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Health Indicator Report of Diabetes Deaths

In 2016, diabetes was 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 and reduce diabetes complications.
The diabetes mortality rate for recent years appears to be lower than that of the early 2000's and the rate appears to decline in a near-stepwise fashion over time. Though there was no significant difference between most intervening 3-year periods, these step-wise decreasing rates are suggestive of a trend toward lower diabetes mortality rates. This same pattern is seen in the U.S. rate.

Notes

Age-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.

Data Sources

  • New Mexico Death Data: Bureau of Vital Records and Health Statistics (BVRHS), New Mexico Department of Health.
  • Population Estimates: University of New Mexico, Geospatial and Population Studies (GPS) Program, http://gps.unm.edu/.
  • U.S. Data Source: Centers for Disease Control and Prevention, National Center for Health Statistics. http://www.cdc.gov/nchs/.

Data Interpretation Issues

Diabetes 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.

Definition

The diabetes death rate: the number of deaths attributed to diabetes per 100,000 people, age-adjusted to the 2000 U.S. population.

Numerator

Number of deaths among New Mexico residents due to diabetes as the underlying cause of death.

Denominator

Estimated total number (population) of New Mexico residents.

Healthy People Objective: D-5.1, Reduce the proportion of the diabetic population with an A1c value greater than 9percent

U.S. Target: 14.6 percent

Other Objectives

New Mexico Community Health Status Indicator (CHSI)

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 rate in 2016 was 26.7/100,000, down from 34.6/100,000 in 2003. National age-adjusted rates have been lower, 25.5/100,000 in 2003 and 21.3/100,000 in 2015, the most recent year available. The number of New Mexico diabetes deaths (i.e., numerator) ranged from a low of 500 in 2000 to a high of 671 deaths in 2016. From 2000 to 2016, an annual average of 609 diabetes deaths occurred, with a total of 10,357 diabetes deaths. The female rates were lower than the male rates for all age groups. Race/Ethnicity Rates: During the period 2014-2016, the New Mexico American Indian population had the highest diabetes death rates and the White had the lowest diabetes death rate. The American Indian rate was roughly double the rates of Black/African American and Hispanic populations, nearly three times that of the Asian/Pacific Islander population, and four times that of the White population. When looking at the race/ethnicity rates by sex, male rates are higher than female rates in all groups except Asian/Pacific Islander, where there was no significant difference. 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 2014-2016, the Mixed Urban-Rural diabetes death rate was the highest and the Metropolitan rate the lowest. The Mixed Urban-Rural rate was 39% higher than that of the Metropolitan rate. The rates for Rural and Mixed Urban-Rural were not statistically different.

How Do We Compare With the U.S.?

From 2000 to 2016 New Mexico rates were 15% to 36% 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 Diabetes Prevention and Control Program (DPCP) works with health care providers and community partners, agencies and coalitions to provide multiple diabetes prevention and management services and programs. Services and programs include: professional development trainings and resources for diabetes prevention and management; the National Diabetes Prevention Program (National DPP), a proven community-based physical activity and nutrition intervention to prevent or delay diabetes in persons at high risk; community resources to help people manage their diabetes through skill building, such as the Chronic Disease Self-Management and Diabetes Self-Management Education Programs; Kitchen Creations cooking schools; and health system disease management interventions that improve blood glucose, blood pressure, and cholesterol. The DPCP provides education, information, and resources about prediabetes and diabetes, particularly to health care providers, to increase screening, testing and referral to prevention and management programs. This includes a centralized referral and data system that helps providers easily make referrals to the above programs. DPCP?s partners support built environment improvements so people at risk for or with diabetes can be physically active and initiatives that increase access to healthy foods. Both are essential components of effective population-based diabetes prevention and control. The DPCP consults with populations that are disproportionately affected by diabetes and/or those that serve them to develop programs and services that are culturally appropriate for these populations.

Evidence-based Practices

Diabetes and its complications can be prevented, delayed and/or managed through participation in evidence-based programs, including the National Diabetes Prevention Program or NDPP (provided in a clinical, community, or web-based setting), the Diabetes Self-Management Education Program or DSMEP (provided in a community or web-based setting), and Diabetes Self-Management Education and Support programs or DSME/S (usually provided in a clinical setting). Improving the quality of clinical care for people with and at risk for diabetes is also an evidence-based practice. The following DPCP activities are in alignment with these accepted programs and practices: 1. Increase use of the NDPP to prevent or delay onset of type 2 diabetes among people at high risk by raising awareness about prediabetes and the NDPP, increasing delivery sites, facilitating the screening and referral process, and working to obtain health insurance coverage (including Medicaid) for the program. 2. Increase access to sustainable self-management education and support services (DSMEP and DSME/S) to improve control of A1C, blood pressure, and cholesterol, and to promote tobacco cessation, by increasing delivery sites, facilitating the referral process, and working to obtain health insurance coverage (including Medicaid) for the programs. 3. Implement evidence-based worksite programs and policies that help people prevent or manage diabetes and related chronic conditions, promote tobacco cessation, and help employees improve control of their A1C, blood pressure, and cholesterol. 4. Improve health outcomes for people with and at risk for diabetes by supporting health care organizations to improve quality of care through use of the Planned Care Model, Patient Centered Medical Home, and Electronic Health Record. Within these organizations, support policy and protocol implementation that institutionalize and help sustain quality care improvements. 5. Promote the sustainability of Community Health Workers (CHWs) involved in providing diabetes prevention and management services.

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, Kitchen Creations cooking schools for people with diabetes and development of walking trails -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://archive.diabetesnm.org/ or call 1-888-523-2966.
Page Content Updated On 02/09/2018, Published on 02/09/2018
The information provided above is from the New Mexico Department of Health's NM-IBIS web site (http://ibis.health.state.nm.us). The information published on this website may be reproduced without permission. Please use the following citation: "Retrieved Sun, 15 July 2018 from New Mexico Department of Health, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.nm.us".

Content updated: Fri, 9 Feb 2018 15:37:26 MST