Posted: January 2nd, 2023

Evidence Base in Design: H.R. 4550

NURS 6050 week 7 Discussion 1: Evidence Base in Design

The health policy that I have chosen for this week’s discussion is H.R. 4550 (Congres.gov, n.d.). It amends the Public Health Service Act to provide grants for the treatment of minorities with diabetes. The bill was introduced on September 27, 2019, and currently resides in the Committee on Energy and Commerce. The treatments that will be covered for diabetic minorities include routine care, diabetes prevention and control, eye care, foot care, and treatment for other complications of diabetes (Congress.gov, n.d.). The bill also mentions that treatment considerations for language barriers and culture.

Many studies show minorities are more likely to be diagnosed with diabetes than their non-Hispanic white counterparts. According to Joo and Liu (2019), 7.4% of non-Hispanic whites are diagnosed with diabetes, 12.1% of Hispanics are diagnosed with diabetes, and 12.7% of African Americans are diagnosed with diabetes. There must be either availability of services or resources for minorities with diabetes. The Centers for Disease Control and Prevention (CDC) is funding ten national organizations to start in-person visits to people with diabetes in underserved areas (CDC, n.d.). Millions of minorities require diabetic preventative care and treatment NURS 6050 week 7 Discussion 1: Evidence Base in Design.

One study by Rodriguez and Campbell (2017) showed that there is also a disparity between minorities and non-Hispanic whites in testing medications to treat diabetes. Some of the medicines that treat diabetes have different reactions to some ethnic groups. Some examples are Sulfonylureas cause arterial stiffness in African Americans; Metformin lowers hemoglobin A1C in African Americans more than non-Hispanic whites; and Sitagliptin dropped Asian Americans hemoglobin A1C by 1% but was not tested on African Americans (Rodriguez and Campbell, 2017). The disparity between treatment and prevention of diabetes in minorities would benefit from the H.R. 4550 Minorities Diabetes Act.

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Centers for Disease Control and Prevention (CDC) (n.d.). National diabetes prevention program.

Congress.gov (n.d.). H.R. 4550  Minority Diabetes Initiative Act. Joo, J.Y. & Liu, M.F. (2019). Experience of culturally-tailored diabetes interventions for ethnic minorities: A qualitative systematic review. Clinical Nursing Research, 30(3), 253-262.

Rodriguez, J. E. & Campbell, K.M. (2017). Racial and ethnic disparities in prevalence and care of patients with type 2 diabetes. Clinical Diabetes Journal, 35(1), 66-70.

response

Diabetes has been a hot topic within health care as of recent especially with the more sedentary lifestyles, working from home, and extensive time sitting in front of computers. The Center for Disease Control and Prevention, CDC, (2020) reported that there was increased number of new diagnoses of type 1 diabetes among racial/ethnic minority groups in children/teen populations. With younger generations being diagnosed with diabetes there will be an influx of future health related issues due to being a diabetic long- term issues such as: podiatry needs, poor healing, nerve damage, heart disease and more (Pietrangelo, 2020) NURS 6050 week 7 Discussion 1: Evidence Base in Design.

The health policy H.R. 4550 – Minority Diabetes Initiative Act (Congress, n.d.) would be healthful to public and nonprofit health care providers because it provides funding for diabetic diagnosis and health related issues from the disease in minority/ethnic groups. As you have stated many drugs have not been clinically trialed on ethnic/minority groups, which can create adverse reactions or may not work at all for these individuals’. Minorities/ethnic groups already struggle in today’s society, so creating another barrier for them to hurdle is unfair and unfortunate. I would agree that this Act is supported with evidence-based data and would be a great asset for this group of people. If we are able to treat and help manage this disease at an early stage, we could decrease the amount of future hospital required illnesses.

References

Center for Disease Control and Prevention (CDC). (2020). Diabetes: Rates of new diagnosed cases of type 1 and type 2 diabetes continue to ruse among children, teens. 

Congress.gov (n.d.). H.R. 4550 – Minority Diabetes Initiative Act.

Pietrangelo, A. (2020). The effects of diabetes on your body. Healthline.

response 2

Thank you for your research into this topic. It was informative and enlightening. Your discussion about trialing medications on various ethnicities was an eye-opening for me, because it had not occurred to me that a specific diabetic medication would work in one population, but not another. This is especially concerning to me, because it makes me wonder what other medications have this similar effect.  Much of diabetes treatment is self-management and this can be difficult when there are several disparities among ethnicities in development and course of diabetes including behavioral, social, environmental and the healthcare system. Jones and Crowe (2017) found that many participants felt they were not given adequate support through the healthcare system or provided with adequate information relevant to their lifestyle and they also described having difficulty applying the diabetes education they had received to their daily life. One theme discussed that I found interesting was the idea of managing food from a cultural, social, and economical standpoint. These individuals come from backgrounds that cannot afford to make several different meals especially if they have a large family and healthy options tend be more expensive and therefore not affordable. The commitment to the family often makes self-management behaviors difficult. The generalized feelings brought up in this article are powerlessness, inevitability, and fatalism, which can make management even more difficult in minorities. Milstead & Short (2019) state that public uncertainty about personal coverage and methods of financing care are major issues and I hope the bill HR 4550 alleviates some of these issues that afflict minorities with diabetes NURS 6050 week 7 Discussion 1: Evidence Base in Design.

References

Jones, V. & Crowe, M. (2017, November). How people from ethnic minorities describe their experiences of managing type-2 diabetes mellitus: a qualitative meta-synthesis. International Journal of Nursing Studies, 76(2017), 78-91.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning NURS 6050 week 7 Discussion 1: Evidence Base in Design.