in general. The prevalence of diabetes in Illinois varies based on age, gender, race, geographical location, level of education, and household income. H.P. 2020 seeks to lower the burden of diabetes and improve the quality of life of diabetics. Genomics and diabetes health education programs are being used at the national and state level to prevent diabetes and mitigate its impact.
References
American Diabetes Association. (2022). Introduction: Standards of Medical Care in Diabetes—2022. Diabetes Care, 45(Supplement_1), S1-S2. https://doi.org/10.2337/dc22-Sint
Centers for Disease Control and Prevention (CDC). (2020). A Snapshot: Diabetes in the United States. Retrieved January 2021, from https://www.cdc.gov/diabetes/library/socialmedia/infographics/diabetes.html
Healthy People 2020. (n.d.). Diabetes | Healthy people 2020. https://www.healthypeople.gov/2020/topics-objectives/topic/diabetes
Healthy People 2020. (n.d.). Genomics | Healthy people 2020. https://www.healthypeople.gov/2020/topics-objectives/topic/genomics
IDPH. (2021, June). Diabetes in Illinois. Home. https://dph.illinois.gov/content/dam/soi/en/web/idph/publications/idph/topics-and-services/diseases-and-conditions/diabetes/2021_Illinois_Diabetes_Burden_Report
Pippitt, K., Li, M., & Gurgle, H. E. (2018). Diabetes mellitus: screening and diagnosis. American family physician, 93(2), 103-109.
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Research Topic: Genomics
Identify your target population (for instance, age or other demographic, aggregate population); this must be in your city or state.
Discuss population-based health education interventions for your target population that is aimed at reducing morbidity and mortality for the problem. Be sure to review the research literature and HP2020 for interventions.
Identify how and what data for interventions is being tracked.
In a four (4) page paper, address the following. Refer to rubric for expanded details related to grading expectations.
Identify the problem in the introduction section.
Provide an overview of the problem in your state of (Iliinois) and national.
Review of descriptive epidemiological and demographic data on mortality/morbidity and risk.
HP2020: Present the goal, overview and objectives of Healthy People 2020 for the paper topic.
Population level prevention and health promotion review. Describe population and/or primary health care focused interventions. Use of scholarly literature and HP2020 is required. There should be direct correlation to evidence for all strategies.