List of statewide grants (link to GranteeList_DISP.pdf)
Map of statewide coverage (link to GranteeMap_DISP.gif)
The Problem
The National Institutes of Health defines disparities as “the
differences in the incidence, prevalence, mortality and burden of
disease and other adverse health conditions that exist among specific
population groups in the United States.”
HWTF Solution (program description)
There are 24 grantee organizations providing direct services to
residents in 59 counties across the state. The majority of these
counties is rural and has significant minority and low-income
populations that are chronically underserved. Two of the organizations
that received grants have statewide projects that will have an impact
in the remaining 41 counties. In addition to geographic diversity,
grants were awarded to a variety of organizations across North Carolina
that provide services to:
- Community / faith-based minority organizations
- Health clinics / hospitals
- County health departments
- Historically Minority Colleges and Universities (HMCUs)
- Physician medical societies / foundations
Technical assistance is provided to grantees by health disparities
experts from North Carolina Central University, Department of Public
Health Education (NCCU). Outcomes analysis is conducted by East
Carolina University's Research Division and Department of Family
Medicine.
Key Accomplishments (outcomes to-date)
There was a significant focus on planning in the first year of the
Eliminating Health Disparities initiative. In Year 2, grantees fully
implemented their projects and began providing direct services to
target populations all across North Carolina.
Cohort Study
To examine the impact of the initiative, 18 grantees were recruited to
follow a longitudinal cohort of participants from their grant-funded
programs. Measures for each participant are taken when s/he is first
enrolled in the cohort study, then every six months until the end of
the grant period. The biological markers for the cohort study are:
- Systolic blood pressure
- Body mass index (BMI)
- Cholesterol (for those grantees focusing on cardiovascular disease)
- HbA1c – a test that measures the amount of glycated hemoglobin in blood (for those grantees focusing on diabetes)
Major Findings of Cohort Study Analysis
- Systolic blood pressure was reduced among participants
in projects focusing on cardiovascular disease (CVD), diabetes, and
obesity.
- Among participants who are presumed to
have diabetes, average HbA1c (which is a key diabetes measure) was
significantly reduced while the percentage of participants with HbA1c
lower than 7 increased from approximately 25% to 40%.
These preliminary outcomes suggest that the HDI interventions are
positively impacting the health of North Carolinians, especially
underserved minority citizens. Improvements of this magnitude, if
maintained, have been associated with reductions in diabetes and
cardiovascular morbidity and mortality. Additional follow-up data will
be carefully evaluated to confirm these initial findings.
Beginning in February 2008, participants were also asked to complete a
health survey. Grantees were instructed to administer the survey the
next time that they saw each participant and then every six months
following. The goal was to have the survey administered on the same
schedule as the biological measures were collected. Survey measures
include: fruit and vegetable consumption, physical activity, quality of
life, and access to care. Time 2 data has not yet been widely
collected, but will be collected throughout Year 3 of the grant funding
and reported in the next reporting period.