A National Approach 

State Programs Reduce Diabetes in African Americans 

By Aimee Swartz


Closing the Gap, Diabetes • September/October 2002


“Here in South Carolina, African American men are almost twice as likely to die of diabetes as White men, 

and African American women are more than four times 

as likely to die of the disease as Whites,” said Rhonda Hill, PhD, a 

division director with the South Carolina Diabetes Control Project. 

“African Americans are also likely to suffer amputations and end-stage 

renal disease.” 

With outcomes like these, diabetes control has become a major 

issue for state health departments. The Federal Centers for Disease 

Control and Prevention (CDC) makes assistance to state diabetes 

control programs (DCPs) an important element of its national strategy to reduce the incidence of diabetes, in the U.S., providing money 

and technical assistance to DCPs in 50 states, the District of Columbia, and eight U.S.-affiliated jurisdictions. 

State programs like South Carolina’s are designed to improve 

access to affordable, high-quality diabetes care and services, with priority on reaching high-risk and disproportionately affected populations. Other goals of state-based DCPs include: determining the scope 

of diabetes-related problems, why they exist and how to prevent 

them; developing and evaluating new strategies for diabetes prevention; increasing awareness of diabetes prevention and disease management within the community; and improving access to quality diabetes care to prevent, detect, and treat diabetes complications. 

The South Carolina Department of Health has received CDC 

funds for diabetes control since 1994. Diabetes is the sixth leading 

cause of death in South Carolina. “Our primary target group is African Americans, because they are more likely to suffer disproportionately from diabetes,” added Hill. 

The Department’s projects target three primary areas: health systems, health communication and coalitions, and community education. 

3⁄4 Health systems. Project targets community health centers for 

interventions that are designed to improve diabetes care in officebased practices in medically undeserved areas, and to increase the 

diabetes self-management skills in patients who attend these clinics. Approximately 90 percent of the patients served are African 

American. Other priority populations are the elderly, the uninsured, and the underinsured. 

3⁄4 Health communication and coalitions. Project develops coalitions at the community level for better resource use and advocacy. For example, the project created and maintains an Internet 

list-serve to enable diabetes patients to share ideas and current 

information. 

continued on page 2>>>> 

Prevalence of Diabetes Age-Standardized Prevalence of Diagnosed Diabetes per 100 Adult Population by 

State, United States, 2000 

For more information, go to the Centers for Disease Control and 

Prevention’s (CDC) Web site at http:/ 

/www.cdc.gov/diabetes

 <4% 	 4-4.9% 5-5.9% 6+%


Office of Minority Health Resource Center	 1 U.S. Department of Health and Human Services 
A National Approach 

State Programs Reduce Diabetes in African Americans 

By Aimee Swartz


Closing the Gap, Diabetes • September/October 2002


3⁄4 Community education. Project conducts community-based, 

community-owned programs for the prevention and management of diabetes. The project implements the CDC’s signature 

Diabetes Today program, which mobilizes communities to raise 

awareness of the burden of diabetes. A major educational effort 

is the Annual African American Conference on Diabetes. Held 

every November in observance of National Diabetes Awareness 

month, the conference targets patients, caretakers, health care 

professionals, and interested community members. 

South Carolina has an immediate goal of increasing the number 

of diabetes patients who receive appropriate preventative measures, 

such as foot exams, hemoglobin A1c tests, flu shots, and pneumonia 

vaccinations. Its long-term goal is to achieve a reduction in disparities 

of complications and preventable deaths from diabetes in South Carolina among African Americans. 

Reducing Complications and Death 

As in South Carolina, diabetes threatens the lives of many residents in Ohio. A study conducted by the Central Ohio Diabetes 

Association found that diabetes and its long-term morbidity and 

mortality rates have increased dramatically in citizens of central Ohio, 

particularly in African American males. The reason for the increased 

rates of diabetes and its related complications were attributed, in part, 

to higher rates of obesity, hypertension, physical inactivity, and heredity, as well as lack of access to health care and lower socioeconomic 

status. 

In response to this problem, in 2001, the Ohio Commission on 

Minority Health launched the Ohio State University (OSU) Community Diabetes Partnership Project—a five-year study to determine 

whether intensive intervention of diabetes control will prevent longterm complications and death from diabetes-related complications. 

“There had been increasing evidence that diabetes care teams 

that were lead by a diabetologist were more successful at reaching the 

patient’s treatment goals than a primary care physician, but we hadn’t 

seen that studied in inner city America,” said Cheryl Boyce, MS, 

executive director, Ohio Commission on Minority Health. 

During the five-year project, health care providers from OSU 

attend neighborhood clinics on a monthly basis to provide expert care 

for diabetic patients attending the clinics. At each visit, a physician, 

dietician, and diabetic educator evaluate the patient. 

The primary endpoints are the improvement in fasting glucose 

less than 120 mg/dl and A1c test results less than 7 percent. The 

secondary endpoint is to demonstrate that an intensive communitybased diabetes care program reduces the rate of long-term complications and cardiovascular deaths. 

In addition to the study, the Commission is also 

addressing diabetes through its Coalition of Networking Neighbors Effecting Change Together (CONNECT) program. CONNECT seeks to address higher death rates in 

the African American community through health assessments, including screening for cholesterol and glucose and blood pressure monitoring; classes that teach heart-healthy cooking and shopping; exercise 

classes; and assessment and evaluation of changes in healthy behavior, 

risk reductions, and incentives to change unhealthy behavior. 

“We’re trying to change health outcomes for African Americans 

by changing their behavior,” Boyce explained. 

CONNECT is comprised of participants from the minority community, community-based health care providers, student volunteers, 

and members of a local church. CONNECT advertises its services 

through local television, radio, and newspapers, as well as religious, 

social, and political networks. 

For more information on the South Carolina Diabetes Control Program, contact Dr. Rhonda Hill at 803-898-0757.

For more information on diabetes in Ohio, contact Cheryl Boyce, 

Ohio Commission on Minority Health at 614-466-4000.

What is Your Eye-Q? 

Do you know that diabetic eye disease is a leading cause of 

blindness? If you have diabetes, do you know how to reduce 

your risk of visual loss? 

Below are a few questions to test your Eye-Q from the National Eye Institute. The answers are below upside down. 

1.	 Diabetic eye disease usually has early warning signs. 

True____ False____ 

2.	 People who have good control of their diabetes are not at 

highrisk for diabetic eye disease. 

True____ False____ 

3.	 The risk of blindness from diabetic eye disease can be reduced. 

True____ False____ 

To see the complete quiz, both in English and Spanish, 

contact the National Eye Institute at http:// 

www.nei.nih.gov

 Often there are none in the early stages of the disease. False. 1.	

Vision may not change until the disease becomes severe. 

 Glaucoma is almost twice as likely to occur in people . False 2.	

diabetes than in those without the disease. with 

eatment, the risk of ith early detection and timely tr W ue. r T 3.	

blindness from diabetic eye disease can be reduced. 

Office of Minority Health Resource Center	 2 U.S. Department of Health and Human Services