Health Indicator Report of Diabetes Deaths
Diabetes is the 6th leading cause of death for New Mexicans and the 7th leading cause in the U.S. Diabetes complications, which are costly to individuals, families and to society, include premature death, cardiovascular disease, blindness, end stage kidney disease, and lower extremity amputations. People with diabetes are two to four times more likely to develop cardiovascular disease and stroke; about 65% of deaths in people with diabetes nationwide are due to these conditions. Costs of diabetes extend beyond medical costs, such as costs due to lower productivity, disability and loss of productive life due to premature death, and care-taking by family members. Effective and accessible diabetes prevention and management programs and resources are necessary to reverse the increasing rates of diabetes in our communities.
NotesAge-adjusted to U.S. 2000 population, except for rates by age group. Diabetes deaths include those with ICD10 codes E10 - E14 and as underlying cause of death. U.S. rate used for comparison is the preliminary 2011 age-adjusted rate.
Data Interpretation IssuesDiabetes deaths include those with ICD10 codes E10 - E14. The International Classification of Diseases (ICD) is a coding system that provides the rules for coding and classifying causes of death. Diseases listed on death certificates are assigned specific ICD codes. The ICD is developed collaboratively between the World Health Organization (WHO) and 10 international centers, such as the U.S. National Center for Health Statistics. This system allows death data to be collected and compared among different areas. Under the ICD, the underlying cause of death is the disease or injury that started the sequence of events leading directly to death.
In addition, multiple causes of death can also be assigned; these are all the diseases or injuries which led to death. Diabetes can be one of the multiple causes of death in significant percentages of heart disease and stroke deaths. Thus the diabetes death rates shown here are an underestimate of the extent of diabetes-related deaths, since the rate is based only on the underlying cause and doesn't reflect its influence on heart disease or stroke deaths.
DefinitionA rate defined as the number of deaths attributed to diabetes per 100,000 people, age-adjusted to the 2000 U.S. population; also known as the 'diabetes death rate'.
NumeratorNumber of deaths among New Mexico residents, per year, due to diabetes as the underlying cause of death.
DenominatorEstimated total number (population) of New Mexico residents in a specific year.
Healthy People Objective: Reduce the diabetes death rateU.S. Target: 65.8 deaths per 100,000 population
How Are We Doing?Death rates for both New Mexico and the US are far below the HP 2020 target of 66.6 deaths per 100,000 population. New Mexico age-adjusted diabetes death rates have generally fluctuated around 26 to 35 deaths per 100,000 persons from 2000 to 2013, compared with US age-adjusted rates for the same time period that have ranged from 21 to 26 deaths per 100,000. The US rates have decreased since 2000. The number of New Mexico diabetes deaths (i.e., numerator) ranged from a low of 500 in 2000 to a high of 648 deaths in 2012. From 2000 to 2013, an annual average of 601 diabetes deaths occurred, with a total of 8,411 diabetes deaths.
Diabetes death rates increase as age increases, as is the case with many chronic diseases. The age-sex graph show this clearly. In addition, the female rates are lower than the male rates for age groups 45-54, 55-64 and 65-74; the rates are statistically the same for ages 35-44 and 75+ years.
Race/Ethnicity Rates: The New Mexico American Indian population had the highest diabetes death rates; the New Mexico White Non-Hispanic population had the lowest rates; and the Hispanic rates were in the middle. In 2010-2012, there was a four-fold difference between the American Indian/Alaska Native rate, and a two-fold difference between the Hispanic rate, and the White rate. There was a 2.7-fold difference between the American Indian/Alaska Native rate and the Asian/Pacific Islander rate, as well as between the Black/African American rate and the White rate.
When looking at the race/ethnicity rates by sex, male rates are higher than female rates in the Hispanic and White populations. Among males, the American Indian/Alaska Native rate was four times, and the Black/African American rate was two times, higher than the White rate. The American Indian rate was two times higher than the Hispanic rate and the Black/African American rate. Among females, the American Indian/Alaska Native rate was almost five times higher than the White rate, and two times higher than the Hispanic rate. The Hispanic female rate, as with the male rate, was twice the White rate. All these differences are statistically significant.
Urban/Rural: Counties were categorized into Metropolitan, Small Metropolitan, Mixed Urban-Rural and Rural. In 2012-2013, the Mixed Urban-Rural diabetes death rate was the highest, the Small Metropolitan rate the lowest and the Metropolitan rate was in the middle. The Mixed Urban-Rural rate was 45% higher than the Small Metropolitan rate. The rates for Rural, Metropolitan and Small Metropolitan were statistically the same.
How Do We Compare With the U.S.?From 2000 to 2013 New Mexico rates were 18% to 40% higher than the U.S. rates. Poverty is a significant determinant of illness and death in any population. New Mexico poverty rates have been higher than the US for many decades. New Mexico has a higher proportion of American Indians and Hispanics compared to the US as a whole. For many decades these two populations have experienced higher poverty rates than New Mexico generally. These two New Mexico populations have had the highest rates of diabetes deaths since 2000.
What Is Being Done?The NM Department of Health's Diabetes Prevention and Control Program (DPCP) provides multiple diabetes prevention and management services and programs. In each case, DPCP works with health care providers and community agencies and coalitions. Services and programs include: professional development trainings and resources on prediabetes, diabetes and tobacco, diabetes and depression; and diabetes and chronic disease management; proven physical activity and nutrition programs to prevent or delay diabetes, such as the National Diabetes Prevention Program (National DPP); community resources to help people manage their diabetes through skill building, such as Kitchen Creations cooking schools; and health system interventions to improve disease management indicators such as blood glucose, blood pressure, and cholesterol.
The DPCP and its partners conduct provider and consumer education campaigns about prediabetes and diabetes and support built environment improvements so people at risk for or with diabetes can be physically active. The DPCP consults with populations that are disproportionately affected by diabetes to develop programs and services that are culturally appropriate for those populations.
Evidence-based PracticesDiabetes and its complications can be prevented and managed through these strategies:
1. Improve quality of clinical care to improve control of A1C, blood pressure, and cholesterol, and to promote tobacco cessation.
2. Increase access to sustainable self-management education and support services to improve control of A1C, blood pressure, and cholesterol, and to promote tobacco cessation.
3. Increase use of CDC-recognized lifestyle change programs to prevent or delay onset of type 2 diabetes among people at high risk.
CDC recommends specific major activities to implement these three effective strategies.
1) Improve quality of clinical care for people with and at risk for diabetes.
-Support health care organizations to implement practice changes to improve quality of care through use of the Planned Care Model and/or Patient Centered Medical Home.
-Support the implementation of policies and protocols within health care organizations that institutionalize and help sustain quality care improvements.
2) Increase access to sustainable self-management education and support services for people with diabetes.
-Expand access to the following:
a. diabetes self-management education/training (DSME/T) programs that meet national standards and demonstrate improved behavioral and/or clinical outcomes; and,
b. diabetes or chronic disease self-management (CDSM) programs that demonstrate improved behavioral and/or quality of life outcomes.
-Promote the sustainability of DSME/T or CDSM programs, such as insurance or Medicaid reimbursement for DSME/T or CDSM programs.
-Implement evidence-based worksite programs and policies that promote tobacco cessation and that help employees improve control of their A1C, blood pressure, and cholesterol.
-Increase access to tobacco cessation services.
-Expand the role of allied health professionals by replicating and scaling evidence-based programs based on the principles of the Asheville Project and the Diabetes 10-City Challenge.
-Promote the sustainability of Community Health Workers (CHWs) involved in providing diabetes self-management education and support services.
3) Increase use of lifestyle change programs.
-Lead/coordinate CDC approved health communication and marketing campaigns or coalition initiatives to raise awareness among people at high risk about prediabetes risk factors, the locations of CDC-recognized lifestyle change programs and how to enroll in these programs.
-Work with health care providers to raise awareness of how to recognize and treat prediabetes; and, to implement referral systems for people with prediabetes or multiple type 2 diabetes risk factors to sites offering CDC-recognized lifestyle change programs.
-Partner with state and local government agencies to recommend that the CDC recognized lifestyle change program be offered as a covered benefit for public employees and/or Medicaid recipients.
-Lead/coordinate use of National Diabetes Education Program primary prevention tools with populations at high risk for developing type 2 diabetes, to increase awareness of and support lifestyle change behaviors.
As a complement to these strategies, promote health communication campaigns or coalition initiatives to increase access to self-management education and support services or improve the quality of clinical care, and support other chronic disease prevention programs in implementing environmental approaches to change modifiable risk factors.
Available Services-Professional development opportunities, including online trainings with continuing education credits on Diabetes & Depression, Smoking & Diabetes, and Prediabetes
-Technical assistance to clinics and primary care providers to support system changes that improve health outcomes (e.g. AIC, blood pressure, LDL cholesterol and smoking cessation)
-Support for community-based prevention and management initiatives such as the National Diabetes Prevention Program and Kitchen Creations cooking schools for people with diabetes.
-Free meters and strips for underinsured and uninsured people with diabetes at selected sites
-Technical assistance with data, surveillance, and epidemiology
All are free of charge. For more information on any programs or services provided by the NM Department of Health, Diabetes Prevention and Control Program, go to http://nmhealth.org/about/phd/cdb/dpcp/ or call 1-888-523-2966.
Page Content Updated On 10/31/2014, Published on 03/11/2015