COLLABORATIVE US-MEXICO BORDER DIABETES PREVENTION PROJECT

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COLLABORATIVE US-MEXICO BORDER DIABETES
PREVENTION PROJECT

• Presenters
• Gloria Beckles
• Rodolfo Valdez

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The US-MEXICO BORDER
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Border Population I

• About 70 Hispanic
• High annual growth rates (3.1 for Mexico and
  2.4 for U.S)
• The rates suggest that the US/MX border
  population will double in about 25 years.

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Border Population II

• High poverty levels on both sides of the border
• A large portion of the Hispanic population is
  uninsured or underinsured
• Several US border communities are designated
  Medically Underserved Areas

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Diabetes Mortality Rates for Selected US-Mexico
Border Communities, 1995-1997
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Diabetes Mortality Rates/100,000 inSelected
US-Mexico Border Counties and Municipalities,
1992-1994 / 1995-1997
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Description

• This is a five-year US-Mexico collaborative
  project to determine the prevalence of diabetes
  along the US-Mexico border and to develop
  binational diabetes prevention and control
  programs specific to the needs of the border
  population

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Partners

• Pan American Health Organization
• US-Mexico Border Health Association
• Centers for Disease Control and Prevention
• Secretaría de Salud de México
• State Health Authorities and Diabetes Control
  Programs of
• Arizona Baja California
• California Chihuahua
• New Mexico Coahuila
• Texas Nuevo León
• Sonora
• Tamaulipas
• Paso del Norte Health Foundation
• El Paso Diabetes Association
• Border Health Foundation
• California Endowment / Project Concern
  International

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(No Transcript)
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AMERICAN DIABETES ASSOCIATION RECOGNITION FOR
EXCELLENCE Facility Columbia Medical Center
Program Name Columbia Diabetes Treatment Center
Comprehensive Education Outpatient Program
Original recognition date 9/25/98 Current
recognition date 9/25/98
Diabetes Today
El Paso Diabetes Association
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Funding

• CDC awarded PAHO 824,000 for project activities
• Paso del Norte Health Foundation has assigned
  more than 400,000 for the prevalence study in
  its area of influence (Texas).
• Texas Department of Health contributed 60,000.
• New Mexico Department of Health contributed
  80,000 to fund the position of US Coordinator.
• California Endowment awarded the Border Health
  Initiative of Project Concern International
  272,000 to fund project activities in California

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Management

• PAHO coordinates activities supported by
• Executive Committee
• Scientific Committee
• Workgroups
• Intervention Advisory Committee
• Workgroups
• CDC and SSM advisors

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Rationale

• Diabetes is common among people of Mexican
  ancestry.
• The prevalence of diabetes along the US/MX border
  is unknown.
• Health Departments in the US border states are
  concerned that the information from the statewide
  BRFSS may not be applicable to the border
  population.

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Purpose

• The purpose of the project is two-fold
• Assess the burden of diabetes and related factors
  in the border population.
• Provide information for diabetes program
  development and implementation.

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Objectives

• Phase I
• Prevalence of diabetes
• Prevalence of lifestyle factors
• Access to/Quality of health care
• Data analysis
• Literature review of community interventions
• Phase II
• Intervention

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Sample I

• Persons aged 18 years or older
• Counties contiguous with US/MX border
• Residents of census tracts in counties with
  cities of 50,000 people or more
• Residents of census tracts in municipalities with
  2,500 people or more

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Sample II US

• Strata
• Arizona
• California-San Diego County
• California-Imperial County
• New Mexico
• Texas-El Paso County
• Texas-Other counties
• Within each stratum two ethnic groups
  (Hispanic, Non-Hispanic) will be selected

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Sample III Mexico

• Strata
• Baja California
• Sonora
• Chihuahua
• Coahuila
• Nuevo León
• Tamaulipas

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Sample size US
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Sample size Mexico / Total
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Data Collection

• Questionnaire (Demographics, behavioral risk
  factors, access to health care, quality of care)
• Venipuncture (FPG, HbA1c)
• BP measurement (SBP, DBP, HBP)
• Anthropometry (Ht, Wt, WC)

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Prevalence estimates

• Diabetes prevalence estimates for
• US-México Border region
• US Border population
• Hispanic
• Non-Hispanic
• México Border population
• Border population of each state

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Current Status I

• Household questionnaires and operation manuals
  have been developed in English and Spanish
• A field test has been completed in El Paso and
  Ciudad Juárez area
• A binational sample design has been developed
• Communities to be surveyed have been selected
• Communication plan is being developed

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Current Status II

• IRB approvals have been obtained from the US and
  Mexico
• OMB approval has been obtained (US)
• Laboratories for blood analyses have been
  identified
• Inventory of interventions has been created
• The survey is about to start in the Texas-New
  Mexico-Chihuahua and California-Baja California
  regions

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The US-MEXICO BORDER