A community-centered approach to diabetes in east harlem
Open accessAbstract
Objective Residents of East Harlem, an impoverished, non-white community in New York city (NYC), have up to 5 times the mortality and complication rates of diabetes compared with NYC residents overall. To determine potentially remediable problems underlying this condition, a community-based collaboration of health providers, community advocates, and researchers, surveyed East Harlem residents with diabetes to assess their knowledge, behaviors, barriers to care, and actions taken in response to barriers. Design Telephone interviews. Setting The 3 hospitals and 2 community clinics serving East Harlem. Participants Nine hundred thirty-nine of the 1,423 persons (66%) with diabetes identified from these 5 healthcare sites with 2 or more ambulatory visits for diabetes during 1998 who lived in East Harlem. Results While most respondents (90%) said they know how to take their medicines, between 19% and 39% do not understand other aspects of their diabetes management. Many limit their diabetes care due to concerns about money (16% to 40%), and other barriers, such as language and transportation (19% to 22%). In multivariate analyses, Latinos (relative risk [RR] = 0.77; 95% confidence interval [95% CI] 0.63 to 0.91) and those who do not keep a diabetic diet due to concerns about money (RR = 0.85; 95% CI 0.70 to 0.99) had poorer health status. Conclusions A community-based coalition was able to come together, identify areas of concern in diabetes care and assess the needs of adults with diabetes residing and obtaining care in East Harlem. The coalition found that even among those with access to care there remain significant financial barriers to good diabetes care, and a need to address and optimize how individuals with diabetes manage their disease.
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Preparing culturally familiar healthy foods has been found to be an important skill for diabetes management among Puerto Ricans.
“Preparing healthy foods that are culturally familiar has been found an important skill for diabetes management among Puerto Ricans”
From Cognitive-Behavioral Group Therapy for Latino Youth with Type 1 Diabetes and Depression (2017) · cites this paper as Horowitz, Williams, & Bickell, 2003
The Results (page unavailable) report that few East Harlem patients knew how to shop for and prepare a diabetic diet. The Discussion (page unavailable) identifies a lack of information about healthy, ethnically familiar foods. The paper does not establish that preparing those foods is an important skill specifically among Puerto Ricans; its findings concern East Harlem patients more broadly. (LLM, conf=0.84)
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Self-citation
- Authors
- Horowitz, C. R., Williams, L., & Bickell, N. A.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Horowitz, Carol R.
- Venue
- Journal of General Internal Medicine
- Published
- 2003-07
- Volume
- 18
- Issue
- 7
- Pages
- 542-548
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC1494885
- OpenAlex
- W2064515133
- Cited by
- 44
- References
- 20
- Citations by year
- 2025: 1 · 2022: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 3 · 2013: 2 · 2012: 4
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Community Health and Development
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- diabetes mellitus, East Harlem, barriers to care, financial barriers, language barriers, transportation barriers, Latino health disparities, health status, community health
- MeSH terms
- Adolescent, Adult, Aged, Black or African American, Diabetes Mellitus, Female, Health Services Accessibility, Health Services Needs and Demand, Health Services Research, Health Status, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, New York City, Community Health Planning
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