Improving access to high-quality diabetes care
An estimated 34.2 million Americans—more than 10 percent of the population—are living with diabetes, according to the U.S. Centers for Disease Control and Prevention.1
Individuals from underserved communities are disproportionately affected by diabetes and its related complications, including heart disease, kidney disease, and eye problems. They also experience persistent inequities in access to high-quality diabetes care, which often lead to poor health outcomes.
Multisectoral collaborations can reduce health disparities and improve health outcomes by integrating high-quality medical care with community resources, such as access to nutritious food, adequate housing, and safe options for physical activity.
The Merck Foundation is helping improve health equity – the opportunity for everyone to attain their highest level of health – by supporting evidence-based programs that are working to transform the delivery of diabetes care and address social and environmental barriers to care.
Reducing disparities to in diabetes care for underserved populations
The Merck Foundation is supporting the Bridging the Gap: Reducing Disparities in Diabetes Care (Bridging the Gap) initiative with a $16 million, five-year (2017-2021) commitment. Bridging the Gap and its programs aim to improve access to high-quality diabetes care and reduce disparities in health outcomes among people living with type 2 diabetes in underserved communities across the U.S.
Bridging the Gap aims to:
- Build sustainable partnerships within the health care sector and among other sectors to address the medical and social factors that influence health outcomes for people living with diabetes
- Redesign health care systems –particularly primary care – to improve the delivery of diabetes care for underserved populations
- Improve health outcomes for individuals with type 2 diabetes through measures such as better glucose and lipid control
- Disseminate key findings and lessons learned to advance cross-sector approaches that improve population health and reduce disparities among people living with diabetes
Bridging the Gap program sites
Through grants to eight organizations across the United States, the Foundation is supporting evidence-based programs working to improve the delivery of diabetes care:
- Alameda County Public Health Department (Oakland, California)
- Clearwater Valley Hospital and St. Mary’s Hospitals and Clinics (Orofino, Idaho)
- La Clínica del Pueblo (Washington, D.C.)
- Marshall University (Huntington, West Virginia)
- Minneapolis Health Department (Minneapolis, Minnesota)
- Providence Health and Services (Portland, Oregon)
- Trenton Health Team (Trenton, New Jersey)
- Western Maryland Health System (Cumberland, Maryland)
The University of Chicago serves as the National Program Office for Bridging the Gap. It is supporting the grantee organizations’ programs, leading the cross-site program evaluation, and building a national public-private partnership to help reduce disparities in diabetes care.
The University of Chicago is conducting a comprehensive evaluation of the eight program sites over the course of the five-year initiative. The evaluation team reported that, from October 2017 through July 2019, Bridging the Gap sites collectively reached more than 8,000 people living with diabetes and community residents through their programs.
In 2019, the evaluators conducted a baseline assessment of participants engaged in diabetes self-management with support from various healthcare providers (e.g., community health workers, certified diabetes educators, nurse care managers, care coordinators) at five of the eight program sites. The baseline findings from 407 program participants are summarized below.
- Engagement in care: Nearly 30% of responding participants reported that their primary care physician asked (sometimes or never) for their ideas about managing their own health
- Diabetes self-efficacy: Nearly 50% of responding participants reported low confidence in managing high blood sugar levels
- Self-rated health: Over half of responding participants rated their health as poor or fair
- Quality of life: Approximately 70% of responding participants reported that their health worsened or was about the same as it was six months earlier
1 Centers for Disease Control and Prevention. National diabetes statistics report 2020: Estimates of diabetes and its burden in the United States. www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf.