The Public Health Perspective: The National Diabetes and Women’s Health Action Plan
Michelle D. Owens, PhDCenters for Disease Control
and Prevention
Obesity and Diabetes Epidemic
Obesity and diabetes: major causes of morbidity and mortality
Association with diabetes 300,000 adults die of obesity-related
causes Diabetes: 5th leading cause of death
Risk Factors for Diabetes and its Complications Living in poverty Working in small companies with few
benefits Being uninsured; lacking access to care Being overweight and not exercising
Sedentary Lifestyles and Obesity
Lifestyle factors: type 2 diabetes Obesity and weight gain Physical inactivity
Sedentary behaviors
Public health campaigns to reduce obesity and type 2 diabetes
Impact of sedentary behaviorsTelevision watching and eating behaviors
study (Hu, Li, Colditz et al, 2003)Males: 29 hours per week of televisionFemales: 34 hours per week
Television Watching
TV watching: lower metabolic rate Exposure to food advertising Hu study with women:
Assessed average weekly time watching TVAmount of time on average: physical activity50,277 women in final analysis
Hu study results
Women and watching tv: more likely to smoke, drink alcohol, and less likely to exercise
Higher intake of total energy, total saturated fats
Lower intakes of fish, vegetables
Hu Study Results 6 years follow-up: 3,757 women became
obese Association between tv watching and obesity 1,515 newly diagnosed cases of type 2
diabetes Association between time spent watching tv
and risk for type 2 diabetes
Hu Study Results
30% of obesity cases and 43% of type 2 diabetes cases can be prevented
Concerns with tv watching and risk of obesity and type 2 diabetes
Diabetes Prevention Program Study (DPP) Diabetes Prevention Program supports Hu
study findings Diet, exercise, and behavior modification
reduce risk of developing type 2 diabetes Lifestyle intervention group Impact on participants 60 and older Metformin-only group
Diabetes: Priority health issue for DHHS
Requires collective energies
National Public Health Initiative on Diabetes and Women’s Health
The National Public Health Initiative on Diabetes and Women’s Health
Phase 1: Assessment: Diabetes and Women’s Health Across the Lifestages
Phase 2: Proposed Recommendations for Action
Phase 3: Implementation of the National Agenda for Public Health Action
Phase III
Diabetes and Women Initiative Sponsored by
American Diabetes Association
American Public Health Association
Association of State and Territorial Health Officials
Centers for Disease Control and Prevention
Public Health Vision
Prevent or delay diabetes Provide women support Promote appropriate care Prevent, delay, minimize
complications
The National Agenda for Public Health Action
Collaboration among many partners
Mobilizing diverse organizations
Goals of the Initiative Garner attention of multiple sectors of
society Develop priority strategies, policies, and
research Unite partners for diabetes prevention and
control Empower women to adopt prevention
strategies
Diabetes and Women’s Health
Across the Life Stages
Challenges: The Adolescent Years
Lack of diabetes education/prevention materials
Lack of awareness of need for weight control
Plethora of fast food options Insufficient recreational activities
Challenges: The Reproductive Years
Barriers to self-care: impact of multiple roles
Limited time for physical activity and healthy eating
Weight gain and pregnancy
Challenges: The Middle Years Challenges are similar to those
experienced in the reproductive years
Needs of children, grandchildren, and aging parents may influence self-care
Challenges:The Older Years Vulnerability to other chronic illnesses Disability Poverty Depression Urinary incontinence Injurious falls Pain
Strategy Areas of the Action Plan Advocacy and Policy
Services and Programs
Communication and Education
Research and Surveillance
Ten Major Steps to Action: The Recommendations1. Strengthen advocacy2. Expand community-based health promotion3. Encourage and support diabetes prevention
and control programs4. Fortify community programs
Ten Major Steps to Action: The Recommendations5. Expand population-based surveillance6. Educate community leaders7. Encourage risk assessments, quality
care in health care settings8. Ensure access to quality services
Ten Major Steps to Action: The Recommendations
9. Encourage health care coverage10. Conduct public health research
Call to Action Conference: Update
October 2003 Call-to-Action Conference Implementation of National Agenda
Implementation Will require multiple partnerships
Develop coalitions, ways to collaborate
Build upon existing resources
Identify gaps
American Diabetes Associationwww.diabetes.org 800-342-2383
American Public Health Associationwww.apha.org 202-777-2534
Association of State and Territorial Health Officials www.astho.org 202- 371-9090
Centers for Disease Control and Prevention/Division of Diabetes Translation Toll-free number: 1-877-CDC-DIAB
Internet: www.cdc.gov/diabetes or for more information about the Initiative:
http://www.cdc.gov/diabetes/projects/women.htm