Current Theory, Methods And Intervention Strategies

The incidences of diabetes are growing annually, and predicted to increase within the coming decades. The number of cases yearly is not only increasing, but the age of onset for diabetes has decreased. This means more individuals are developing diabetes at an earlier age. Diabetes not only affects individuals and communities but countries as well. The prevalence of diabetes has gathered billions of dollars in healthcare costs. [1]Type 2 diabetes also leads to other serious medical conditions such as heart disease, renal failure, blindness, and tissue damage in extremities that will eventually lead to amputation. These illnesses, as a result, result in further costs in the form of disability and the loss of a portion of our workforce. However, incidences of type 2 diabetes are in higher occurrence amongst Hispanic groups. According to the Hispanic Health and Nutrition Examination Survey, Mexican Americans have an unusually high prevalence of diabetes compared to that of the general population [2]. Hispanic females have the highest lifetime risk of becoming diabetic – 52% [3], compared to that of the average risk of

Based on the United States census, it is estimated that by the year 2050 one in three people living in the United Sates will be of Hispanic/Latino origin which include sub groups like Puerto Rican, Mexican, Cuban, Central Americans, and South Americans (Heart Association, 2014). Within those subgroups, the prevalence varied for people of Mexican descent from as high of 18.3 percent to as low as 10.3 percent for people of South American descent, Dominicans and Puerto Rican descent 18.1 percent, Central American descent and Cubans descent 13.4 percent all living in the United States with diabetes type 2. On another commentary being published in the same issue of Diabetes Care, the author wrote, “the differences in diabetes and obesity prevalence among Latinos subgroups are marked when all individuals are combined into a single group” (Heart Association, 2014). Diabetes in Latino Americans has become more prevalence with aging, by the time they reach the age of 70 years, 44.3 percent of Latino men age 70 years old to 74 years old will have develop diabetes. The same study also indicated that the longer Latino Americans live in the United States the more likely they will develop diabetes, that is according to the education and income level of the person. The study also shows

that African American adults are 50% to 100% more likely to have diabetes than are Whites,

According to the American Diabetes Association, more Americans die each year from diabetes than from AIDS and breast cancer combined. As a result, researchers have extensively studied the causes, treatments, and interventions for diabetes. Despite efforts to ameliorate its effects, diabetes remains a prevalent danger in society. In 2014, 7% of U.S. adults were living with diagnosed diabetes (Centers for Disease Control and Prevention [CDC], 2016). In Louisiana that number was even higher - 10.4% of adults have been diagnosed with diabetes. Breaking it down by age group, however, in Louisiana 3% of people aged 18 and 44 have been diagnosed, and 15.2% of people 45-64. (Centers for Disease Control and Prevention [CDC], 2015a). Several studies have predicted future rates of diabetes both in the United States and worldwide - nearly all of these studies reached a similar conclusion: rates of diabetes will continue to rise (Boyle et al., 2001).

While only 7.6 percent of non-Hispanic whites and 9 percent of Asian-Americans have diabetes, 12.8 percent of Hispanics have diabetes. Other high-risk ethnic groups are non-Hispanic blacks (13.2 percent) and American Indians/Alaskan Natives (15.9 percent). For Hispanics living in the United States, the prevalence of type 2 diabetes is lower in those coming from Central and South America (8.5 percent) or Cuba (9.3 percent), but higher for those who are Mexican American (13.9 percent) and Puerto Rican (14.8 percent), who comprise the majority of Hispanic immigrants in the U.S. (Valencia, Oropesa-Gonzalez, Hogue & Florez,

Diabetes is a prevalent health disparity among the Latino population. Diabetes is listed as the fifth leading cause of death among the Latino population in the website for Center for Disease Control and Prevention, CDC, in 2009. According to McBean, “the 2001 prevalence among Hispanics was significantly higher than among blacks.” (2317) In other words among the Hispanic or Latino community, there is a higher occurrence of diabetes as compared to other racial/ethnic groups such as Blacks and Native Americans. The prevalence of diabetes among Latinos is attributed to the social determinants of health such as low socioeconomic status and level of education. Further, this becomes an important public health issue when it costs the

Approximately 1 in 6 individuals are Hispanic in the United States, and the population is expected to grow to 1 in 4 by 2035 (CDC, 2015). Given that, Hispanics are the biggest minority group in the US (CDC, 2015). The leading cause of death among the Hispanic population is heart disease and cancer responsible for around 2 out of 5 deaths (CDC, 2015). Hispanics have a 50% greater chance of death resulting from diabetes or liver disease than whites (CDC, 2015). Additionally, there are 3 times as more uninsured Hispanics than whites (CDC, 2015). According to the US average, whites are 15 years older than the Latino population, so prevention will greatly benefit the health of the Latino population (CDC, 2015).

The Hispanic population is constantly growing and we have an estimated 13.7% of Hispanics making up the United States. “The annual percentage of patients with prediabetes in whom overt type 2 diabetes develops is about 5% in the general US population and may reach 15% in the Hispanic American population” (Idrogo & Mazze, 2004, para. 7). This a community health issue because of the percentage of Hispanic individuals that may end up with diabetes. These individuals need to be educated to help the promotion, protection, and maintenance of diabetes in this group. That is why I have created the intervention program for this ethnic group.

African Americans, American Indians and Alaska Natives living in N.D are twice as likely to have diabetes than Whites.

However, due to the United States’ aging population, along with an increasing prevalence of obesity, diabetes is on the increase. Of the approximately 313 million population count in the United States, 97 million adults are overweight or obese. “Both excess body fat and physical inactivity predispose to type 2 diabetes. Several ethnic groups are particularly susceptible to Type 2 diabetes” (Scott 1134). Hispanics, blacks,

Diabetes in Hispanic Americans is a serious health challenge because of the increased prevalence of diabetes in this population, the greater number of risk factors for diabetes in Hispanics (Smith, 2010).” In the years of 2004-2006, about 11.9% of Hispanic American aged twenty (20) years or older are diagnosed with diabetes. About 75% of the Hispanic American trend to be overweight or obesity. When work with Hispanic American clients, you have to gain support from clients’ families to enhance their acceptability of the diet. Healthcare provider encourages pregnant Hispanic to eat low-fat cheeses, lean red meat, and fresh fruits and vegetables. “Gender differentiation and male dominance are issues to consider while working with Hispanic households. The father is the leader of the family while the mother runs the home, shops and prepares the food (Smith,

Hispanics represents one of the most dramatic and important demographic trends affecting the United States (Escarce, Morales, & Rumbaut, 2006). Some common chronic conditions, including diabetes, hypertension, cardiovascular disease, and cancer are some of the medical issues that plague the Hispanic community. Diabetes Compared with non-Hispanic whites, Hispanics have higher rates of Type 2 diabetes. Due to the higher prevalence of diabetes in Hispanics, the burden of complications attributable to diabetes is greater for Hispanics than for other groups (Escarce et al., 2006). Complications of

Diabetes Data for Bexar County: According to the 2014 City of San Antonio Diabetes Fact Sheet, The percentage of adults with diabetes in Bexar county has been on the increase in the last few years. In 2012, 11.4% of the population in Bexar county had been diagnosed with diabetes; in 2013, number of diagnosed residents increased to 12.7%, and in 2014, it had increased to14.2%. Diabetes prevalence did not differ significantly between adult males (13%) and females (15%). Percentage of adults with diabetes by age was 1% for adults 18-29 years; 6% for adults age 30-44 years; 22% for people age 45-64 years and 33% for people age 65 years and older. In 2014, percentage of adults with diabetes by ethnicity was: Hispanics 15%; non-Hispanic

According to a study provided in USNews, there are regional issues when it comes to the rates of type-2 diabetes within the United States today (Seppa, 2011). The "diabetes belt" that can clearly be seen in the Southeast part of the country is one of these regional issues. Southern people, on average, tend to have a higher incidence of diabetes than people in other areas of the country. With that in mind, it is important to realize that there are various reasons why that is the case. It is not just one factor causing the problems, and it is not just the Southeast where diabetes is seen. There are other areas of the country where pockets of diabetes are seen, so no specific place or region of the country is immune to problems with diabetes. The following map shows the basic breakdown of diabetes across the country for the latest year where statistics on the issue are available (Seppa, 2011).

     According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 17 million Americans have diabetes and every year about 1 million more age 20 or older are diagnosed with the disorder. People who are overweight, do not exercise, and are 30 years or older are more likely to get the disease (especially type 2 diabetes). People who are also of African American, Latino/Hispanic, Native American, Alaskan