Diabetes - Community Health Collaborative
The Community Health Collaborative (CHC), located in the Norris Square Section of Philadelphia, was established in 2004 and has applied for non-profit status. CHC’s mission is to eliminate disparities in health care by enabling low income, underserved, minority communities to access state of the art education and services and to work with the communities to lower barriers to care. CHC’s first project involves total diabetes management.
Diabetes, a chronic disease requiring complex, often daily, management decisions, is two to four times more prevalent in the African-American and Latino communities as it is in the Caucasian community. Among Latinos, the Puerto Rican and Mexican communities have the highest rates of diabetes. Type 2 diabetes, the type seen in over 95% of people with diabetes is associated with obesity and lack of physical activity, conditions highly prevalent in the Latino community. Untreated, or poorly treated diabetes can lead to heart problems, kidney failure, blindness and amputation.
In addition to the usual barriers to care such as lack of insurance, lack of access to care, low literacy, transportation and child-care, many Latinos also must contend with language, cultural and immigration issues. Because of these problems, the Latino community has the highest rate of uninsured members and high rates of diabetes related complications.
Project Dulce, the diabetes management program being implemented by CHC was begun at the Whittier Diabetes Institute in San Diego and has served over 7,000 people with diabetes. Philadelphia and CHC were chosen as the first “franchise” site. Project Dulce addresses the barriers to care by involving community members in the program at the most basic level. The hallmark of Project Dulce is the use of highly trained community members to serve as educators and advocates (promotoras). Promotoras must come from the community served, speak the language and be aware of community expressed needs, rather than imposing an “outside” program on members.
Promotoras are supervised by a nurse led team that provides diabetes care by co-managing the members with the primary care provider. Diabetes management is based on guidelines covering best practices in diabetes care. Electronic records are being established to track all aspects of care including objectives results and subjective results such as patient and provider satisfaction.
All of these efforts are based one fact; the person with diabetes is the true primary care provider and every effort must be made to give that person the education and tools to care for him/herself.
CHC may be reached at 267-972-0534 or bfgm1 @aol.com.