"As the prevalence of type 2 diabetes grows, the country's ability to reduce health care costs and improve health outcomes depends on how well patients can manage their disease through their access to clinical services and through self management that takes place in their homes and communities," says John Damonti, president, Bristol-Myers Squibb Foundation and vice president, Corporate Philanthropy, Bristol-Myers Squibb. "Several of the projects we are announcing today have the potential to have a significant and sustained impact on diabetes management as well as on policy and advocacy at the state and national levels."
The risk of developing type 2 diabetes increases as people age. While only 3.7 percent of adults ages 20-44 have diabetes, according to the U.S. Centers for Disease Control and Prevention's 2011 National Diabetes Fact Sheet, the incidence rate more than triples to 13.7 percent for adults 45-64 and then nearly doubles again to 26.9 percent for adults 65 and older. More importantly, adults with type 2 diabetes are at greater risk for comorbid conditions and complications that can shorten their life expectancy. A 10-year study of 250,000 adults reported last month by CDC and the National Institutes of Health found that a diagnosis of type 2 diabetes in middle age reduces a patient's life span by 10 years.
In order to improve health outcomes for patients with multiple chronic diseases including diabetes, the U.S. Department of Health and Human Services calls for national scaling of evidence-based self-management programs such as the Stanford Diabetes Self-Management Program (DSMP).
National Council on Aging (NCOA) will receive $4.87 million over three years to demonstrate a nationally scalable model for delivering the Stanford DSMP on-line and in community settings in partnership with the national YMCA, OASIS Institute, WellPoint and Stanford University.
The project will leverage the ability of OASIS Institute and the YMCA to deliver evidence-based health and wellness programs in the community setting and NCOA's existing online delivery structure to help 2,500 adults with type 2 diabetes adopt healthier behaviors that will improve their overall health and reduce their need for health care services. WellPoint, one of the nation's largest health insurers, will promote the project to adults who are enrolled in its commercial and Medicare Advantage health insurance plans as well as to providers. WellPoint will also assist with evaluation of the project, including analysis of costs. The project will be piloted in St. Louis and a second metropolitan area. "It is widely recognized that the U.S. health care system fails to adequately empower patients with diabetes and other chronic conditions to manage those conditions in ways that improve symptoms and quality of life and avoid preventable exacerbations leading to high-cost health care utilization," says James Firman, Ed.D., NCOA's president and CEO. "This project will directly address key barriers to getting public and private payers to add DSMP to their benefit packages by providing evidence of a highly scalable delivery model that will produce costs savings and improve health outcomes for their insured populations."
The Center for Health Law and Policy Innovation at Harvard Law School will receive $981,862 over four years to develop comprehensive state-level policy recommendations for eliminating barriers to care, improving outcomes and enhancing health care policy for patients with type 2 diabetes as part of the Center’s Providing Access to Healthy Solutions (PATHS) initiative.
PATHS will work on two levels. First, the Center will conduct an in-depth state-based pilot program in Mississippi, New Jersey and North Carolina whose goal is to produce state-level advocacy and policy recommendations. Those recommendations will then serve as a roadmap for ongoing advocacy efforts in other states through a broader information- and network-building effort with Together on Diabetes™ grantees across the country.
"Although national, state and local organizations focusing on diabetes have been active for many years, there remains the urgent need for effective programs of community education, grassroots advocacy, coalition building, leadership development, strategic planning and community mobilization - programs that will constructively impact diabetes-related health care policy at the state and national levels," said Robert Greenwald, director of the Center for Health Law and Policy Innovation and a clinical law professor at Harvard Law School. "Overcoming the deficit of effective advocacy and implementing policy change regarding diabetes prevention, care and management are essential to improve outcomes at a scale comparable to that seen in the advances with cancer, HIV/AIDS and other chronic diseases."
Sixteenth Street Community Health Center in Milwaukee, Wisconsin, will receive $295,615 over three years to help Hispanic patients with type 2 diabetes who have fallen out of a doctor's care for their diabetes at least twice in a 12-month period to reconnect to care, drawing lessons on linkage to care models used for people living with HIV/AIDS.
SSCHC will use targeted outreach, bilingual health education and ongoing support to re-engage inactive patients, teach them how to manage their own care, verify they are receiving care on a regular basis, and maintain an appropriate level of care over time.
Expansion to China and India
The Foundation also announced a $15 million expansion of Together on Diabetes™ to China and India, countries with rapidly growing numbers of type 2 diabetes patients.
The Chinese Center for Disease Control and Prevention (China CDC) will receive US $709,016 over three years to enhance the capacity of rural health care providers to manage and prevent type 2 diabetes at the village level in Western China, where diabetes is growing faster than in China's cities and where rising medical costs are an important factor leading to poverty.
China CDC's efforts will focus on identifying high-risk rural populations and ensuring timely intervention to prevent onset of disease; standardizing training courses for diabetes prevention and control in rural settings; enhancing disease awareness and health education and using technology in rural communities to improve patient-self management; and mobilizing government and community leaders to prioritize management of type 2 diabetes.
Shanghai Charity Foundation (SCF) will receive US $522,797 over three years to create an efficient and effective community-based, block-by-block approach for managing type 2 diabetes in Shanghai, a mega-city of 23 million people.
The most recent survey conducted by the Shanghai Center for Disease Control (SCDC) shows the prevalence of type 2 diabetes in Shanghai reached 16 percent last year, more than 6 percentage points above the national average and nearly 5 percentage points higher than other Chinese cities.
Working with the SCDC and the Shanghai Municipal Health Bureau, SCF will leverage existing city management systems and technology to build and pilot an integrated model of diabetes prevention and management that can be deployed in other Chinese cities.
The first Together on Diabetes™ grants in India will be announced later.
About Together on Diabetes™
Together on Diabetes™ is a five-year, $115 million initiative of the Bristol-Myers Squibb Foundation to improve health outcomes of adults living with type 2 diabetes in the United States, China and India by strengthening patient self-management education, community-based supportive services and broad-based community mobilization.
About the Bristol-Myers Squibb Foundation
The Bristol-Myers Squibb Foundation is an independent 501(c)(3) charitable organization whose mission is to reduce health disparities and improve health outcomes for patients around the world who are disproportionately affected by serious disease.