Health Equity: 10/07/10

Thursday, October 7, 2010

[EQ] Diabetes Along the U.S.-Mexico-Border

Pan American Journal of Public Health, Special Issue on:

Diabetes Along the U.S.-Mexico-Border

Table of Contents: Vol. 28 No. 3 / September 2010

Available online at: http://bit.ly/dAIUHm

EDITORIAL

Securing a diabetes-free border Mirta Roses Periago

Highlights the results from phase I of a prevalence study conducted by the U.S.-Mexico Border Diabetes Prevention and Control Project.

Coordinated by the Pan American Health Organization/World Health Organization (PAHO/WHO) U.S.-Mexico Border Office in collaboration with the U.S. Centers for Disease Control and Prevention (CDC) and the Mexican ministry of health (or Secretaría de Salud, SSA).

“…….The traditionally unique yet diverse demographic, social, cultural, and political characteristics of the U.S.-Mexico border area made this study particularly challenging. At the beginning of the XXI century, this geographic zone was home to approximately 14 million people spread across the 44 counties and 80 municipalities comprising the six northern Mexican states and four southern states in the United States.

The history of public health enterprise along the U.S.-Mexico border is filled with a series of ambitious events and the development of effective mechanisms propelling binational collaboration. The Project whose work is presented in the following pages is a shining example of how the cohesive, on-the-ground efforts of a binational partnership led to a determination of the prevalence of diabetes, identification of the risk factors, and development of a viable diabetes prevention and control program capable of responding to the specific needs of the border population.

The Project came about because local public health authorities on both sides of the border became alarmed by the disproportionately high morbidity and mortality rates related to diabetes. They became painfully aware of the chronic and debilitating effect this disease was having not only on those living with its effects, but also on families, communities, health services, and local economies.

The information emerging at the turn of the 1990—2000 decade pointed to an ever-increasing number of the population presenting with diabetes and other risk factors for chronic diseases. In the United States, public health authorities were concerned by the high prevalence of chronic diseases among the Hispanic population, the country’s largest minority group, which had large concentrations living in the southern states.

Meanwhile, in Mexico, health authorities were taking note of a similar trend, particularly among communities situated along the northern border. Considering that the U.S.-Mexico border area has a relatively young population with about 25% being under the age of 30, the need to carry out a comprehensive study to better understand and address the situation of diabetes became an imperative…………….” [Mirta Roses]

Bridging the knowledge-action gap in diabetes along the U.S.-Mexico border Maria Teresa Cerqueira

“….The information shared in this special issue contributes significantly to strengthening the knowledge about diabetes and chronic disease risk factors on the border, and we hope that in so doing it will contribute to improving the policy and environmental conditions that are the underlying causes of diabetes mellitus type 2 (DM2 ) on the border.

The evidence clearly points to a critical need to create supportive environments for an active lifestyle, increase access to healthy and affordable foods, improve outreach and access to quality health services, continue research to enrich the evidence base of effective experiences, and strengthen surveillance along and across the border using a common methodology and considering the whole border as an integral epidemiological region….” [Maria Teresa Cerqueira]

SPECIAL REPORTS

A historical overview of the United States-Mexico Border Diabetes Prevention and Control Project

Rita V. Diaz-Kenney , Rosalba Ruiz-Holguín , Federico G. de Cosío , Rebeca Ramos , Betsy Rodríguez ,
Gloria L. Beckles , Rodolfo Valdez , Patricia E. Thompson-Reid

United States-Mexico Border Diabetes Prevalence Survey: lessons learned from implementation of the project

Federico G. de Cosío , Beatriz A. Díaz-Apodaca , Rosalba Ruiz-Holguín , Agustín Lara , Carlos Castillo-Salgado

ARTICLES

Cooperación transfronteriza en investigación sobre diabetes mellitus tipo 2: México-Estados Unidos

Jaume Canela-Soler , María Frontini , Maria Teresa Cerqueira , Rosalba Ruiz-Holguín , Beatriz A. Díaz-Apodaca

Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the
United States-Mexico border region

Maya Vijayaraghavan , Guozhong He , Pamela Stoddard , Dean Schillinger

Prevalence of type 2 diabetes and impaired fasting glucose: cross-sectional study of multiethnic adult population
at the United States-Mexico border

Beatriz A. Díaz-Apodaca , Shah Ebrahim , Valerie McCormack , Federico G. de Cosío , Rosalba Ruiz-Holguín

Access to health care and undiagnosed diabetes along the United States-Mexico border

Xuanping Zhang , Gloria L. Beckles , Kai McKeever Bullard , Edward W. Gregg , Ann L. Albright , Lawrence Barker , Xinzhi Zhang ,
Rosalba Ruiz-Holguín , Maria Teresa Cerqueira , María Frontini , Giuseppina Imperatore

Acculturation and healthy lifestyle habits among Hispanics in United States-Mexico border communities

Suad Ghaddar , Cynthia J. Brown , José A. Pagán , Violeta Díaz

Disparities in undiagnosed diabetes among United States-Mexico border populations

Pamela Stoddard , Guozhong He , Maya Vijayaraghavan , Dean Schillinger

Quality of diabetes care: a cross-sectional study of adults of Hispanic origin across and along
the United States-Mexico border

Beatriz A. Díaz-Apodaca , Federico G. de Cosío , Jaume Canela-Soler , Rosalba Ruiz-Holguín , Maria Teresa Cerqueira

Ethnic and health correlates of diabetes-related amputations at the Texas-Mexico border

Nelda Mier , Marcia Ory , Dongling Zhan , Edna Villarreal , Maria Alen , Jane Bolin

Smoking behavior among Hispanic adults with diabetes on the United States-Mexico border: a public health opportunity
Pamela Stoddard , Guozhong He , Dean Schillinger

Short communication

Support for disease management, depression, self-care, and clinical indicators among Hispanics with type 2 diabetes
in San Diego County, Unites States of America
Addie L. Fortmann , Linda C. Gallo , Chris Walker , Athena Philis-Tsimikas

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[EQ] The effect of social franchising on access to and quality of health services in low- and middle-income countries

[Intervention Review]

The effect of social franchising on access to and quality of health services in low- and middle-income countries

Tracey Perez Koehlmoos¹, Rukhsana Gazi², S. Shahed Hossain², K Zaman³

¹Head, Health and Family Planning Systems Programme, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
²Health Systems and Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
³Child Health Unit, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh

Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD007136. DOI: 10.1002/14651858.CD007136.pub2.

Available online at: http://bit.ly/cWHXNt

Background

Social franchising has developed as a possible means of improving provision of health services through engaging the non-state sector in low- and middle-income countries.

Objectives

To examine the evidence that social franchising has on access to and quality of health services in low- and middle-income countries.

Search strategy

We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (up to October 2007), Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 3), MEDLINE, Ovid (1950 to September Week 3 2007), EMBASE, Ovid (1980 to 2007 Week 38), CINAHL, Ovid (1982 to September Week 3 2007), EconLit, WebSPIRS (1969 to Sept 2007), LILACS, Science Citation Index Expanded and Social Sciences Citation Index (1975 to March 2008), Sociological Abstracts, CSA Illumnia (1952 September 2007), WHOLIS (1948 November 2007).

Selection criteria

Randomized controlled trials, non-randomized controlled trials, controlled before and after studies and interrupted time series comparing social franchising models with other models of health service delivery, other social franchising models or absence of health services.

Data collection and analysis

Two review authors independently applied the criteria for inclusion and exclusion of studies to scan titles and abstracts. The same two review authors independently screened full reports of selected citations . At each stage, results were compared and discrepancies settled through discussion.

Main results

No studies were found which were eligible for inclusion in this review.

Authors' conclusions

There is a need to develop rigorous studies to evaluate the effects of social franchising on access to and quality of health services in low- and middle-income countries. Such studies should be informed by the wider literature to identify models of social franchising that have a sound theoretical basis and empirical research addressing their reach, acceptability, feasibility, maintenance and measurability.

Plain language summary
Social franchising to increase access to and quality of health services in low- and middle-income countries
Governments are looking for ways to increase the access to and quality of health care services in low- and middle-income countries. One system not connected to the public sector, has been to provide health services through a franchise, called social franchising. The concept of franchising for health services is similar to franchises in business. A franchiser develops a successful way to provide the health services, and then other franchisees copy the model in other franchises. Each franchisee, though, has to follow the original model. There is also usually specific training, protocols and standards to follow, monitoring, and a brand name or logo which identifies that the provider is part of a franchise.

There is hope and early work reports that social franchising may quickly spread health services in low- and middle income countries to improve health. But this Cochrane review did not find any rigorous evidence to demonstrate the effect of social franchising on access to and quality of care in low- and middle-income countries….”

http://blogs.bmj.com/bmj/2010/10/06/tracey-koehlmoos-systematic-reviews-of-health-systems-and-policy-research-where-do-they-belong/





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[EQ] A Foundation for Evidence-Driven Practice: A Rapid Learning System for Cancer Care

A Foundation for Evidence-Driven Practice:
A Rapid Learning System for Cancer Care

Workshop Summary

Sharon Murphy and Margie Patlak, Rapporteurs;

IOM (Institute of Medicine). 2010. Washington,DC: The National Academies Press

ISBN: 0-309-15127-9, 124 pages, 6 x 9, (2010)

Available online at: http://bit.ly/anfRol

“…..Evidence of what is effective in clinical practice, especially evidence of what is appropriate for specific individual patients, is often lacking. In addition, if such evidence is available, it is often not translated rapidly into standard clinical practice, nor is it followed uniformly across healthcare practices. Our current healthcare system is plagued by overuse, underuse, and misuse, leading a recent Institute of Medicine (IOM) committee to conclude there is an urgent need to “know what works” (IOM, 2008).

This is problematic and challenging given the rapidity with which medical advances render standard care obsolete. A delay in translation or inappropriate care can shorten the life span of patients with life-threatening diseases.

Regrettably, much of the information that could improve care is not currently collected or distributed at the point of care, despite recent advances in information technology that make this possible….”

“…..There is a compelling public interest to advance the evidence base for cancer treatment and control measures, and to transform the way evidence is aggregated and applied in real-time, driving the process of discovery as a natural outgrowth of patient care, to ensure innovation, quality, safety, and value. A learning health care system for cancer would take full advantage of private and public sector databases and emerging information technology, including electronic medical records, to advance clinical cancer data, both as a public utility and a point-of-care patient-centered clinical decision support system. In light of substantial public investments in health information technology and comparative effectiveness research, this workshop is both timely and topical.

The promise of personalized cancer medicine and targeted therapies for cancer add further urgency to foster development of rapid learning systems to know what works and deliver higher value cancer care.

The goal of this workshop is to foster progress toward this vision for a rapid learning health care system for cancer. The workshop will examine the foundation stones upon which to build such a system and explore aspects of information technology which will enable such a system to operate seamlessly.

The impact on oncology providers and policy challenges will be examined with the aim of stimulating collaboration and action…”





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[EQ] High-Powered Incentives in Developing Country Health Insurance

High-Powered Incentives in Developing Country Health Insurance:

Evidence from Colombia’s ‘Régimen Subsidiado’

Grant Miller, Stanford Medical School and National Bureau of Economic Research (NBER)
Diana Pinto, Pontificia Universidad Javeriana School of Medicine and Fedesarrollo - Colombia
Marcos Vera-Hernández, University College London and Institute for Fiscal Studies (IFS)

October 2009

High-Powered Incentives in Developing Country Health Insurance:

Evidence from Colombia’s Regimen Subsidiado http://bit.ly/cGMpcU

Available online PDF [57p.] at: http://bit.ly/cGMpcU

“…..Despite current emphasis on health insurance expansions in developing countries, inefficient consumer incentives for over-use of medical care are an important counterbalancing concern. However, three factors that are more acute in poor countries (credit constraints, principal-agent problems, and positive externalities) result in substantial under-use and misuse as well.

This paper studies Colombia’s Régimen Subsidiado, the first major developing country effort to expand insurance in a way that purposefully addresses these inefficiencies. Using a regression discontinuity design, we find that Colombia’s insurance program has provided risk protection while substantially increasing the use of traditionally under-utilized preventive services (with measurable health gains) through high-powered supply-side incentives….”

Winners of the Inter-American Award for Research on Social Security 2010





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