Improving access to high-quality diabetes care

An estimated 37.3 million people in the U.S. 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 disparities 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, stable housing and safe options for physical activity.

The Merck Foundation is helping improve health equity by supporting evidence-based programs that are working to transform the delivery of diabetes care and address social drivers of health.

Reducing disparities in diabetes care for underserved populations

For five years (2018-2022), the Merck Foundation supported the Bridging the Gap: Reducing Disparities in Diabetes Care (Bridging the Gap) initiative with a $16 million commitment.  Bridging the Gap and its programs helped improve access to high-quality, culturally responsive diabetes care and reduce disparities in health outcomes among people living with diabetes in underserved communities across the U.S.


Bridging the Gap focused on:

  • Building 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
  • Redesigning health care systems –particularly primary care – to improve the delivery of diabetes care for underserved populations
  • Improving health outcomes for individuals with diabetes through measures such as better glucose and lipid control
  • Disseminating key findings and lessons learned to advance cross-sector approaches that improve population health and reduce disparities among people living with diabetes

Program sites

Through grants to eight organizations across the U.S., the Foundation supported evidence-based programs working to improve the delivery of diabetes care:

The University of Chicago served as the National Program Office for Bridging the Gap. It supported the grantee organizations’ programs, leading the cross-site program evaluation, and building a national public-private partnership to help reduce disparities in diabetes care.

Approach and outcomes

The eight program grantees implemented comprehensive programs that brought together stakeholders from inside and outside the health care system to better coordinate diabetes care and address the many social factors that influence health outcomes. These efforts demonstrated how redesigning primary care and establishing robust community partnerships that address the social drivers of health can help improve the delivery of diabetes care.

The outcomes and lessons learned from this initiative are published in a special supplement of the peer-reviewed Journal of General Internal Medicine, titled “Bridging the Gap: Transforming Medical and Social Care for Diabetes.”

1 Centers for Disease Control and Prevention. National diabetes statistics report website. Accessed April 6, 2023.