In a 2012 article for Health Affairs, Monica E. Peek and co-authors observe that racial and ethnic disparities in diabetes care and outcomes arise from a multitude of causes — including differential access to high quality healthcare, healthy food, and opportunities for safe recreation; cultural traditions regarding cooking; beliefs about disease and self-management; distrust of medical care providers; and socioeconomic status. The authors assert that effective interventions to address these disparities must be multifactorial, as education and lifestyle change motivation alone are likely to have minimal effect if key social determinants of health go addressed.
Peek et al offer a case study of an intervention on the South Side of Chicago that integrated the strength of health systems, patients, and communities to reduce disparities in diabetes care and outcomes. Among the key takeaways:
- START SMALL
- INCLUDE COACHING
- UNDERSTAND ORGANIZATIONAL CULTURE
- FOLLOW THE PRINCIPLES OF COMMUNITY BASED RESEARCH
- KEEP THE GRAND VISION IN VIEW
- PROVIDE COMMUNICATION TRAINING
- IDENTIFY PERSONNEL COMMITTED TO COMMUNITY ENGAGEMENT
- ALIGN WITH OTHER STRATEGIC INITIATIVES
- BE PERSISTENT
- FOCUS ON SUSTAINABILITY FROM THE START