Media Alert◆ Media Alert◆ Media Alert◆ Media Alert◆ Media Alert◆ Media Alert November 1, 2005     Nearly 21 million people in the U.S. today suffer from diabetes, a chronic condition that is the country’s 6th leading cause of death. Notably, all minority groups other than Alaska Natives have a prevalence of type 2 diabetes that is two to six times greater than that of the white population.     The Journal of Health Care for the Poor and Underserved, published by Johns Hopkins University Press for Meharry Medical College, today publishes four articles that speak to different facets of the disease. Liking the Doctor Makes People Take Better Care of Themselves     Jessica Greene and Michael Yedidia (of the U. of Oregon and NYU) surveyed just under 1,000 people with either asthma or diabetes from an ethnically diverse, low-income cohort in 17 settings across the country. They found that patients with positive assessments of their providers were substantially more confident in self-care. Among patients with diabetes, high assessments of provider support were significantly associated with self-management tasks – amounting to approximately one more day per week compared with patients who rated their provider’s support less favorably. Survey of New York Medicaid Patients with Diabetes        The NYS Department of Health, in an effort to improve services for Medicaid patients with diabetes, surveyed over 2,000 such patients regarding their satisfaction with care. While the sample overwhelmingly found their care satisfactory, those expressing dissatisfaction tended to be those who also reported not receiving education in self-care, being in poor health, and not performing recommended self-care. Diabetes Worse When Access to Care is Impeded        A research team from the Mayo Clinic Scottsdale and Emory University reports that limited access to health care impairs glycemic control among diabetics. Studying a sample of over 600 patients with low incomes, most of whom were African American, Dr. Mary Rhee and colleagues found that hemoglobin A1c levels were higher among patients who had difficulty obtaining care, used acute care facilities (such as emergency rooms), or had no usual source of care than among those who successfully sought care at doctors’ offices or clinics. Improving Testing      Correct management of diabetes necessitates regular testing of hemoglobin A1c levels. A team from Emory University in Atlanta led by Dr. Dana Flanders earlier demonstrated the success of an intervention (including guidelines and intervention aids) to improve rates of Hb A1c testing by primary care physicians. In the paper published today, the team shows that the improvement slows significantly when the providers face other stressors: in counties with more patients on Medicaid, fewer physicians per capita and higher county-level poverty, providers were less likely to increase HbA1c testing as a result of the intervention.     The Journal of Health Care for the Poor and Underserved (JHCPU) is published by Johns Hopkins University Press for Meharry Medical College. JHCPU releases three issues November 1, 2005, the regular issue and supplements sponsored by NIH (on the rise of HIV/AIDS in the African American community) and by the HBCU Research Network on Health Disparities. For more information Virginia Brennan, PhD, MA, Editor, JHCPU 800-669-1269 vbrennan@mmc.edu www.factline.org Also note: On Nov. 1, Jackie Judd, VP for Communications at the Kaiser Family Foundation interviews Dr. William Cunningham of UCLA, author of “The effect of socioeconomic status on the survival of people receiving care for HIV/AIDS in the U.S.,” an article in the November issue of JHCPU. See announcement at http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=1536