Diabetes and Public Health Impact Choose a disease process with extensive public health implications (e.g. heart failure dementia kidney disease).

Research its impact upon both the national and international community using such resources as the World Health Organization.

Review the goals of Healthy People 2020 regarding this disease process.

What inequities exist?

Give examples of policies that shape the public nursing response to the disease process.

Apply one of the theories of health maintenance and promotion to the aggregate. How does systems theory influence policy design?

Diabetes: A Global Public Health Challenge

National and International Impact

Diabetes is a chronic disease with significant public health implications worldwide. According to the Centers for Disease Control and Prevention (CDC), over 37 million Americans have diabetes, and 96 million have prediabetes. The World Health Organization (WHO) reports that globally, diabetes affects over 422 million people and is a leading cause of blindness, kidney failure, heart disease, and lower-limb amputation. The burden is disproportionately high in low- and middle-income countries, where access to healthcare and treatment options are limited.

Healthy People 2020 Goals

The Healthy People 2020 initiative aimed to:

• Reduce the disease burden of diabetes by lowering the number of new cases and complications.
• Improve glycemic control among diabetics to prevent complications.
• Increase the percentage of people receiving diabetes education and routine screenings.
• Expand access to healthy foods and physical activity opportunities to prevent obesity-related diabetes.

Health Inequities

Significant health disparities exist in diabetes prevalence and management.

• Socioeconomic Status: Low-income individuals face barriers to healthy food, medication, and preventive care.
• Race and Ethnicity: In the U.S., African American, Hispanic, and Indigenous populations have higher rates of diabetes due to genetic, environmental, and social determinants of health.
• Geographic Disparities: Rural communities have less access to endocrinologists, diabetes specialists, and preventive care.

Policies Shaping Public Health Nursing Response

• Medicare’s Diabetes Prevention Program (MDPP): Provides lifestyle coaching for high-risk individuals to prevent diabetes.
• Affordable Care Act (ACA): Expanded insurance coverage for diabetes screenings and management.
• School Nutrition Policies: Federal programs like the Healthy, Hunger-Free Kids Act promote balanced meals to prevent childhood obesity, a risk factor for Type 2 diabetes.

Application of Health Promotion Theory

Pender’s Health Promotion Model focuses on empowering individuals to engage in healthy behaviors to reduce risk factors. For diabetes prevention, this includes nutritional counseling, exercise promotion, and routine screenings. APA