HRSA 2019 Uncontrolled

Diabetes in California

Mojdeh Amini
Jerin Madhavappallil
Chris Manaois
Terry Vincent
Background
Mission
➢ Hired by HRSA to evaluate the highest prevalence of uncontrolled diabetes in California.
Current Findings
➢ Cities located predominantly in the south and west have higher prevalence of diabetes
(CDC, 2020).
➢ Poverty Increases the incidence of uncontrolled diabetes (CDC, 2020).
➢ Exploring if geographic variation and financial factor are consistent with the HRSA data.

Project Team
Analyst: Mojdeh Amini
Project Manager: Jerin Madhavappallil
Technical Writer: Chris Manaois
Subject Matter Expert: Terry Vincent
Project Timeline (EQuIP)
Problem Statement
“There is a High Rate of
Uncontrolled Diabetes in
California Cities due to poverty
levels. “
● In the US, about 34.2 million (10.5%) people had diabetes in
2018 (CDC, 2019).

● It was estimated that about 13 million (46%) Californian

adults have prediabetes or undiagnosed diabetes while
another 2.5 million (9%) have been diagnosed (UCLA Center
for Health Policy Research, 2016).

● Differences in prevalence are seen according to

socioeconomic status (CDC, 2019).
 Methods
2019 HRSA Dataset
● Age and Race-Ethnicity
● Clinical Data
● Patient Characteristics
3-Level Left Join Calculations &
● State Visualization
● City ● Diabetes Count
● Health Center ● Uncontrolled Diabetes
Count
● Controlled Diabetes
Results 2019 HRSA, the Count of Uncontrolled Diabetes in the United States
 Results
Top 5 Cities in
California with The Bar chart clearly
Uncontrolled Diabetes demonstrates the Top
5 cities with highest
Los Angeles 30,170 number of patient
with Diabetes and
Bakersfield 22,797 Uncontrolled Diabetes.

Commerce 20,101
Among these 5 cities
Visalia 16,164 Los Angeles has the
highest and San Diego
San Diego 9,843 the lowest prevalence
of Diabetes and
uncontrolled Diabetes
in Comparison with
three other cities,
Bakersfield,
Commerce and Visalia
respectively.
Results
Top Clinic Rates of
Uncontrolled Diabetes
Count in California

Commerce Alta Med 6.9%

Health

Visalia Family 5.5%

Healthcare

Bakersfield Clinica Sierra 4.4%

Vista

Omni Family 3.4%

Health

Borrego Borrego 3.3%

Spgs Community

Merced Golden Valley 2.5%

San Diego Family Health 2.5%

Centers
 Discussion
These finding are supported by the research that has been done in
the field of Diabetes Self-Management Education (DSME) :

1. 18-54 y/o are less likely to follow guidelines for self care
2. No insurance
3. Hispanic descent
4. Educational level
5. Income less than $25,000 annually
6. Men

(Let’s Get Healthy California, 2016; Boakye et al, 2018)

Discussion
As compared to patients who were not enrolled in a diabetes management
program, patients who had undergone such program were able to save money
and have improved outcomes.

● Per month, each member had saved a little over $100

● Fewer emergency room visits
● More favorable diabetic laboratory and medical screening results
○ HbA1c and Lipid tests
○ Eye and Kidney Screening

This would be more than $29,000,000 in savings, per month in California alone.

(Cunningham et al., 2018)

Call to Action
Recommendation
➢ Developing Self Diabetes Management
Program in the Healthcare Centers across CA.

➢ Prioritizing the Region and cities with the

highest rate of uncontrolled diabetes and
poverty such as the Top 5 Cities.

➢ Utilizing Telehealth/Telemedicine for annual

Wellness Program especially in rural area
Improving Internet and Health Literacy.

➢ Conducting further Data Analysis on the

effect of poverty on diabetes.
(ADA, 2020)
 References
American Diabetes Association [ADA]. (2020). Advocacy Overview. Retrieved from https://www.diabetes.org/advocacy

Boakye, E.A., Varble, A., Rojeck, R., Peavler, O., Trainer, A.K., Osazuwa-Peters, N., & Hinyard, L. (2018). Sociodemographic Factors Associated with Engagement in
Diabetes Self-management Education Among People with Diabetes in the United States. Public Health Reports, 133(6), 685-691.
https://doi.org/10.1177/0033354918794935

Centers for Disease Control and Prevention [CDC]. (2019). Diabetes Report Card 2019 - Centers for Disease Control. Retrieved from
https://www.cdc.gov/diabetes/pdfs/library/Diabetes-Report-Card-2019-508.pdf

Center for Disease Control and Prevention [CDC]. (2020). Mortality Trends.https://www.cdc.gov/nchs/data-visualization/mortality-trends/

Cunningham, A.T., Crittendon, D.R., White, N., Mills, G.D., Diaz, V., & LaNoue, M.D. (16 May 2018). The Effects of diabetes Self-management education on HbA1C
and quality of life in African-Americans: a systematic review and meta-analysis. BMC Health Services Research.
https://doi.org./10.1186/s/2913-018-3186-7

Health Resources and Services Administration (HRSA). (2019, May). Uniform Data System Reporting Instructions for 2019 Health Center Data. Retrieved from
https://bphc.hrsa.gov/sites/default/files/bphc/datareporting/reporting/2019-uds-manual.pd

Let’s Get Healthy California. (2016). Decreasing Diabetes Prevalence..https://letsgethealthy.ca.gov/goals/living-well/decreasing-diabetes-prevalence/

Rama Chandran, S., A. Vigersky, R., Thomas, A., Lim, L. L., Ratnasingam, J., Tan, A., & S.L. Gardner, D. (2020). Role of composite glycemic indices: A comparison of
the comprehensive glucose Pentagon across diabetes types and HbA1c levels. Diabetes Technology & Therapeutics, 22(2), 103-111.

Sledge, K. E. (2019). Reviewing the Effects of Poverty and Food Scarcity on the Prevalence of Type II Diabetes Mellitus in the Metro Atlanta Area. Retrieved from
https://smartech.gatech.edu/bitstream/handle/1853/61357/SLEDGE-UNDERGRADUATERESEARCHOPTIONTHESIS-2017.pdf

UCLA Center for Health Policy Research. (2016, March 10). Majority of California adults have prediabetes or diabetes. Retrieved from
https://newsroom.ucla.edu/releases/majority-of-california-adults-have-prediabetes-or-diabetes
Audience Questions