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National Agenda for Public Health Action:
A National Public Health Initiative on Diabetes and Women’s Health

Foreword

Diabetes is very often preventable.  Yet, more than 17 million Americans have the disease—and more than half are women. This number is expected to increase, placing added demands on the health care delivery system and on other sectors of society. The estimated cost of diabetes to the United States for direct health care and other indirect expenditures is about $98 billion each year. 

The time for addressing this epidemic is now.  On behalf of women with diabetes and those at risk, the Centers for Disease Control and Prevention (CDC) along with its cosponsors—the American Diabetes Association (ADA), the American Public Health Association (APHA), and the Association of State and Territorial Health Officials (ASTHO)—convened numerous partners to develop and now release a National  Agenda for Action. It is hoped this agenda will guide the nation in a rational and concerted effort to address diabetes and women's health. The ultimate vision is a nation in which

  • diabetes among women is prevented or at least delayed whenever possible,
  • women at risk for diabetes receive the family and community support they need to prevent or delay diabetes and its complications,
  • appropriate care and management of diabetes among women is promoted across the life stages, and
  • the occurrence of complications from diabetes among women is prevented, delayed, or minimized.

Ten recommendations are offered for realizing this public health vision.

  1. Strengthen advocacy on behalf of women with or at risk for diabetes. 
  2. Expand community-based health promotion education, activities, and incentives for all ages in a wide variety of settings—schools, workplaces, senior centers, churches, civic organizations, and other locations where women live, learn, work, and play. 
  3. Encourage and support diabetes prevention and control programs in state health departments to develop prevention and management efforts for all women and establish efficient links for women at risk of type 2 diabetes.
  4. Fortify community programs for women with sufficient funding, training, tools, and materials.
  5. Expand population-based surveillance to monitor and understand (a) variations in the distribution of diagnosed and undiagnosed diabetes and of impaired glucose tolerance within and among groups; and (b) the factors—cultural, racial, ethnic, geographic, demographic, socioeconomic, and genetic—that influence the risk for diabetes and complications among women at all life stages.
  6. Educate community leaders about diabetes and its management and the value of healthy environments.
  7. Encourage health care providers to promote risk assessment, quality care, and self-management for diabetes and its complications in their practice settings.
  8. Ensure access to trained health care providers who offer quality services consistent with established health care guidelines. 
  9. Encourage health care coverage and incentives for recommended diabetes prevention and management practices. 
  10. Conduct public health research to further our knowledge of the epidemiologic, socioenvironmental, behavioral, translational, and biomedical factors that influence diabetes and women's health.

Achieving this vision through these 10 recommendations requires more than the combined powers of CDC and the organizations cosponsoring the National Public Health Initiative on Diabetes and Women's Health.  It requires the collective energies and resources of policy makers, public health professionals, other advocates for women's issues, researchers, and the general public.  Together, we can make tremendous strides toward improved health for all women with or at risk for diabetes.  We urge you to join us in this urgent and worthwhile pursuit.  Let us begin today.

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