Most people would rather pop a pill to feel better, than look at the big picture of their overall healthy living options. But, that is about to change for our nearby rural counties of Bullitt, Henry and Shelby based on a new grant from the Center for Disease Control that targets community involvement in the fight against diabetes in older adults, particularly minorities, a vulnerable population group nationally.
All of us with TV sets, cell phones, and internet access hear messaging from various sources about getting “out there” and exercising, but the barriers to doing just that may be so strong in some communities that the words are not the answer.
The activity has begun to examine the finer layers of community life to bring “prevention is the best medicine” back to those facing diabetes in our surrounding rural counties under KIPDA, and its academic partner, The Kent School of Social Work at the University of Louisville. This 5-year, $2.5 million grant will provide research, assessment, and community coalition formation to reduce health disparities regarding diabetes for older adults in Bullitt, Henry, and Shelby counties. These counties have been identified in our state as having the highest incidence of diabetes (10.1%), higher than the average rate for Kentucky (9.9%) and US (7.7%).
It is no secret that diabetes in one of the top health risk factors for those living in the state of Kentucky. And, nationally the wave of increasing diabetes continues to be a problem, so much so that the Center for Disease Control determined that particular populations should be studied in their resident communities to determine how to turn the tide. Other grantees, with similar objectives to those of KIPDA, were awarded for studying Native Americans, younger adults, and Hispanic populations.
Barbara Gordon, Director, Division of Social Services, of KIPDA which actually covers 7 counties in Ky., and two in Indiana, believes that this type of grant can fundamentally change the modeling we do in our communities and even affect economic development planning. “The first phase of research allows people to take a snapshot of their community looking at needs, gaps, and resources. Potential disparities to healthcare access involves evaluation of a lot of communities. We know that individuals with diabetes should be eating healthier, but do they actually have access to fresh markets for vegetables and fruits? And can they afford it? We map the community and look at problem areas,” she said.
One of the target modeling exercises is to measure distances from individuals’ homes to how many fast food restaurants reside nearby within walking distance; exercise options within walking distance, such as sidewalks, and parks; access to physician care tied to transportation options; and access to grocery stores that offer the purchase of fruits and vegetables. This first phase gives individuals with diabetes an opportunity to document their own environment in a typical day in pictures they take. Sample questions include, for example: how do you shop, where do you exercise, what transportation do you use, and where do you really go in a day’s time?
Evaluations will take place throughout the 5-year project , looking at baseline data, and then engaging the community in a grass roots effort for coalition development for change. The sustainability factor is critical to a Diabetes Coalition of professionals, healthcare providers, professors, and citizens coming together to make changes that can matter. For example, new dollars for walking paths may need to be found in the community. On Feb. 24th, there will be a meeting to form the tri-county coalition in Shelby County at the Stratton Center from 10 AM to 1 PM. County executives will be invited, as well as all area community leaders and their constituents. This will be promulgated with public notice. KIPDA’s Program Manager for this is Bonnie Buchanan, Bonnie.Buchanan@ky.gov.
Gordon indicates that “as early as the third year, we will identify real interventions from outcomes that we will achieve.” She expects that the level of awareness, regarding the onset and management of diabetes, will grow.
The official start date of this grant was Sept. 1, 2010, so the grant will end in 2015. Dr. Pam Yankeelov, PhD,( my sister), is one of the principals at the Kent School, involved in this assessment process. Others involved on the U of L team include: Dr. Annatjie Faul, PhD; Dr. Wanda Lott Collins, PhD; and Joseph D’Ambrosio, JD, MSSW .
Dr. Yankeelov (Pam) pointed out that it is the interpersonal connections that make or break the outcome in healthy living initiatives:
(a) First, you and your family dialoguing about your health and your activities.
(b)Secondly, you, your family, and your physician, including simple measures, like having a caregiver check the feet for sores (an early sign of diabetes), to getting flu shots annually, to standards regarding diabetic diagnosis, and annual blood tests–regarding how much glucose is in your blood stream and whether you (the patient) is even taking prescribed medications.
(c) you, your family, your physician, and other healthcare institutions in the community that offer specialized support, such as public health departments, health clinics, and hospitals.
(d) you, your family, your physician, and other organizations, like the newly forming diabetes coalitions that fight for progress in healthy living. Also cited>mental health institutions, community farm alliances, and food policy groups.
If you want change in the health of an individual, there is no less important place to look than the community. Here’s to the work being done in Kentucky this year. New Year’s resolutions on their way… if you will.