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Topics > Reducing Health Disparities Initiative > What We Are Doing > Diabetes Deaths Health Disparity for African Americans and Latinos

Diabetes Deaths Health Disparity for African Americans and Latinos

(Pictured from left to right) Dr. Troy Kaji, Richmond Health Center; Otilia Tiutin, CCHP Manager of Health Education, Cultural Linguistics Services; and Ken Tilly, CCHP Quality Management Director.

(This story is a longer version of one that ran in the April, 2006 Director's Report)

African Americans living in Contra Costa are three times as likely to die from diabetes than the rest of Contra Costa County as a whole. Latino residents also are more likely to die from disease than the rest of the county. (See our Community Health Indicators for Selected Cities and Places in Contra Costa available online at health data.)

Diabetes is an important disparity to address because people with diabetes are more likely to have heart disease, blindness, kidney failure and leg and foot amputations. Improving long-term care for diabetics, increasing culturally appropriate health education about diabetes self-care and tackling the causes of diabetes are key to reducing this disparity, said Dr. Kate Colwell, a physician at our Richmond Health Center (RHC) who is leading a project to improve the health of people with chronic illnesses.

Emphasis on patient education

Contra Costa Regional Medical Center (CCRMC) currently has classes taught by dietitians and patient educators, but the self management approach is a shift in relating to patients and will require staff training, Dr. Cowell said.

"This is a difficult task during a time of limited resources," Dr. Colwell said. Other educational efforts include Contra Costa Health Plan's Living Well with Diabetes program, which encourages diabetics to speak with trained nurses to learn about how to control blood sugar levels, what to ask the doctor and the kinds of tests needed to keep healthy. Materials are offered in both English and Spanish and are in an easy-to-understand, accessible format, said Otilia Tiutin, CCHP Manager of Health Education, Cultural Linguistics Services.

Raising patient and provider awareness is important because African Americans, compared to our health plan membership as a whole, are significantly less likely to get eye exams to check for diabetes-related problems and also have poorer results for tests that measure long-term blood sugar control, said Ken Tilly, Quality Management Director for Contra Cost Health Plan. CCHP's Quality Management Department calculates its required performance measures by ethnicity, allowing the health plan to track disparities in care and health outcomes, Ken said.

Diabetes registry

To evaluate and focus efforts to reduce health disparities, Dr. Colwell is working with Information Services and another RHC physician, Dr. Troy Kaji, to customize CCHS' diabetes registry to allow for reporting by patient ethnicity and language. The registry, which already includes some information on CCHS' 12,000 diabetic patients, provides clinicians with information about whether diabetic patients have had the lab tests and other care that they need, allowing for intervention to improve care and decrease the risk of early disability or death. Plans are to have the enhanced registry available countywide by 2008. CCRMC also recently secured a $100,000 grant from Kaiser Permanente to evaluate health education for chronic care in our system.

Tackling causes

To address the major causes of diabetes - obesity, lack of exercise, and poor diet, - Tracey Rattray, Director of our Community Wellness & Prevention Program (CW&PP), said her program is supporting the Teen Age Program's work with middle school students to promote healthy eating in their schools. CW&PP also is also working with the Promotoras program, which enlists Spanish community members to serve as health outreach workers in the Latino community. The Promotoras are providing classes in Spanish about healthy eating, decreasing television viewing and other topics.

Send feedback about this story to Kate Fowlie at

Content provided by the Reducing Health Disparities Initiative.

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