2. Population Assessment Presentation Inadequate Healthcare in Rural Communities for African Americans with Type II Diabetes Amy Douglas July 24, 2013 NURS 7350

3. Introduction/Background What is Type II Diabetes? Race and Ethic Differences in Prevalence of Diagnosed Diabetes  7.1% of Non-Hispanic Whites  8.4% of Asian Americans  12.6% of Non-Hispanic Blacks  11.8% of Hispanics American Diabetes Association. (2011). Diabetes Statistics 2011 Fact Sheet. Retrieved July 15 from http://www.diabetes.org/diabetes-basics/diabetes-statistics

4. Statistics  50% of African Americans born since 2000 will develop diabetes (AADE, 2012)  Diabetes affects some racial/ethnic groups more than others (AADE, 2012)  The risk of diagnosed diabetes is 77% higher among non-Hispanic blacks (CDC, 2011)

5. Overall Goal Statement  Determine effective ways to improve or increase the knowledge level of African Americans that are newly diagnosed with Type II Diabetes in a rural community

6. Objectives  Examine the barriers to health care access for African Americans with Type II diabetes in a rural community  Determine the current diabetes education offered to African American patients with Type II diabetes  Increase the availability of information concerning self-management strategies to diabetic patients in the rural population

7. Community Assessment Summary  Survey of Type II Diabetic patients in a Rural Area Do you regularly see your primary physician? Do you exercise regularly? Do you have adequate transportation? Do you have insurance? Do you have access to self-monitoring materials to check your blood sugar? Have you made changes in your diet since being diagnosed with diabetes? Are you able to read and understand the material given to you concerning diabetes? Do you take your medications as prescribed?

8. Results from Survey  5 of out 10 patients see their doctor once a month  2 out of 10 patients exercise 3 times a week  2 out of 10 patients have adequate transportation  6 out of 10 patients have Medicaid  2 out of 10 patients regularly check their glucose at home  4 out of 10 patients have made diet modifications  8 out of 10 patients verbalized understanding of education  5 out of 10 patients take their medications as prescribed

9. Factors Affecting Overall Health:  Lack of knowledge  Shortage of primary care providers and facilities  Lack of affordable quality insurance and high health care cost  Increased complications and death

10. Health Disparities Identified  Lack of transportation to quality health care providers  Financial limitations, poverty  Patient’s mistrust of health care providers  High rate of illiteracy in the population  Limited access to affordable insurance  Minimum exposure to health education concerning self- monitoring and self-management of diabetes  Lack of self-monitoring materials  Unconscious clinician bias toward socially disadvantaged population

11. Strategies for Health Promotion  Access to primary care in rural areas  Cultural competence of health care providers  Diabetes education material at proper literacy level

12. Conclusion  Despite significant efforts to reduce the barriers to adequate healthcare of African American diabetic patients in rural areas, the health disparities continue to exist. Interventions aimed at eliminating these disparities should include improving health literacy among patients, ensuring cultural competency among healthcare providers, and encouraging self-care and self- monitoring techniques.

13. References American Association of Diabetes Educators (2012). Diabetes Fact Sheet. Retrieved on July 15, 2013 from www.diabeteseducator.orgwww.diabeteseducator.org American Diabetes Association. (2011). Diabetes Statistics 2011 Fact Sheet. Retrieved July 15 from http://www.diabetes.org/diabetes-http://www.diabetes.org/diabetes- basics/diabetes-statistics Center for Disease Control and Prevention (2011). National Diabetes Fact Sheet. Retrieved from http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf Fiscella, K. (2011). Health reform and equity: promise, pitfalls, and prescriptions. Annals of Family Medicine, 9(1), 78-84. Retrieved from ebscohost.com Mullins, C., Blatt, L., Gbarayor, C., Yang, H., & Baquet, C. (2005). Health disparities: A barrier to high-quality care. American Journal of Health-System Pharmacy, 62(1), 1873-1882. Retrieved from ebscohost.com