Date Available

1-13-2023

Year of Publication

2023

Document Type

Undergraduate Capstone

College

Undergraduate Education

Department

Public Policy and Administration

First Advisor

Dr. Cory Curl

Abstract

The purpose of this policy brief is to illuminate the dire circumstances surrounding the ongoing diabetes epidemic in Kentucky. Type II diabetes mellitus, a preventable and manageable chronic illness, affects nearly 465,000 Kentuckians currently. Beyond the daily struggle associated with diabetes, many acute complications can arise that are severly detrimental to quality of life, such as blindness or lower extremeity amputation. Additionally, the costs associated with diabetes are tremendous, to patients, to providers, and to the state. It is in the best interest of all stakeholders to do whatever we can in order to reduce prevalence and improve management of already established cases. While major efforts have been very successful in increasing our biomedical understand of the disease and treatments, it has taken much longer for research into lifestyle intervention programs to receive similar attention. These provide several different opportunities for policy intervention that have been proven successful, yet challenges surrounding access, awareness, and cost are real. The National Diabetes Prevention Program (DPP), established by the Center for Disease Control (CDC), has been proven by clinical trial to reduce risk of developing diabetes. Chronic care management (CCM) services are designed to strengthen the point of care of individuals who have higher needs of care. This is done through monthly check-ups via phone or internet calling, and can help patients with the burden of scheduling appointments, refilling medication, and maintaining healthy behavior goals. Finally, there are aspects of our society that substantially increase risk of developing diabetes that individuals have little control over, deemed social determinants of health. Targeted policy interventions designed to mitigate the negative social determinants of an individual’s health can greatly improve overall quality of life and reduce the chance of developing diabetes. Some of these opportunities for intervention carry larger costs than others, and there are various methodologies behind implementation that require different levels of burden to be overcome. Many of the major legislative recommendations in this memo face extreme difficulties in terms of political feasibility. However, it is imperative that we continue to push for action and innovative solutions. Do not be mistaken, the solution to this epidemic lies beyond the front door of primary care clinics and hospitals. It is a social disease that will require a social cure.

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