[PHNUTR-L] New diabetes report documents devastating effects in New York City-Hospital costs have doubled since 1990

[Kathrynne Holden]

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Public release date: 24-Jul-2007
http://www.eurekalert.org/pub_releases/2007-07/nych-ndr072307.php

Contact: Sara Markt
smarkt at health.nyc.gov
212-788-5290
New York City Health Department

New diabetes report documents devastating effects in New York City

Hospital costs have doubled since 1990

The diabetes epidemic is taking a large and growing toll on New York 
City, a new Health Department report shows, as death rates, debilitating 
complications, and hospitalization costs soar. Some 500,000 New Yorkers 
– one out of eight adults – have been diagnosed with diabetes. Another 
200,000 have diabetes but don’t yet know it. The death rate from 
diabetes rose by 75% between 1990 and 2003.

The new publication, which synthesizes research findings from the past 
several years, is available at www.nyc.gov/health. In addition to 
charting the impact of diabetes in NYC, it exposes unacceptable 
disparities among neighborhoods and racial/ethnic groups.

     * New Yorkers in East Harlem, Williamsburg-Bushwick and certain 
parts of the South Bronx are hospitalized for diabetes at 10 times the 
rate of people living on the Upper East Side.

     * Residents in the most affected areas also die from diabetes at 
seven times the rate of New Yorkers in the least affected neighborhoods.

     * Among racial/ethnic groups, black New Yorkers have the highest 
death rate from diabetes, dying at three times the rate of white New 
Yorkers.

“Diabetes is hitting the city hard,” said Dr. Thomas R. Frieden, New 
York City Health Commissioner. “Tragically, it is hurting our low-income 
communities much more than others. With good management, we can prevent 
devastating complications of diabetes, such as heart disease, blindness, 
leg amputations and kidney failure.”

New Yorkers with diabetes are now hospitalized at a rate nearly 80% 
higher than the national rate. And the cost of these hospitalizations 
has skyrocketed in recent years, hitting $481 million in 2003, up from 
$242 million in 1990. Figures drawn from national estimates of total 
diabetes costs, including lost productivity and other non-medical costs, 
suggest that the economic impact of diabetes in New York City exceeds $6 
billion annually.

“Diabetes is not only hurting our health, it’s hurting our wallets,” 
said Frieden. “The cost of treating diabetes is an unsustainable burden 
on our health system and economy. But even worse, behind these 
statistics are tragic individual stories that challenge our city and our 
health system to respond.”

Diabetes Management is Key

Many diabetes hospitalizations and deaths can be prevented by better 
management of the disease. Dr. Shadi Chamany, director of the Health 
Department’s Diabetes Prevention and Control program, emphasized that 
people with diabetes can live long and healthy lives if they carefully 
manage their blood sugar (an A1C level of less than 7%), blood pressure 
(less than 130 over 80) and bad cholesterol (LDL level below 100 mg/dL).

While most New Yorkers with diabetes are accessing health care, the 
report finds that both patients and providers could do much better. 
Among New Yorkers with diabetes:

     * Most had a check-up in the past year, but more than one third did 
not receive an eye or foot exam.

     * About 80% had their blood sugar tested in the past year, but only 
16% knew their blood sugar level.

     * About 45% had poor control of blood sugar, putting them at risk 
of serious health complications.

     * One in five New Yorkers with diabetes is a smoker

Tracking Diabetes

The Health Department monitors blood sugar control citywide by requiring 
clinical laboratories to report blood sugar (A1C) test results to a 
central registry. This registry – the first of its kind in the nation – 
will enable the Health Department to give clinicians and patients 
feedback and resources that can improve the quality of care and quality 
of life for New Yorkers with diabetes.

The New York City Health and Nutrition Examination Survey, conducted by 
the Health Department in 2004, provided the first-ever estimates on 
diabetes prevalence and blood sugar control by using interviews, blood 
tests, and medical exams. This survey provided baseline data for 
tracking diabetes over time.

Other Initiatives

     * The Department's Primary Care Information Project is working to 
improve health outcomes by helping primary care providers adopt 
electronic health records that make it easier to track and manage 
diabetes and other chronic conditions. The first phase of this 
initiative is now under way in the South Bronx, where the Health 
Department is working with providers who care for low-income patients.

     * The Diabetes Public Health Detailing Campaign, completed in 2006, 
engaged more than 5,000 primary health care providers citywide to 
improve care and treatment of people with diabetes.

     * The Diabetes Quality Improvement Collaborative works with clinics 
and hospitals in the City's highest-risk neighborhoods to improve care 
for people with diabetes.

     * The Department has also launched programs to promote physical 
activity as part of a healthy lifestyle. SPARK is a training initiative 
for daycare and school staff to incorporate physical activity into 
education. Shape Up New York is a free family fitness program offered at 
parks, community centers and housing sites around the City.

     * The Department also promotes healthy eating through the Healthy 
Bodegas Initiative and the Health Bucks program, aimed at increasing the 
accessibility of healthy food in the city.

Data Sources

The report drew upon numerous city and state data sources. Data on risk 
factors and health care indicators came from the New York City Community 
Health Survey (CHS), an annual telephone survey of 10,000 New York City 
adults. The survey derives health information from self-report.

Diabetes prevalence was assessed in the New York City Health and 
Nutrition Examination Survey (NYC-HANES) using a one-time blood test.

Hospitalization data come from the Statewide Planning and Research 
Cooperative System (SPARCS; New York State Department of Health, 2006) 
and consists of hospital discharge records for acute care hospitals in 
New York State.

Data were also complied from the 2000 Census, Medicare, and Medicaid 
records. A complete list of sources is available at the conclusion of 
the report.
-- 
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
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