Minnesota’s Action Plan to Address Cardiovascular Disease, Stroke and Diabetes 2035 (MN 2035 Plan) is a calling to all to acknowledge and specifically address diabetes, cardiovascular disease, and stroke, especially within those communities facing the highest rates of those diseases. Its three overall goals are:
▪ Elimination of racial, geographic, and other health inequities that lead to higher rates of cardiovascular disease, stroke and diabetes for certain populations in Minnesota.
▪ Removal of barriers to good health and well-being.
▪ Increased access to affordable and culturally appropriate prevention strategies, clinical services and self-management options for those who have, or are at risk of experiencing, heart disease, stroke and diabetes.
Learn more on the MN 2035 Plan website: https://www.health.state.mn.us/2035plan.
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A Focus on Diabetes
This month, we are discussing the impact of diabetes on Minnesotans and its relation to the MN 2035 Plan. To appreciate the importance of addressing this issue, it is important to understand the impact of this among individuals, Minnesotans, racial and ethnic groups, and communities.
In Minnesota, diabetes is a significant health concern. Diabetes is the 6th leading cause of death in Minnesota. As of 2020, just under 9% of Minnesota adults have been diagnosed with diabetes type 1 or type 2. This equates to approximately 390,000 individuals. Approximately 24,000 new cases are diagnosed yearly. It is estimated that 118,000 Minnesotans have diabetes but are unaware of it. The economic impact to Minnesotans and our communities is large at an approximate cost of $4.7 billion dollars each year.
Much like the other diseases discussed previously, diabetes also disproportionately impacts certain populations in Minnesota. Native American, African American, and Hispanic populations have much higher rates as compared to Caucasian populations. People living within rural areas have higher rates and higher rates of complications due to limited healthcare services and access to those services. Addressing these disparities is essential for promoting equitable health outcomes and reducing the impact of diabetes in Minnesota.
Key points to understand related to disparities within populations in Minnesota:
- American Indians have one of the highest rates of diabetes in Minnesota.
- Only 26% of American Indians meet optimal diabetes care outcomes.
- 38% of Hispanic/Latinx adults meet the optimal diabetes care outcomes.
- African American individuals are more than twice as likely to develop diabetes as compared to Caucasian individuals.
Here are some key risk factors related to type 1 diabetes, prediabetes, and type 2 diabetes:
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Type 1 Diabetes
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Prediabetes & Type 2 Diabetes
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Family history: Having a parent or sibling with type 1 diabetes.
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Genetics: Certain genes are associated with a higher risk of diabetes.
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Age: Although type 1 diabetes can develop at any age, it is more commonly diagnosed in children, teens, and young adults.
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- Having overweight or obesity
- Being physically active less than 3 times a week
- Having a parent or sibling with type 2 diabetes
- Having ever had gestational diabetes (diabetes during pregnancy)
- Having a family background that is African American, American Indian, Hispanic/Latinx, or Alaska Native
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Sources: Diabetes Risk Factors - CDC and Diabetes Data and Reports - MN Dept. of Health
The MN 2035 Plan outlines ten priority outcomes, each accompanied by specific strategies. Steele County Public Health’s Home Care Department will be using these strategies to improve the health and outcomes of clients we serve and potential clients we hope to serve in the future. SCPH Home Care will be using the MN 2035 Plan as a guide for implementing quality improvement programming and projects this year, and in coming years.
Our Home Care team currently works with many community partners; however, we plan to use the MN 2035 plan to guide some of our discussions and use this information to create new partnerships and working groups within our community. We hope to improve outcomes for individuals and improve access and equity for all. We accept clients for care of all social circumstances and regardless of pay source. Care can be provided at home or within our Public Health clinic. We also refer individuals to additional resources when needed. On a larger scale, our Public Health Director is working together with a group of community partners, the Racial Division Action Team, that specifically addresses and works to improve health equity for all.
Considering these ideas, how can Home Care make a difference and affect outcomes for individuals? Home Care is not a "one-size-fits-all" service. Home Care can play an important role in meeting individualized needs of client. Listed below are examples:
Comprehensive Assessment and Treatment Plan:
- Home Care nurses assess the patient’s condition, including symptoms, vital signs, risk factors, activity, diet, and medication management.
- The Home Care team creates personalized treatment plans based on physician orders to achieve optimal outcomes for diabetes management at home.
Monitoring and Early Intervention:
- Home Care team members monitor signs and symptoms of diabetes disease processes and subsequent secondary changes within the body.
- They promptly report any changes to the physician and obtain necessary orders.
- Medication effectiveness and side effects are closely monitored.
Disease-Specific Education:
- Nurses and therapists educate patients and their families about cardiovascular health, stroke prevention, diabetes, lifestyle modifications, and self-management.
- They provide guidance on nutrition, exercise, and stress management.
- They provide tailored education by using materials in multiple languages and culturally relevant examples.
- Adapting educational materials and plans to match literacy levels.
- Education empowers patients to better manage their condition.
Emotional support:
- Coping with diabetes related challenges can be difficult. Home care offers companionship, encouragement, and mental health support.
- Emotional support can significantly impact a client’s willingness or motivation to engage in recommended treatment of diabetes.
Mobility and Endurance Support:
- The Home Care team assists patients in achieving optimal mobility and endurance.
- They encourage physical activity within safe limits.
- The Home Care team may guide patients through exercise or activity regimens that may improve diabetes outcomes.
Reducing Hospital Readmissions:
- Home Care helps prevent unnecessary hospital re-admissions.
- Home Care providers of all disciplines provide tips and tricks for managing symptoms, enhancing quality of life, and promoting self-care.
Culturally and Ethnically Appropriate Care:
- Consistent training to identify, develop, and deliver culturally competent service.
- Integrating cultural and ethnical beliefs, culturally relevant diet plans, alternative treatment regimens, or traditional remedies into a personalized treatment plan.
- Tailoring care and communication to each individual’s cultural needs.
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