The Dartmouth Atlas of Health Care reported recently that blacks with diabetes in Chicago had 1.7 times the rate of limb amputations than whites with diabetes (3.4 per 1,000 vs. 2.0 per 1,000).
Losing a leg from diabetes isn't a given, nor are racial differences in this health outcome. We know how to prevent diabetes-related complications such as limb amputations, blindness, and kidney failure. Controlling blood sugar, blood pressure and cholesterol can significantly reduce the risk of complications and improve quality of life.
The problem is that lifestyle changes to control diabetes (e.g., healthy eating, regular physical activity, taking medications, and regular visits to the doctor) are often a challenge, particularly in low-income minority communities where resources are limited.
People with diabetes are supposed to do 150 minutes of physical activity every week and eat vegetables as 50 percent of their meals. Concerns about crime have driven many indoors, and food deserts make purchasing fresh produce difficult.
We need more communities where making the "healthy choice" is the easy choice -- that is, safe places to exercise, affordable, healthy food, "walkable" neighborhoods with safe sidewalks and bike paths, and much more.
Chicago is leading the nation in creating healthy communities, but we still have a long way to go.
The Chicago Department of Public Health (CDPH) launched Healthy Chicago in 2011, the city's first comprehensive public health agenda providing more than 200 actionable strategies to improve health, including efforts to reduce obesity and heart disease. We have taken more than 2.4 million trips on the City's new bike-sharing program, more than 26,000 children and family members joined us during this summer's PlayStreets events and we continue to open new grocery stores and fresh food carts in neighborhoods across the City.
And the numbers show we are making progress. Life expectancy -- in every single neighborhood -- is climbing up.
But there is still more work to do.
CDPH hopes to identify critical health disparities and actionable, measurable solutions. We are working now to identify new ways we can improve the health of our residents. Everyone from politicians and city planners to health departments and school systems has a role to play in improving the health of all Chicagoans and reducing racial and ethnic disparities.
Fortunately, efforts are already underway in Chicago to do just that.
CDPH has been collaborating with organizations, such as the Chicago Center for Diabetes Translation Research (CCDTR) at the University of Chicago, to improve the city's health. For example, CDPH and CCDTR are identifying community "hot spots" of preventable diabetes-related hospitalizations that can inform potential efforts at community-based health promotion, diabetes prevention and population health management.
The South Side Diabetes Project, supported by the University of Chicago's CCDTR, the Merck Foundation's Alliance to Reduce Disparities in Diabetes and the National Institutes of Health (NIH), aims to reduce diabetes disparities by involving multiple stakeholders -- CDPH, clinicians and health systems, patients, advocacy organizations, Chicago Park District, businesses and community organizations.
For example, the South Side Diabetes Project provides "Food Rx" for healthy food (redeemable at participating Walgreens and a local farmer's market) and "exercise prescriptions" for six months of free access to exercise facilities at city parks. The project conducts weekly tours at low-cost grocer Save-A-Lot to help residents learn how to shop healthy on limited budgets.
The South Side Diabetes Project provides a real-world example of how to leverage local assets to improve community health and reduce disparities.
This fall, CDPH will launch a comprehensive community assessment that includes phone surveys among residents, roundtables with health leaders and a webpage where residents provide suggestions about making the city healthier.
Get involved and make your voice heard. Join an upcoming CDPH roundtable or register your thoughts for a healthier Chicago by clicking here.
Together, we can make a difference.
Monica E. Peek, MD, MPH
Assistant Professor of Medicine
Associate Director, Chicago Center for Diabetes Translation Research
The University of Chicago
Bechara Choucair, MD, MS
Chicago Department of Public Health
Marshall H. Chin, MD, MPH
Richard Parrillo Family Professor of Healthcare Ethics
Director, Chicago Center for Diabetes Translation Research
The University of Chicago