A strategic approach to advancing health equity for priority populations with or at risk for diabetes - name: north dakota department of health and human services address: 600 east boulevard AVE,…

A strategic approach to advancing health equity for priority populations with or at risk for diabetes - name: north dakota department of health and human services address: 600 east boulevard AVE, dept. 325, bismarck, ND 58505-0250 project abstract summary: in north dakota, the most vulnerable and underserved populations suffer from the highest rates of diabetes and have the poorest health outcome. Income-related inequalities drive much of the disparity seen in chronic disease data nationally, and the frontier nature of north dakota's landscape provides an additional barrier for individuals to access healthcare. This application leverages collaboration between internal and external partners to develop and implement sustainable policies and system changes to better address the needs of all north dakotans with or at-risk for diabetes, especially those experiencing low socioeconomic status (SES). Anticipated outcomes include, but are not limited to, increased access to diabetes management and prevention programming tailored to meet the needs of underserved adults, increased participation of underserved adults in evidence-based diabetes management and prevention programming, and increased number of persons who have successfully completed a centers for disease control and prevention (CDC)-recognized national diabetes prevention program (DPP) and reduced their risk for type-2 diabetes. Opportunities exist for the north dakota department of health and human services (dhhs) to strengthen diabetes management and prevention programming through increased access to and utilization of evidenced-based programming. To address the social determinants of health (sdoh) that reduce individuals' capacity to effectively manage their chronic disease diagnosis or risk, implementation of statewide infrastructure to support BI-directional communication and shared health outcomes data tracking between clinical and community organizations is needed and will be a strategy approach of the north dakota dhhs. The north dakota dhhs has the capacity to serve all populations and communities within the state and will support expansion and sustainability of multidisciplinary care and diabetes self-management education and support, the national DPP, and community programming addressing sdoh through utilization of a shared platform within the state. North dakota dhhs's proposed work to meet the intended outcomes of component a - statewide evidence-based approaches to diabetes management and type 2 diabetes prevention under CDC-RFA-DP-23-0020 a strategic approach to advancing health equity for priority populations with or at risk for diabetes will require a wide variety of current, new, and expanded partnerships. Partnerships will include health systems, pharmacies, local public health, and community-based organizations. Ongoing collaboration with three of the five tertiary health systems will generate system-level changes that affect approximately 75% of north dakota's population. In addition, a long-standing partnership with an expansive network of federally qualified health centers will result in improved quality of care for a patient population of primarily low SES.