Duke and Durham County Embark on Public Health Initiative to Manage Diabetes

“Attacking a complex problem like diabetes requires a committed team, resources, community engagement, and alignment of healthcare and societal forces,” says Robert M. Califf, MD, vice chancellor for clinical research at Duke and leader of the steering committee for the Durham Diabetes Coalition.

“We're excited by this chance to build on the vibrant relationships that already exist between Duke, the Durham Health Department, and other community stakeholders. Together, and with the support of the BMS Foundation, we will provide patients with diabetes and their health care providers with the tools they need to effectively manage their conditions and help them overcome barriers to better health.”

“Changing the course of the nation’s diabetes epidemic requires radically new thinking and intensified collaborative action,” said Patricia M. Doykos, PhD, director of the Bristol-Myers Squibb Foundation. “The project is bringing both to everything from how to account for the diverse drivers of diabetes burden to who can play a role to what to do and how to measure whether it is making a positive impact at the population level.”

During the planning phase, the Coalition is employing a powerful technology, called geospatial mapping, which takes information related to disease and health care and fits it to the physical map of a community, allowing researchers to visualize complex relationships between the locations of diabetes patients, patterns of health care, and available social resources.

This information is also being used to explore gaps in access to care and self-management resources, help patients connect with the community assets, and identify interventions that can result in better health outcomes, both for the individual and the neighborhood as a whole. Geospatial data will also be used to create a continuous feedback loop for improving the quality of project efforts.

Diabetes affects nearly 25.8 million Americans, or 8.3 percent of the country’s population. According to Gayle Harris, MPH, RN, director of the Durham County Health Department, “One source estimates more than 10 percent of Durham County residents have been diagnosed with diabetes and at least another 2 percent remain undiagnosed. Diabetes is a significant risk factor for heart disease, stroke, kidney failure, and cancer -- the leading causes of death in Durham. Only through community interventions like the Durham Diabetes Coalition can we really change the trends in new cases of diabetes and improve the care of persons with diabetes.”

The Durham Diabetes Coalition will employ a Diabetes Communication Officer (DCO) who is responsible for designing and implementing communication programs to provide relevant health and lifestyle information to the community. The DCO will also develop community messages and support programs to motivate residents to participate in lifestyle initiatives as a group.

“We want this program to integrate health care all the way from the household and neighborhood to specialty clinics in order to provide people with the necessary tools to improve their outcomes,” says Califf. “We hope that Durham and the Diabetes Coalition will serve as a model for similar diabetes management control interventions in communities across the country.”