the public health perspective: the national diabetes and women’s health action plan michelle d....
TRANSCRIPT
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The Public Health Perspective: The National Diabetes and Women’s Health Action Plan
Michelle D. Owens, PhDCenters for Disease Control
and Prevention
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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
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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
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Sedentary Lifestyles and Obesity
Lifestyle factors: type 2 diabetes Obesity and weight gain Physical inactivity
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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
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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
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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
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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
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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
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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
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Diabetes: Priority health issue for DHHS
Requires collective energies
National Public Health Initiative on Diabetes and Women’s Health
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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
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Phase III
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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
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Public Health Vision
Prevent or delay diabetes Provide women support Promote appropriate care Prevent, delay, minimize
complications
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The National Agenda for Public Health Action
Collaboration among many partners
Mobilizing diverse organizations
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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
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Diabetes and Women’s Health
Across the Life Stages
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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
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Challenges: The Reproductive Years
Barriers to self-care: impact of multiple roles
Limited time for physical activity and healthy eating
Weight gain and pregnancy
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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
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Challenges:The Older Years Vulnerability to other chronic illnesses Disability Poverty Depression Urinary incontinence Injurious falls Pain
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Strategy Areas of the Action Plan Advocacy and Policy
Services and Programs
Communication and Education
Research and Surveillance
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Ten Major Steps to Action: The Recommendations
1. Strengthen advocacy
2. Expand community-based health promotion
3. Encourage and support diabetes prevention and control programs
4. Fortify community programs
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Ten Major Steps to Action: The Recommendations5. Expand population-based surveillance
6. Educate community leaders
7. Encourage risk assessments, quality care in health care settings
8. Ensure access to quality services
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Ten Major Steps to Action: The Recommendations
9. Encourage health care coverage
10. Conduct public health research
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Call to Action Conference: Update
October 2003 Call-to-Action Conference Implementation of National Agenda
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Implementation Will require multiple partnerships
Develop coalitions, ways to collaborate
Build upon existing resources
Identify gaps
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American Diabetes Association
www.diabetes.org 800-342-2383
American Public Health Association
www.apha.org 202-777-2534
Association of State and Territorial Health Officials www.astho.org 202- 371-9090
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Centers for Disease Control and Prevention/Division of Diabetes Translation
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