View Report: Equal Treatment; The Case for Diabetes Care in Select New York City Neighborhoods

New York City Comptroller William C. Thompson, Jr. today released a report, “Equal Treatment,” that shows diabetic patients suffer disproportionately from complications associated with the disease depending on where they live in the city.

An estimated 450,000 New Yorkers have diabetes and an additional 225,000 people have the disease and are unaware of it. Old age, obesity, lack of exercise and family history are risk factors for the disease, which is prevalent in Black and Hispanic populations. Diabetes is rapidly rising in the city, making it one of the leading causes of death. Serious complications often accompany diabetes such as stroke, heart attack, kidney disease, blindness and nervous system damage.

Thompson’s study notes that diabetes rates vary greatly from neighborhood to neighborhood, for example, rates vary from 15% in places such as East Harlem and Williamsburg/Bushwick to 2% in places like the Upper East Side and Gramercy Park/Murray Hill. In addition, only 15% of the city’s diabetics know their current blood sugar level, which puts them at risk of developing severe medical complications.

“Diabetes and complications associated with it are preventable and treatable with proper education and appropriate care from a physician, and yet many New Yorkers are unnecessarily dying from the disease,” Thompson said. “Targeted outreach to medical providers serving these neighborhoods can go a long way towards delaying and avoiding serious complications suffered by their patients...Effective medical management can significantly reduce the human and financial cost associated with this debilitating disease.”

Thompson’s report studied 42 neighborhoods throughout the city and identified the communities where diabetics suffer disproportionate numbers of serious medical complications. Of these neighborhoods, nine proved to have the most serious problems. They are: Stapleton/St.George, Willowbrook, and Port Richmond, all on Staten Island; East Harlem, Central Harlem/Morningside Heights, both in Manhattan; Williamsburg/Bushwick, Bedford Stuyvesant/Crown Heights in Brooklyn; and Jamaica and Flushing/Clearview in Queens.

For example, Thompson’s report shows that Stapleton/St. George on Staten Island has 29% fewer diabetics than the average rate in the city, yet the area has 53% more complications than the average citywide.

“For the first time ever, this report identifies the neighborhoods where diabetics become the sickest from the disease,” Thompson said. “In these neighborhoods, provider education and outreach could have an enormous impact by ensuring that these patients get the same level of attention and quality medical care as those in other parts of the city.”

Comptroller Thompson recommends:

• The Department of Health and Mental Hygiene (DOHMH) should identify the specific health facilities and providers that serve people who live in the nine neighborhoods identified in the report as having many more diabetes complications than expected.

• With the assistance of the State Health Department, DOHMH should evaluate those providers’ diabetes management practices.

• If justified by the results of such studies, DOHMH should expand the amount of professional education about diabetes management in those areas.

• DOHMH should also take into account where the number of people who develop diabetes complications is out of proportion to the number of diabetics and use this information as an indicator of possible deficiencies in disease management, particularly when designing campaigns for educating health professionals.

• In designing future community health surveys, DOHMH should ask interviewees additional questions about the development of diabetes complications and use this information to examine further the issue of why diabetics who live in some neighborhoods are more likely to develop complications than diabetics who live in other neighborhoods.

As appropriate, DOHMH should use the methodology set forth in the Comptroller’s report to look at complications from other chronic diseases, for example, cancer and heart disease.

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