In Pursuit of Health Equity. A panel discussion

In Pursuit of Health Equity A panel discussion MNCM Annual Seminar 2017

There is variation in quality results by race, ethnicity, language and country of origin 2016 Health Equity of Care Report, page 10. 2 2017 MN Community Measurement. All Rights Reserved.

There is variation in quality results by purchaser 2016 Health Care Disparities Report, page 10. 3 2017 MN Community Measurement. All Rights Reserved.

Optimal Diabetes Care Improved Results Type one or two, between 18-75 years old, established relationship with primary care or endocrinologist 2003 2015 A1C < 8.0 64% 72% Blood Pressure < 140/90 n/a 84% Tobacco Free 69% 84% Daily Aspirin, If required 68% 99% Proper Statin Use n/a 87% Optimally Managed All Goals n/a 46% A1C < 8.0 Tobacco Free Daily Aspirin 2003 2015 2016 Health Equity of Care Report, page 73. 4 2017 MN Community Measurement. All Rights Reserved.

Optimal Diabetes Care Gaps Results Range by Demographics Lowest Highest Gap Race American Indian 27% Asian 53% 26% Ethnicity Hispanic 39% Non Hispanic 47% 8% Language Hmong 36% Vietnamese 65% 29% Country of Origin Bosnia 32% India 61% 29% Insurance Medicaid 34% Medicare 52% 18% 2016 Health Equity of Care Report, page 75-78. 5 2017 MN Community Measurement. All Rights Reserved.

Optimal Vascular Care Statewide Results by Race As seen in 2016 Health Equity of Care Report, page 105. 6 2017 MN Community Measurement. All Rights Reserved.

Optimal Vascular Care Regional Results by Country of Origin As seen in 2016 Health Equity of Care Report, page 119. 7 2017 MN Community Measurement. All Rights Reserved.

Adolescent Mental Health and/or Depression Screening Statewide Results by Preferred Language As seen in 2016 Health Equity of Care Report, page 26. 8 2017 MN Community Measurement. All Rights Reserved.

Adolescent Mental Health and/or Depression Screening Regional Results by Race As seen in 2016 Health Equity of Care Report, page 31. 9 2017 MN Community Measurement. All Rights Reserved.

In 2014, the ACS and CDC launched

MN was already well prepared

Provider Case Study Webinars

Clinic Recognition

How can we address disparities?

HealthPartners Facebook Ads/Blogs

CRCS Campaign IFOBT Home Test Kits Newspaper Disparity Reports to Clinic Managers Translated Instructions and FAQs Facebook Allinahealth.org CRCS Media Campaign In-Person Culturally-Tailored Messaging from Clinicians Personal Phone Outreach to LEP s, African Americans and American Indians Public Access TV (e.g. faith communities, barber shops, social hubs) Radio Reinforcement from from Care Guides Patient-Level Intervention Community-Level Intervention 16

17 African American & Hispanic Latino

International Medical Graduates There are between 250-400 International Medical Graduates living in Minnesota Many would like to use their medical training to improve the health of their communities Some have expressed a willingness to help the MN Department of Health Sage Scopes program increase colon cancer screening in the insured as well as uninsured populations.

Minnesota Department of Health Pilot Immigrant Medical Graduates teach and navigate patients based on common native language or country of origin. Initial pilots at o People s Center Cedar Riverside o Hennepin County Medical Center- Richfield Clinic

In Pursuit of Health Equity 20

MISSION IN MOTION PREVENT CURE IMPROVE LIVES 21

STRATEGIC PLAN PROCESS Diabetes ecosystem Diabetes touches every aspect of life for individuals and communities. Helping people with diabetes is the central focus of our mission. We bring people together from every corner to combat the disease. People with diabetes 22

PRIORITIES TO DEFEAT DIABETES Drive discovery TYPE 2 Raise voice Support people Through research, partnerships and innovation on a global scale, drive discoveries to prevent, manage and ultimately cure diabetes. Intensify the urgency around the diabetes epidemic, and mobilize bold action through advocacy and engagement. Provide new, effective resources for individuals and populations living with and at risk of developing diabetes and for the health care professionals serving them, and offer that those resources when, where and how they are needed. 23

Provide new, effective resources for individuals and populations living with and at risk of developing diabetes and for the health care professionals serving them, and offer those resources when, where and how they are needed. Support people 24

Standards of Care diabetes.org/professional Promoting Health and Reducing Disparities in Populations This section was renamed and now focuses on improving outcomes and reducing disparities in populations with diabetes. Recommendations were added to assess patients social context as well as refer to local community resources and provide self-management support. Tailoring Treatments to Reduce Disparities includes: Ethnic/Cultural/Sex Differences, Access to Health Care, System-Level Interventions, Food Insecurity, Treatment Options, Homelessness and Language Barriers 25

Standards of Care diabetes.org/professional Recommendation is A1c below 7% Less stringent A1C goals (such as,8%) may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, extensive comorbid conditions, or long-standing diabetes in whom the goal is difficult to achieve despite diabetes self-management education, appropriate glucose monitoring, and effective doses of multiple glucose-lowering agents including insulin 26

SUPPORT PEOPLE Professional Services Key Initiatives Diabetes Prevention - Diabetes Prevention Program (DPP) An evidence-based lifestyle change program which has been demonstrated to delay or prevent the development of type 2 diabetes among people at high risk New association-wide initiative in 2017. Diabetes is Primary A comprehensive 10-hour CE program for primary care providers focused on improving clinical care Education Recognition Program Recognition of Diabetes Self Management Education Programs that qualify for reimbursement Diabetes INSIDE An 18-month QI program that guides health systems through a series of process-improvement training activities and data-driven educational programs 27

MISSION IN MOTION Intersections: The Partnering Approach True, lasting partnerships require mutually adopted strategies The Association seeks to develop a joint strategy with partners in order to develop synergy, efficiency and scale to the mission. The American Diabetes Association, National Health Equity Committee is developing programs and/or adapting current programs to communities. Evidence Based Programs Impacting Health Outcomes ADA Strategy 28

SUPPORT PEOPLE ADA Strategy To reach those we are not currently reaching, in different ways. Examples of how ADA is reducing barriers and disparities. Diabetes Camps Power Up Camps Living With Type 2 Diabetes What Can I Eat? Walmart Wellness Days 29

Clippers n Curls for the Heart is dedicated to reducing the incidence of heart attack and stroke in African Americans by screening for high blood pressure in Twin Cities barber shops and beauty salons. Here is a video that might better explain what we are doing https://youtu.be/zen_gq3hp5c Best regards, Clarence