Diabetes & Disparities

The Rise in Diabetes

A new study projects an increase in diabetes among people under 20. The Centers for Disease Control and Prevention released a press release on the findings, stating the importance of addressing chronic conditions and advancing health equity. Many people with diabetes cannot afford their insulin. Over 1.3 million Americans have rationed insulin in the past year due to its high cost. Beginning this month, the cost of insulin is capped at $35 for those covered under Medicare. Learn more about diabetes and access in insulin in America below:

• COVID: Individuals with diabetes have an increased risk of complications from COVID-19. There is emerging evidence of increased risk of new-onset diabetes following COVID.
• Treatment: The US Food and Drug Administration recently approved the first treatment to delay the onset of type 1 diabetes. Drugs designed for diabetes are increasingly being used for obesity and weight loss.
• Disparities: Disparities in diabetes outcomes have widened, according to a recent study. Another study found that White patients were twice as likely to receive an insulin pump as Black patients.
• Addressing Cost of Insulin: Under a NIHCM grant, The Conversation reported on the lack of generic competition for insulin to drive down costs. Blue Cross and Blue Shield companies are partnering with CivicaRx to increase access to low-cost generic insulin.

Resources & Initiatives:

• See the CDC’s resources on diabetes, such as this one on prevention for people with disabilities.
• The American Diabetes Association has resources on addressing health inequity in diabetes.
• St. Vincent de Paul, a Blue Cross Blue Shield of Arizona community partner, increased access to diabetes education and counseling.
• BlueCross BlueShield of South Carolina is working to reduce diabetes in its state and supported the launch of a diabetes prevention program for women.

Disparities in Health Care

The COVID-19 pandemic has highlighted health disparities that we continue to grapple with in 2023. Learn about how gender and racial bias impact care:

• Gender Bias in Medicine: Women’s health care concerns are often dismissed. Several studies support the claim that women’s pain is not taken as seriously as men’s, affecting treatment for many health conditions. Additionally, women are not getting equal medical advice when it comes to heart health and strokes.
• Mental Health: Shortages of child and adolescent psychiatrists are most acute in low-income communities of color, contributing to poor teens of color being underdiagnosed or misdiagnosed. Additionally, depression may look different in Black women, also resulting in missed care.
• Maternal Health: Pregnant Black women face a higher burden of their health concerns being ignored or dismissed. Black mothers in America are more than twice as likely as White and Hispanic women to have a stillbirth.

Resources & Initiatives:

• Blue Cross Blue Shield of Massachusetts is the first health plan in the state to reward clinicians for eliminating racial and ethnic inequities in care. Learn more about the impact of value-based payments from this STAT article about the work in MA.
• NIHCM grantee, Fortune, covers a medical device that prevents excessive bleeding after delivery. The journey to market reflects gender biases in medical innovations.
• This resource from Elevance Health highlights how where you live impacts maternal health.
• Independence Blue Cross fights racial disparities in maternal health care by using maternity navigators who visit people at home.
• See NIHCM’s resources on health equity.

Telehealth Continues

Telehealth emerged as a strong care delivery system during the pandemic. The US Department of Health and Human Services shared new insights on how telehealth programs could be strengthened. Congress expanded COVID-era telehealth flexibilities through 2024.

• Mental Health: A large study found telehealth to be as effective for treating anxiety and depression as in-person visits. Many schools are turning to telehealth to support students’ mental health needs.
• Rural Health: Telehealth is connecting rural patients to sexual assault nurses, when before they had to travel to a hospital in another county for care. There is also emerging evidence of telerehabilitation in rural areas.
• Substance Use: The Substance Abuse and Mental Health Services Administration proposes to expand access to opioid use disorder treatment by using telehealth to initiate buprenorphine at opioid treatment programs.

Resources & Initiatives:

• A recent study found that telehealth enabled mental health care for an increasing number of patients.
• Horizon Blue Cross Blue Shield of New Jersey shares information on when telehealth is the right choice for care.

In Other Public Health News…

COVID-19: Across the US, nearly 20% of counties have a high community level of COVID-19 (as of 1/5/23). The Omicron strain XBB.1.5 has become the most prevalent strain, making up more than a quarter of cases nationally. The World Health Organization has deemed this subvariant to be the most transmissible yet.

• The CDC recommends staying up-to-date on COVID-19 vaccination and boosters. Learn more and find out where vaccines are available!

Buffalo Blizzard: At least 44 deaths have been confirmed as a result of Western New York’s recent blizzard, its deadliest disaster in a decade. Of these deaths, a majority were people of color. Underlying structural issues, including poverty, poor housing, and food deserts exacerbated the impact of the storm, from preparedness to emergency response.

• Highmark Blue Cross Blue Shield teamed up with the NFL Foundation and the Buffalo Bills Foundation to respond to the Buffalo Blizzard by donating funds to support victims and community-level recovery efforts.

Lasting Impact of Air Pollution: A recent study linked elevated levels of two outdoor air pollutants with non-viral asthma attacks in children and adolescents, predominantly living in low-income urban areas. In addition, exposure to air pollutants during infancy has been associated with hindered cognitive development. The Environmental Protection Agency recently announced new air quality standards aimed at curbing rising cases of respiratory diseases.

• NIHCM grantee, The Journalist’s Resource, highlights how indoor air quality in schools impacts students’ learning and health.