Preventing Diabetes and its Complications: What Works in the Hispanic Community

1. Preventing Diabetes and its Complications: What Works in the Hispanic Community Wednesday, September 28, 2005 2:00 p.m. EDT Please wait. The Web conference will begin shortly. Thank you.

2. Preventing Diabetes and its Complications: What Works in the Hispanic Community Lynne Flynn, Web conference moderator Director of Health Policy The Council of State Governments

3. CSG’s Healthy States Initiative • CSG’s Partners: • National Black Caucus of State Legislators-- www.nbcsl.com • National Hispanic Caucus of State Legislators— www.nhcsl.com • Complete information on Healthy States: www.healthystates.csg.org • Click on the Healthy States link on lower left and other resources listed • Supported by the Centers for Disease Control and Prevention (CDC)

4. Upcoming Web conferences • 2 more planned this year, including: • Prevention of Teen Sexual Risk Behaviors • Colorectal Cancer Prevention • 6 archived on Web site: Immunizations Disparities, Heart Disease & Stroke, Vaccine Safety, Oral Health, Anti-smoking and School Health

5. Technical Problems? • For problems connecting to the Web, call 1.866.767.6902 • If you have any difficulty with audio or Web connections, press *0 for operator assistance

6. Please Complete Evaluation at End of Web Conference • We need your help! • Please complete the evaluation poll at the end of the Web conference

7. Today’s Speakers • Centers for Disease Control and Prevention • Jane Kelly, MD, Director National Diabetes Education Program Centers for Disease Control and Prevention, Division of Diabetes Translation • Betsy Rodriguez, BSN, MSN, CDE, National Diabetes Education Program – (NDEP), Public Health Advisor, Centers for Disease Control and Prevention, Division of Diabetes Translation • New York State Assemblyman Felix Ortiz, President National Hispanic Caucus of State Legislators • Arizona State Representative Amanda Aguirre, M.A., R.D.

8. Assemblyman Felix W. Ortiz • New York State Assemblyman representing the 51st Assembly District since 1994 • Named President of the National Hispanic Caucus of State Legislators in June 2005 • Democratic District Leader of the 51st Assembly District in 1992 to 1994 • Serves on Alcoholism/Drug Abuse; Banks; Corporations, Authorities and Commissions; Correction; Economic Development, Job Creation, Commerce and Industry; Energy; Labor Committees

9. Why Diabetes Prevention is Important • Diabetes is a problem that affects all of our society… every individual and business taxpayer is affected in addition to the families who suffer from the complications of diabetes. • Obesity and diabetes are costing our society over $100 billion, and much of that is Medicaid spending. • In the coming weeks The New York Times will publish a story about how diabetes is becoming the number one health problem affecting New York City, especially in Hispanic populations.

10. Obesity Is The Cause • Obesity among Hispanics is increasing at a rate of 20% to 30% each decade. • Over 32% of the children age 2-5 who are participating in New York WIC program are overweight

11. Diabetes Is The Effect • This leads to illnesses such as diabetes in young children. CDC research estimates that 53 percent of healthy 2 to 3 year-old Hispanic girls and 45 percent of the boys are likely to develop diabetes in their lifetimes unless children start eating less and exercising more.

12. Dr. Jane Kelly • Program director, National Diabetes Education Program (NDEP), Centers for Disease Control and Prevention • NDEP is a joint initiative of CDC and National Institutes of Health • Internist with over 15 years’ experience as a primary care provider in resource-challenged settings with cross-cultural diversity from South Carolina to Arizona to Alaska. • Indian Health Service (IHS) Alaska Community Health Aide Program Medical Director (1992-1996) and the IHS Alaska Area Diabetes Control Officer (1996-2000) • Faculty for the Institute for Health Care Improvement since their first Diabetes Collaborative in1998. • Authored several articles on diabetes care for Indian Health Service, and evaluation programs using community health workers

13. Prevalence of diagnosed and undiagnosed diabetes in Mexican Americans, U.S.,1988-94 Diabetes is a Growing Epidemic for Hispanic/Latino Americans • Over 2 million Hispanics have diagnosed diabetes • Over 10 percent of all Hispanics have diabetes • On average, Hispanics are almost 2 times more likely to have diabetes than non-Hispanic whites of similar age * National Diabetes Information Clearinghouse. (2002). National diabetes statistics. (NIH publication 02-3892. Fact sheet).

14. 1991 Obesity Trends* Among U.S. AdultsBRFSS,1991, 1996, 2004 (*BMI 30, or about 30 lbs overweight for 5’4” person) 1996 2004 No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

15. Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes) BRFSS, 1990,1995 and 2001 1990 1995 2001 No Data <4% 4%-6% 6%-8% 8%-10% >10% Source: Mokdad et al., Diabetes Care 2000;23:1278-83; J Am Med Assoc 2001;286:10.

16. Of Hispanic/Latino children born today in the United States, 1 in 2 will develop diabetes in his or her lifetime…unless something changes

17. Assemblyman Felix Ortiz Policy Issues • Preventing and Reducing Obesity • Preventing and Reducing Diabetes and Complications • Changing Behavior and Environment -Food -Physical Activity -Healthcare

18. Policy Solutions • Community-based education (Gov’t programs) • Marketplace information (Restaurant labeling) • School-based care (Diabetes checkup at school) • Funding (Fat Tax)

19. Betsy Rodríguez • Nurse specialized in chronic and critical care and certified diabetes educator; bicultural specialist in social marketing strategies and in the development of media products for the Hispanic Latino population. • Instructor, Pontifical Catholic University and the Interamerican University in Puerto Rico • Working since 1990 with the International Diabetes Federation in the Central and South America Region (SACA) coordinating diabetes health education programs and the SACA strategic plan • Founder of Programa Educativo de Salud Integral, In. (PESI), a Health Education and Prevention Program, with a multidisciplinary approach, including Nurses, dietitians, health educators, diabetes educators, community heath workers and social workers • Since 2001, Public Health Advisor at CDC in the National Diabetes Education Program (NDEP); project officer for the National Alliance for Hispanic Health and the National Latina Health Network

20. Ideas for States to decrease health disparities • Join forces with the state diabetes prevention and control programs • Promote the message that diabetes is serious, common, costly, yet controllable • Advocate for diverse partnerships

21. Ideas for States to decrease health disparities • Increase awareness of the strategies for preventing diabetes and its complications. • Promote health care policies

22. It’s an opportunity… • One size doesn’t fit all • But there are many common needs and rights: • The right to be treated with respect • The right to receive the correct treatment and medications • The right to preserve your dignity as a human being

23. Arizona State Representative Amanda Aguirre, M.A., R.D. • Since 1991, Executive Director of the Western Arizona Area Health Education Center • Involved for more than 20 years in public health education and administration with a strong emphasis in U.S.-Mexico border health issues. • Professional training included a clinical dietetic internship at the Center for Developmental Disabilities, UCLA’s Affiliated Program, Children’s Hospital in Los Angeles, California. • Bachelor’s Degree in Chemistry from the University of Sonora in Hermosillo, Sonora, and Master’s Degree from the California State University in Los Angeles, California in Nutrition, with focus on feeding problems of children with developmental disabilities. • Co-founder of the “Nuestros Niños” Foundation, a private foundation dedicated to improve the quality of life and meet the needs of children and their families along the U.S.-Mexico border.

24. Improving Access to Healthcare in Rural Communities Health Promotion and Disease Prevention Health Professional Training Access to Healthcare Health Professional Recruitment and Retention

25. Community Health • Su Corazon, Su Vida • Paso a Paso (Chronic • Disease Prevention) • Steps Forward (Diabetes, physical activity and nutrition education) • Osteoporosis • STD’s • Sexuality and Minors • HIV • Substance Abuse • Domestic Violence • Mental Health • Oral Health Environmental Health Asthma Training Pesticide Worker Protection Household Chemicals Promotores Trainings Women’s Health Breast & Cervical Cancer Entre Amigas Self Esteem Menopause

26. South Yuma County Wellness and Nutrition Institute “Paso a Paso”  Fat & Cholesterol  Diabetes Hypertension Nutrition

27. Yuma County and Nutrition Institute •  To improve the quality of medical care by providing medical providers with standards for preventive healthcare practices • School Health Index/Health-Career Clubs • Community-based Diabetes Education/Counseling Support Groups

28. Q & A Session Instructions • Submit questions either way: • Email: Use the question box on the bottom right portion of the web page • Phone: Press *1, let the operator know you have a question. The operator will unmute your line so you can ask your question directly to the panelists.

29. How Can You Access NDEP and CDC Resources? Visit the NDEP’s Web sites: • www.ndep.nih.gov • www.cdc.gov/diabetes/ndep • Call 1-800-438-5383 Visit CDC’s diabetes Spanish language website • www.cdc.gov/diabetes/spanish • Call 1-877-232-3422

30. Diabetes Prevention Panelists

31. This Concludes the Web Conference • Please complete the evaluation poll which will pop up on your screen • Go to www.healthystates.csg.org for complete information on Healthy States Initiative • Thanks for attending!