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Leveraging Policy Solutions for Diabetes Disparities: Suggestions for Improving the National Clinical Care Commission Report’s Recommendations for Hispanic/Latino Populations

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Abstract

In the U.S., Hispanic/Latino populations face increased disparities in both the prevalence and management of type 2 diabetes mellitus (T2DM). This article critically examines the multifaceted nature of T2DM disparities among Hispanic/Latino populations in the U.S. and identifies key factors contributing to T2DM prevalence within these communities, including socioeconomic status, cultural influences, and healthcare access. Utilizing a modified expert consensus procedure, we evaluate the ways in which the National Clinical Care Commission (NCCC) recommendations apply to the Hispanic/Latino community as well as propose recommendations for improved efficacy. Through a comprehensive analysis of government-community health initiatives, food security, environmental exposures, and housing inequalities, we emphasize the need for targeted interventions and health policies to effectively address and dismantle these disparities. Overall, while the National Clinical Care Commission’s recommendations provide a valuable framework for the implementation of policies pertaining to diabetes management and prevention in the general population, our analysis suggests that recommendations may be strengthened by considering the unique cultural, social, and economic needs of the Hispanic/Latino population moving forward.

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References

  1. Cheng YJ, et al. Prevalence of diabetes by race and ethnicity in the United States, 2011–2016. JAMA. 2019;322(24):2389–98.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Aguayo-Mazzucato C, et al. Understanding the growing epidemic of type 2 diabetes in the Hispanic population living in the United States. Diabetes Metab Res Rev. 2019;35(2):e3097.

    Article  PubMed  Google Scholar 

  3. Osborn CY, de Groot M, Wagner JA. Racial and ethnic disparities in diabetes complications in the northeastern United States: the role of socioeconomic status. J Natl Med Assoc. 2013;105(1):51–8.

    PubMed  Google Scholar 

  4. Canedo JR, et al. Racial/ethnic disparities in diabetes quality of care: the role of healthcare access and socioeconomic status. J Racial Ethn Health Disparities. 2018;5(1):7–14.

    Article  PubMed  Google Scholar 

  5. Gaskin DJ, et al. Disparities in diabetes: the nexus of race, poverty, and place. Am J Public Health. 2014;104(11):2147–55.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Auchincloss AH, et al. Neighborhood resources for physical activity and healthy foods and their association with insulin resistance. Epidemiology. 2008;19(1):146–57.

    Article  PubMed  Google Scholar 

  7. Schneiderman N, et al. Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Diabetes Care. 2014;37(8):2233–9.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Cordero C, et al. Diabetes incidence among Hispanic/Latino adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Diabetes Care. 2022;45(6):1482–5.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Commission, N.C.C. Report to congress on leveraging federal programs to prevent and control diabetes and its complications. 2021.   https://health.gov/about-odphp/committees-workgroups/national-clinical-care-commission/report-congress. Accessed 10 Dec 2023.

  10. Herman WH, et al. The National Clinical Care Commission report to congress: recommendations to better leverage federal policies and programs to prevent and control diabetes. Diabetes Care. 2023;46(2):255–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Chater AM, et al. Template for Rapid Iterative Consensus of Experts (TRICE). Int J Environ Res Public Health. 2021;18(19):10255.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Brown SA, et al. Culturally tailored diabetes prevention in the workplace: focus group interviews with Hispanic employees. Diabetes Educ. 2015;41(2):175–83.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Mendez-Luck CA, et al. The Juntos pilot study: a diabetes management intervention for Latino caregiving dyads. Diabetes Educ. 2019;45(5):507–19.

    Article  PubMed  Google Scholar 

  14. Baig AA, et al. Picture good health: a church-based self-management intervention among Latino adults with diabetes. J Gen Intern Med. 2015;30(10):1481–90.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Patton SR, et al. Text message intervention for Latino adults to improve diabetes outcomes. Hisp Health Care Int. 2022;20(4):248–55.

    Article  PubMed  Google Scholar 

  16. Oh H, et al. Addressing barriers to primary care access for Latinos in the U.S.: an agent-based model. J Soc Soc Work Res. 2020;11(2):165–84.

    Article  Google Scholar 

  17. Rangel Gomez MG, et al. Together for health: an initiative to access health services for the Hispanic/Mexican population living in the United States. Front Public Health. 2019;7:273.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Esquives BN, Ramos KQ, Stoutenberg M. Exploring strategies to engage Hispanic patients in screening for a diabetes prevention program at a local community health center. J Health Care Poor Underserved. 2021;32(1):487–505.

    Article  PubMed  Google Scholar 

  19. Soltero E, et al. An SMS text message-based type 2 diabetes prevention program for Hispanic adolescents with obesity: qualitative co-design process. JMIR Form Res. 2023;7:e46606.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Sanchez N, et al. Identification of facilitators and barriers of healthy living and type 2 diabetes prevention among Latinx families. J Lat Psychol. 2022;10(3):225–40.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Agriculture, USDo. Yearly trends in SNAP participants, unemployment, and poverty. 2021 [cited 2023 December 10]; Available from: https://www.fns.usda.gov/yearly-trends.

  22. Shrider EA, Creamer J. U.S. Census Bureau, Current Population Reports, pp. 60–280, Poverty in the United States: 2022, U.S. Government Publishing Office, Washington, September 2023. 2022. Available from: https://www.census.gov/content/dam/Census/library/publications/2023/demo/p60-280.pdf

  23. Loveless TA. Supplemental Nutrition Assistance Program (SNAP) receipt for households: 2018. U.S. Department of Commerce: United States Census Bureau. 2020. Available from: https://www.census.gov/library/publications/2020/demo/acsbr20-01.html

  24. Choi SW, et al. Consequences of the 2019 public charge rule announcement and publication on prenatal WIC participation among immigrant families: evidence of spillover effects. J Immigr Minor Health. 2023;25(6):1229–38.

    Article  PubMed  Google Scholar 

  25. Colorado KP. Increasing SNAP enrollment. kaiserpermanente.org. 2019. Available from: https://about.kaiserpermanente.org/content/dam/kp/mykp/documents/reports/community-health/Colorado-Region-CHNA-2019.pdf

  26. Pooler JA, Srinivasan M. Association between Supplemental Nutrition Assistance Program participation and cost-related medication nonadherence among older adults with diabetes. JAMA Intern Med. 2019;179(1):63–70.

    Article  PubMed  Google Scholar 

  27. Alawode O, Humble S, Herrick CJ. Food insecurity, SNAP participation and glycemic control in low-income adults with predominantly type 2 diabetes: a cross-sectional analysis using NHANES 2007–2018 data. BMJ Open Diabetes Res Care. 2023;11(3):e003205.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Pelto DJ, et al. The nutrition benefits participation gap: barriers to uptake of SNAP and WIC among Latinx American immigrant families. J Community Health. 2020;45(3):488–91.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Disparities N.I.o.M.H.a.H. Food accessibility, insecurity, and health outcomes. 2023 [cited 2023 November 15]; Available from: https://www.nimhd.nih.gov/resources/understanding-health-disparities/food-accessibility-insecurity-and-health-outcomes.html.

  30. Karpyn AE, et al. The changing landscape of food deserts. UNSCN Nutr. 2019;44:46–53.

    PubMed  PubMed Central  Google Scholar 

  31. Valdez Z, et al. Community perspectives on access to and availability of healthy food in rural, low-resource. Latino communities Prev Chronic Dis. 2016;13:E170.

    PubMed  Google Scholar 

  32. Balazs C, et al. Social disparities in nitrate-contaminated drinking water in California’s San Joaquin Valley. Environ Health Perspect. 2011;119(9):1272–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Schaider LA, et al. Environmental justice and drinking water quality: are there socioeconomic disparities in nitrate levels in U.S. drinking water? Environ Health. 2019;18(1):3.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Oh U, et al. Drinking water practices among Latino families in North Carolina: a qualitative study. J Dent Hyg. 2020;94(1):14–20.

    PubMed  PubMed Central  Google Scholar 

  35. Scherzer T, et al. Water consumption beliefs and practices in a rural Latino community: implications for fluoridation. J Public Health Dent. 2010;70(4):337–43.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Weiss MC, et al. Relationships between urinary metals and diabetes traits among Mexican Americans in Starr County, Texas, USA. Biol Trace Elem Res. 2023;201(2):529–38.

    Article  CAS  PubMed  Google Scholar 

  37. Adams SV, et al. Urinary heavy metals in Hispanics 40–85 years old in Dona Ana County. New Mexico Arch Environ Occup Health. 2016;71(6):338–46.

    Article  CAS  PubMed  Google Scholar 

  38. Sun Y, et al. Exposure to air pollutant mixture and gestational diabetes mellitus in Southern California: results from electronic health record data of a large pregnancy cohort. Environ Int. 2022;158:106888.

    Article  CAS  PubMed  Google Scholar 

  39. Yu Y, et al. Ozone exposure, outdoor physical activity, and incident type 2 diabetes in the SALSA cohort of older Mexican Americans. Environ Health Perspect. 2021;129(9):97004.

    Article  CAS  PubMed  Google Scholar 

  40. Paul KC, et al. Traffic-related air pollution and incident dementia: direct and indirect pathways through metabolic dysfunction. J Alzheimers Dis. 2020;76(4):1477–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Baumert BO, et al. Plasma concentrations of lipophilic persistent organic pollutants and glucose homeostasis in youth populations. Environ Res. 2022;212(Pt B):113296.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Murphy L, et al. Exposure to bisphenol A and diabetes risk in Mexican women. Environ Sci Pollut Res Int. 2019;26(25):26332–8.

    Article  CAS  PubMed  Google Scholar 

  43. Perng W, et al. Exposure to obesogenic endocrine disrupting chemicals and obesity among youth of Latino or Hispanic origin in the United States and Latin America: a lifecourse perspective. Obes Rev. 2021;22(Suppl 3):e13245.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Zhu J, et al. Perceived neighborhood environment walkability and health-related quality of life among predominantly Black and Latino adults in New York City. BMC Public Health. 2023;23(1):127.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Hosler AS, et al. Relationship between objectively measured walkability and exercise walking among adults with diabetes. J Environ Public Health. 2014;2014:542123.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Divney AA, et al. Diabetes prevalence by leisure-, transportation-, and occupation-based physical activity among racially/ethnically diverse U.S. adults. Diabetes Care. 2019;42(7):1241–7.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Ferrari G, et al. Walking and cycling, as active transportation, and obesity factors in adolescents from eight countries. BMC Pediatr. 2022;22(1):510.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Brooks MM. Persistent disparities in affordable rental housing among America’s ethnoracial groups. Soc Sci Res. 2023;113:102828.

    Article  PubMed  Google Scholar 

  49. Hood E. Dwelling disparities: how poor housing leads to poor health. Environ Health Perspect. 2005;113(5):A310–7.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Axon RN, et al. Differential impact of homelessness on glycemic control in veterans with type 2 diabetes mellitus. J Gen Intern Med. 2016;31(11):1331–7.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Saha S, et al. Racial and ethnic disparities in the VA health care system: a systematic review. J Gen Intern Med. 2008;23(5):654–71.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Mosley-Johnson E, et al. Relationship between housing insecurity, diabetes processes of care, and self-care behaviors. BMC Health Serv Res. 2022;22(1):61.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Chen KL, et al. Association of neighborhood gentrification and residential moves with hypertension and diabetes control in Los Angeles County, 2014–2019: a retrospective cohort study. Health Place. 2023;83:103109.

    Article  PubMed  Google Scholar 

  54. King BA, et al. National and state estimates of secondhand smoke infiltration among US multiunit housing residents. Nicotine Tob Res. 2013;15(7):1316–21.

    Article  CAS  PubMed  Google Scholar 

  55. Seet RC, et al. Acute effects of cigarette smoking on insulin resistance and arterial stiffness in young adults. Atherosclerosis. 2012;224(1):195–200.

    Article  CAS  PubMed  Google Scholar 

  56. Chang SA. Smoking and type 2 diabetes mellitus. Diabetes Metab J. 2012;36(6):399–403.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Wainwright K, et al. Smoking expectancies and health perceptions: an analysis of Hispanic subgroups. Addict Behav. 2019;98:106008.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Alharthy A, et al. Association between tobacco retailer density and smoking among adults with diabetes and serious mental illness in New York State. Prev Chronic Dis. 2022;19:E01.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Iglesias-Rios L, Parascandola M. A historical review of RJ Reynolds’ strategies for marketing tobacco to Hispanics in the United States. Am J Public Health. 2013;103(5):e15-27.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Mousavi SE, Tondro Anamag F, Sanaie S. Association between cannabis use and risk of diabetes mellitus type 2: a systematic review and meta-analysis. Phytother Res. 2023;37(11):5092–108.

    Article  CAS  PubMed  Google Scholar 

  61. Bancks MP, et al. Marijuana use and risk of prediabetes and diabetes by middle adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Diabetologia. 2015;58(12):2736–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author notes

  1. Devika A. Shenoy and Stephanie H. Rodriguez contributed equally to this work.

    Ayotunde Dokun and Leonor Corsino contributed equally to this work as senior authors.

Authors and Affiliations

  1. Duke University School of Medicine, Duke University, Durham, NC, USA

    Devika A. Shenoy

  2. Carver College of Medicine, University of Iowa, Iowa City, IA, USA

    Stephanie H. Rodriguez

  3. Division of General Internal Medicine, Department of Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA

    Jeydith Gutierrez

  4. Margolis Institute for Health Policy, Duke University, Durham, NC, USA

    Andrea Thoumi

  5. Division of Endocrinology and Metabolism, Department of Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA

    Marcelo Correia & Ayotunde Dokun

  6. Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA

    Leonor Corsino

  7. Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, Duke University School of Medicine, Durham, NC, USA

    Leonor Corsino

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  1. Devika A. Shenoy
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Contributions

All authors contributed to the manuscript’s conception and design. The first draft of the manuscript was written by Devika Shenoy and Stephanie Hosanna Rodriguez. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. All the authors fulfill the ICMJE criteria for authorship.

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Correspondence to Leonor Corsino.

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Shenoy, D.A., Rodriguez, S.H., Gutierrez, J. et al. Leveraging Policy Solutions for Diabetes Disparities: Suggestions for Improving the National Clinical Care Commission Report’s Recommendations for Hispanic/Latino Populations. J. Racial and Ethnic Health Disparities (2024). https://doi.org/10.1007/s40615-024-02027-8

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  • DOI: https://doi.org/10.1007/s40615-024-02027-8

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