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Dona Ana County Diabetes Profile. A Presentation to the Dona Ana County Health and Human Services Alliance February 10, 2010 by Janet Flores, Dr.P.H. NMDOH, Public Health Epidemiologist Jacob Nevarez, M.S. Dona Ana County HHS Dept. Management Analyst.

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dona ana county diabetes profile

Dona Ana County Diabetes Profile

A Presentation to the Dona Ana County Health and Human Services Alliance

February 10, 2010

by

Janet Flores, Dr.P.H.

NMDOH, Public Health Epidemiologist

Jacob Nevarez, M.S.

Dona Ana County HHS Dept.

Management Analyst

slide2

BACKGROUND In 2005, using data from the Healthy Gente/Healthy Border 2010 Indicators, DACHHS adopted diabetes as a community health priority

At that time, available death data indicated that diabetes death rates had increased over time.

Source: Border Epidemiology & Environmental Health (NMSU) www.nmsu.edu/~bec

hospital discharge rates
Hospital Discharge Rates

NM Health Policy Commission, Hospital Discharge Data, 2000 & 2003

slide4

During the Juntos por Cambios (2005-06) process, DAC medical leaders and key informants concurred that diabetes was a DAC health priority.

age adjusted diabetes death rate trends 2004 2007
Age-Adjusted Diabetes Death Rate Trends 2004-2007

Sources: Deaths: Final data. National vital statistics reports, NCHS, 2004-2009, NM Vital Records and Health Statistics 2004-09, NM Bureau of Business & Economic Research NM State and County population estimates, 2004-2007

available nm sources for county diabetes data
Available NM Sources for County Diabetes Data
  • NM Behavior Risk Factor Surveillance Survey (BRFSS)
  • NM Health Policy Commission (NMHPC) Hospital Inpatient Discharge Data (HIDD)
  • NM Vital Records and Health Statistics (NMVRHS) Death Data
nm behavior risk factor surveillance survey brfss
NM Behavior Risk Factor Surveillance Survey (BRFSS)
  • Reports results by US, State, Region, County
  • Covers 21 different health topics, 18 specific health data modules (including diabetes)
  • Annual randomized land-line telephone survey DAC population
    • Diabetes module recurs annually with 12 questions
      • Frequency of self-management behaviors
      • Compliance with DM recommended medical care procedures, and monitoring exams
  • Limitations (Response bias: largely women & retired men, omits cell phone numbers, less representative of colonias)
slide8
Estimated Age-Adj. Average Total Prevalence DAC Adult Diabetes, 2004-2006range of % estimates : DAC(8.9-12.2), NM (8.6-9.7)

Source: National BRFSS results, 2004-06; NMDOH Diabetes Prevention and Control Program County Prevalence Estimates, 2004-06 based on BRFSS data for DAC and NM

estimated prevalence adult diabetes diagnosed in dac 2005 2007
Estimated Prevalence Adult Diabetes Diagnosed in DAC, 2005 & 2007

Source: New Mexico BRFSS Diabetes Module data by County, 2005 & 2007

estimate of dac adults with diabetes by age 1 521 brfss respondents
% Estimate of DAC Adults with Diabetes by Age (1,521 BRFSS respondents)

Source: New Mexico BRFSS Diabetes Module data by County, 2005 & 2007

diagnosed adult diabetes associated with ethnicity
Diagnosed Adult Diabetes Associated with Ethnicity

Source:New Mexico BRFSS Diabetes Module data by County, 2005 & 2007

diabetes prevalence associated with lowest income n 1352
Diabetes Prevalence Associated with Lowest Income (n = 1352)

Source: New Mexico BRFSS Diabetes Module data by County, 2005 & 2007

diabetes and health care coverage n 1523
Diabetes and Health Care Coverage(n=1523)

Source: New Mexico BRFSS Diabetes Module data by County, 2005 & 2007

dac diabetes associated with little to no physical activity
DAC Diabetes Associated with Little to No Physical Activity

Source: New Mexico BRFSS Diabetes Module data by County, 2005 & 2007

sources of diabetes data cont
Sources of Diabetes Data (cont.)
  • NM Health Policy Commission (NMHPC) Hospital Inpatient Discharge Data (HIDD)

- Mandated reports from all non-federal hospitals:

      • Patient discharge numbers, demographics, diagnoses (ICD codes), procedures performed, payer information, & discharge status
    • Limitations: HIPAA restrictions limit access to data, timeliness of reports
dac has 1 day longer average length of hospital stay for diabetes
DAC has +1 Day Longer Average Length of Hospital Stay for Diabetes

Source: NMHPC Hospital Inpatient Discharge Data 2003-2007

of diabetes hospitalizations by patient age 2003 2007
% of Diabetes HospitalizationsBy Patient Age, 2003-2007

Source: NMHPC Hospital Inpatient Discharge Data 2003-2007

payer mix for diabetes hospitalizations
Payer Mix for Diabetes Hospitalizations

Source: NMHPC Hospital Inpatient Discharge Data 2003-2007

sources of dac diabetes data cont
Sources of DAC Diabetes Data (cont.)
  • New Mexico Vital Records and Health Statistics (VRHS) Death Data
    • Reports of all deaths per NM county of residence by:
      • Demographics
      • Causes of death (ICD 10)
dac resident diabetes deaths 2002 2007
DAC Resident Diabetes Deaths2002-2007

Source: New Mexico Vital Records and Health Statistics, 2003 - 2007

dac diabetes deaths by age gender
DAC Diabetes Deaths by Age & Gender

Source: New Mexico Vital Records and Health Statistics, 2002 - 2007

dac hf summary of diabetic patients
DAC HF Summary of Diabetic Patients

Source: Health Fund data collected for FY 08-09

1,964 visits and 804 unduplicated patients

The youngest patient 21 and oldest patient seen was 85

Average age 55

Median age 57

8% of all diabetic visits were for individuals 40 and younger

30% of all diabetic visits were for individuals 50 and younger

percent of dac hf diabetic visits n 13 119
Percent of DAC HF Diabetic Visits (n=13,119)

Source: Health Fund data collected for FY 08-09

percent of dac hf diabetic patients age category n 1 964
Percent of DAC HF Diabetic Patients/Age Category (n= 1,964)

Source: Health Fund data collected for FY 08-09

summary
Summary
  • DAC Diabetes prevalence is similar to NM & US. Diabetes prevalence . . .
    • Increases with age
    • Is greater among Hispanics and other ethnic groups
    • Is highest among the lowest-income groups
    • Is highest among the overweight & obese
    • Is lowest among those who get regular vigorous physical activity
  • DAC Diabetes hospital discharges nonsignificantly differ from NM & other NM counties . . .
    • Slightly longer (+1 day) average hospital stay/diabetes patient
    • Slightly greater % discharges for ages 45-64, and 65+
    • Greater % which are charity care, private insurance, and self-pay pts.
  • 66% of diabetes patients served by the DAC Health Fund are 45-64 y.o.
  • DAC diabetes deaths declined from 7.2% in 2004 to 4.9% in 2006,then rose in 2007 to 5.7% of all deaths.
conclusions
Conclusions

Benefits to examining objective, population- based health data:

  • Can create a “visual” of health issue in county, state, country
  • Can provide basis for prioritizing issues/planning interventions/prevention
  • Gives baselines/benchmarks against which we measure intervention progress/success
authors
Contact

Janet Flores, Dr. PH. New Mexico Public Health Region 5 Epidemiologist

Tel. (575) 528-5074

Slides # 2-22

Contact

Jacob Nevarez, MS. Dona Ana County HHS Management Analyst

Tel. (575) 525-5838

Slides # 23-26

Authors