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CDC director addresses healthcare problems state faces

Jackson — With the number of Mississippians with diabetes skyrocketing, state health care officials and providers held a conference on diabetes care last week with Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, as the keynote speaker. The conference, “Bridging the Gap: Translating Diabetes Care from the Ideal to the Real,” was sponsored by the University of Mississippi Medical Center (UMC) and the Delta Health Alliance. It was held at the Jackson Medical Mall Thad Cochran Center.

A UMC spokesman said the medical center and a host of other organizations have held meetings about diabetes in the Delta and the conference is a culmination of those meetings.
According to Dr. Marshall Bouldin, director of the UMC Diabetes and Metabolism Program, the goals of the conference were to spark reform in the way healthcare providers administer care to diabetes patients and social changes that will reduce the rate of obesity, one of the root causes.

“The state of affairs is that we know what we should do in order to prevent or control most diabetes and its complications,” said Bouldin, an associate professor of medicine. “For many reasons, in the real world that doesn’t wind up happening to the patient.”

Dr. Gerberding attended at the invitation of U.S. Sen. Thad Cochran (R-Miss). “Mississippi’s health care providers will receive advice from Dr. Gerberding about how to best use the experience available from the Centers for Disease Control,” he said. “I believe her tour of the Medical Mall will also provide insight for the CDC into how communities care for patients who suffer from diseases associated with diabetes.”

Gerberding, who became the CDC director in 2002, discussed the burden that diabetes is having on the nation’s health, noting that the number of Americans with diabetes more than doubled from 1980 to 2000, rising from 5.8 million to 13.3 million. She also spoke of the importance of addressing this problem at every stage of life from infancy to adulthood.
Bouldin said the state is facing a difficult challenge when it comes to improving diabetes care. The problems include a shortage of healthcare providers, a high level of acuity and morbidity, and a high number of residents without health insurance.

“Our system of care is designed for acute care and not for chronic diseases,” he said. “There are all kinds of ramifications for that.”

One of the consequences is a high rate of diabetes. In 2002, the latest year statistics are available, Mississippi and 17 other states had diabetes prevalence rates of 8% to 10%, CDC figures show. Virginia had the highest rate with more than 10%. Mississippi also has a high rate of obesity, one of the most common risk factors associated with diabetes. Mississippi, Alabama and West Virginia had the highest obesity prevalence rates in the U.S. in 2002 at more than 25%.

Bouldin said the key to effective diabetes care is a multidisciplinary approach that includes primary care providers, dieticians, educators and case managers. “A multidisciplinary approach can produce extremely good results in diabetes, but it’s very hard to put that kind of team together in the conditions prevailing throughout most of our state,” he said.

Two UMC projects — the Diabetes Management Clinic and the Delta Diabetes Project — are addressing the need for better care for diabetes patients. “These projects are proof that the problems with diabetes quality of care are rapidly reversible with the right approach,” Bouldin said.

The Delta Diabetes Project is under the auspices of the Delta Health Alliance, a partnership formed in 2001 by Delta State University, Mississippi State University, Mississippi Valley State University, the Delta Council and UMC.
Project coordinator Cass Pennington said, “Our largest project at this point is diabetes. Our main emphasis is on that. I don’t think there’s any family in the Delta that’s not touched by it.”

He said Dr. Gerberding’s visit promotes a CDC-Delta prevention collaborative as a strategy to achieve better health and productivity for the people of the region. More than half a million residents – one-fifth of the state’s population – live and work in this northwestern part of Mississippi. Half of the area is rural and most of the 18 counties have fewer than 40,000 residents.

The median age is 32 with relatively more blacks at young ages and whites at older ages. Health and economic indicators show the region to have lower life expectancies from birth, poorer health and less health insurance coverage, higher unemployment and lower incomes in comparison to other regions in the state or neighboring states.

“These measures add up to a significant public health challenge. Yet the opportunities to improve conditions throughout the region are also great,” Pennington said. “Dr.

Gerberding came here to initiate efforts to work with partners from within the state and CDC in an attempt to reduce the burden of chronic disease and injury, work to eliminate health disparities and assume the conditions for a healthier, more prosperous future in the region.”

A retired educator, Pennington hopes the collaborative endeavor to enact both new and proven strategies to enhance public health in the Delta can be replicated and disseminated to other regions around the country.

Contact MBJ contributing Lynn Lofton at mbj@msbusiness.com.

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