Merck and Health Disparities

The Merck Company Foundation (Foundation), the philanthropic arm of Merck & Co., Inc., today announced the launch of The Alliance to Reduce Disparities in Diabetes (Alliance), a new initiative designed to improve healthcare delivery among those populations most at risk for diabetes — African-American, Hispanic, and Native American adults. The U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention (CDC) and the Office of Minority Health (OMH) joined the Foundation in support of the Alliance’s goal to mobilize community-based partners and enhance the delivery of proven, collaborative approaches that can close gaps in diabetes care.

Research shows insufficient health resources, poor disease management, inadequate patient education and support, and individual perceptions about how difficult it is to manage and prevent diabetes all contribute to healthcare disparities. These problems are more acute in low-income, disadvantaged communities. To help enhance care and reduce disparities, the Alliance will support proven, community-based and collaborative approaches to comprehensive diabetes prevention and management. The initiative will engage a range of healthcare stakeholders, including patients, providers and health system leaders, to assist at the grassroots level in five U.S. communities and mobilize additional allies at the national and state levels.

“We cannot and should not ignore the growing physical and economic toll of inadequate healthcare on the lives of many individuals in the United States,” said Richard T. Clark, chairman, president, and chief executive officer, Merck & Co., Inc. “Innovative, community-based programs are making real progress reducing the critical gaps in care that are so difficult for many low-income and vulnerable individuals. The Alliance aims to support that progress by becoming a mobilizing force in improving outcomes for those who are underserved by current healthcare models and at the most serious risk for diabetes.”

Nearly 100 public health officials participated in the launch of the Alliance at a luncheon program that highlighted various opportunities for collaboration and ways to address equity in care. Speakers shared numerous ways in which culturally relevant outreach and community-focused programs can improve patient care and help people with diabetes who are most at risk for complications manage their condition. In the luncheon’s keynote address, Eduardo Sanchez, M.D., M.P.H., vice president and chief medical officer of BlueCross BlueShield of Texas and former Commissioner of the Texas Department of Health, called on his peers to work together to improve the future health of underserved people across the country.

“There are countless opportunities at the local level to improve health and, at the same time, eliminate disparities. Our community health centers, our churches — the places where people go for guidance and support — are critical settings for sharing the right resources and tested tools that will inspire people to make lifestyle changes that can prevent or delay diabetes or to help them effectively manage this serious chronic disease,” Dr. Sanchez said. “We have the power to make this possible, but only working together — individuals and their families, health systems, and community systems — can we change the status quo and ensure that everyone living in America achieves the highest level of health.”

According to the CDC, nearly 24 million Americans are living with diabetes. African-American and Hispanic adults are about two times as likely to be diagnosed with diabetes, while Native American youth aged 10-19 are more likely than any other group to be diagnosed with type 2 diabetes. Not only do minority groups have the highest rates of diabetes, but evidence suggests that these minority groups are also less likely to be insured or have adequate access to local health resources.

“We are aware of the challenges diverse and economically disadvantaged communities face in ensuring effective prevention and management of diabetes. Together, we can take the steps necessary to make a difference in racially and ethnically diverse communities that are most burdened by this deadly disease,” said Garth Graham, M.D., M.P.H., deputy assistant secretary for minority health at the U.S. Department of Health and Human Services.

Even when populations in vulnerable communities do have access to care, many individuals in these communities receive lesser services than in more affluent areas. These groups often experience higher rates of serious complications of diabetes, including cardiovascular disease, blindness, amputation and end-stage renal disease (kidney failure). For example, the death rate from diabetes among Hispanics is 60 percent higher than the death rate for non-Hispanic whites, while Native Americans are disproportionately more likely to die from diabetes-related causes than other Americans, according to the U.S. Commission on Civil Rights. African-Americans with diabetes are more likely to experience kidney disease and amputations of lower extremities (legs and feet).

“CDC applauds the creation of the Alliance to address the disproportionate burden of diabetes among various populations,” said Ann Albright, Ph.D., R.D., director, Division of Diabetes Translation at CDC. “CDC is working with national, state, and local partners to address health disparities among high-risk populations, and we welcome the opportunity to work with other health organizations and community groups on the Alliance initiative to help implement strategies necessary to fight diabetes.”

The Merck Company Foundation has committed $15 million to support programs through the Alliance in an effort to decrease diabetes disparities and enhance the quality of healthcare by improving prevention and management services. Funding will support efforts by Alliance community health partners in Camden, N.J., Chicago, Dallas, Fort Washakie, Wyo. and Memphis, Tenn. as they seek to demonstrate that improvements in healthcare delivery and an increased focus on patient needs can significantly improve health outcomes. Specifically, Alliance efforts include:

– An initiative led by the Camden Coalition of Healthcare Providers to
better coordinate comprehensive primary care services for city
residents with diabetes
– An effort led by the University of Chicago to redesign diabetes
management and care provided at community health centers on the South
Side of Chicago
– An initiative led by the Baylor Healthcare System’s Office of Health
Equity to help physicians develop strategies that promote effective
care and management for low-income, uninsured and underserved people
with diabetes in Dallas
– An effort led by the Eastern Shoshone Tribe and its collaborating
partners in Fort Washakie to improve access to diabetes care and
management among the Eastern Shoshone Tribe of the Wind River Indian
Reservation and Northern Arapaho Tribe
– An initiative led by partners in the Healthy Memphis Common Table
collaborative to promote community outreach and diabetes
self-management through local churches in Memphis

Local partners will implement comprehensive diabetes programs for five years and offer interventions for patients, clinicians and healthcare delivery systems. At the national level, the Alliance will disseminate information and undertake collaborative projects aimed at strengthening the efforts of organizations across the country, while enlarging the network of stakeholders who share the Alliance’s goals.

The Center for Managing Chronic Disease at the University of Michigan will serve as the national program office coordinating Alliance efforts. As the national program office, the Center will encourage innovative work addressing the social, behavioral, environmental and clinical aspects of diabetes control and advocate on behalf of those dedicated to reducing the alarming national disparities in diabetes outcomes. “Evidence-based work at the local level and vigorous support at the national level could dramatically change the picture of diabetes disparities in this country,” said Noreen Clark, Ph.D., director, Center for Managing Chronic Disease and national program office director. “The Center has extensive experience in mobilizing stakeholders who understand the problems of chronic disease management and have the interest and ability to bring about needed change. This experience positions the Center very well to help the Alliance achieve its goals.”