Agenda - 08-18-2009 - 4f - Laserfiche WebLink

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Orange County Health Department's Grant Proposal are living with diabetes. In addition, there are thousands more adults living with undiagnosed diabetes as evidenced by the NC Diabetes Prevention and Control Branch estimation that 228,000 adults statewide are living with undiagnosed diabetes. The diabetes death rate in Orange County for the 2002-2006 period was 17.1 per 100,000, somewhat lower than the state rate of 27.1 per 100,000. However, the minority death rate in Orange County due to diabetes was much higher at 44.9 per 100,000. In addition to the burden of disease, many residents are not receiving or accessing adequate preventive care for their illness. The 2006 Orange County Behavioral Risk Factor Surveillance Survey (BRFSS) estimated that only 55% of those diagnosed with diabetes had taken a course on diabetes management. This equates to 2,305 county residents who have been diagnosed but not received education on how to manage their disease. Currently, UNC Healthcare and Duke University Medical Center provide American Diabetes Association (ADA) recognized Diabetes Self Management Education (DSME) programs in Durham County. There are no known DSME programs in Orange County. The BRFSS also estimated that in 2006, about 30% of people with diabetes had less than two A1C tests (recommended twice annually) and 36% had no foot exam in the previous year (recommended annually). Additionally, there is concern about the number of residents who self monitor their blood glucose as recommended. The CHA community survey indicated that only 37.4% of respondents checked their blood glucose one or more times/day (recommendation is 4 times/day) and 22.5% checked their blood glucose one or more times/week (State Center for Health Statistics, 2006 BRFSS). People with diabetes are also at increased risk for co-morbidities that could result in hospitalizations. In 2006, there were 152 diabetes-related hospitalization costing $14,525 average cost per case. (Impatient Hospitalizations and Charges by Diagnosis and County of Residence, SCHS). Many factors contribute to the onset and management of diabetes including family history, unhealthy eating behaviors, inactivity, obesity, rural living conditions, limited access to health care and medications, and lack of education about the disease. Only 48% of residents are meeting recommendations for physical activity, only 23.5% are meeting recommendations for fruit and vegetable intake and 56% of Orange County adults are overweight or obese, contributing to the increasing prevalence of diabetes. In addition to lifestyle factors, a large proportion of residents have trouble accessing the needed healthcare services for preventive and management of chronic disease. There are 13.9% uninsured county residents and 32% who live in rural areas, where there are few health care resources and very limited public transportation (Economic Development Commission Report, 2007). We anticipate an increase in the prevalence of under/uninsured residents due to current economic conditions, and vulnerable populations may face additional health and wellness challenges impacting individuals, families, and the entire community. J 2