Interim Report:
Proposed Recommendations for Action

A National Public Health Initiative on Diabetes and Women's Health

Return to the Contents

Strategic Framework

Top of Page

Vision and Goals

The ultimate vision of the National Public Health Initiative on Diabetes and Women’s Health is to:

• prevent diabetes among women whenever possible,
• promote early diagnosis and appropriate management of diabetes among women across the life stages,
• prevent, delay, or minimize complications from diabetes among women, and
• educate the families and communities of women at risk for diabetes, and provide the support they need to prevent diabetes and its complications.

With this vision as a foundation, the Initiative’s specific goals are to work within the framework of Healthy People 2010 to:

• garner the national attention of policy makers, public health professionals, other advocates for women’s issues, researchers, and the general public that diabetes is a prominent public health issue,
• develop consensus among key stakeholders that there is a need to develop priority strategies, policies, and research to improve diabetes and women’s health,
• delineate the public health role in diabetes and women’s health at national, state, and community levels, and improve the capacity of these public health sectors to fulfill that role,
• unite partners from multiple sectors of society in a coordinated strategy to prevent and manage diabetes among women, and
• empower women to adopt prevention strategies that will improve their overall health and will delay or prevent diabetes and its complications.

Top of Page

Guiding Principles

The guiding principles underlying the National Public Health Initiative on Diabetes and Women’s Health are as follows:

• A public health approach to diabetes among women should be adopted. This approach aims to improve the health and quality of life for all women primarily through prevention and focuses on all factors influencing health status: physical, behavioral, psychological, and socioeconomic.
• Collaboration within and between multiple sectors of society is essential for success. These sectors include public and private health care organizations, business and industry, education and environment, communication and media, and policy makers.
• Strategies and policies must fully consider and take into account the unique needs of women in different life stages among all racial, ethnic, religious, and cultural groups.
• Women and grassroots organizations should be fully engaged as active partners in policy decisions and in program planning, implementation, and evaluation. The strong involvement and support of men should be sought as well.
• Leadership of state and community agencies and groups must share accountability for adopting approaches to improve the health status of women.
• Actions should be based on sound research from all relevant scientific fields, and the pursuit of additional research should focus on filling gaps in scientific knowledge. Assessment must guide policy and program development.
• Measurable outcomes for programs and policies should be established so that progress and impact can be evaluated and approaches can be modified as needed.
• Strategies and policies must be sustainable and integrated over time, not just one-time activities or interventions. New initiatives should build on existing resources, services, and natural links between local, state, and federal agencies and organizations in both the public and private sectors.

Top of Page

Public Health Prevention Framework

Levels of Prevention
The recommendations in this report encompass three levels of prevention. Primary prevention aims to prevent diabetes from occurring among women. Secondary prevention aims to identify diabetes at its earliest stage so that prompt and appropriate management can be initiated. Successful secondary prevention reduces the negative impact of diabetes on a woman’s life. The goal of tertiary prevention is to reduce or minimize the consequences of diabetes once it has developed. That is, to eliminate, or at least delay and reduce, the onset and severity of complications and disability due to diabetes.

Life Stages
These recommendations also recognize the unique challenges to prevent diabetes and its complications among women in different life stages. The adolescent years (ages 10-17 years) are marked by major biological and psychosocial changes that transform adolescents into adults. Many adolescents with diabetes face life choices that can affect their ability to control the disease. Primary prevention and instituting lifelong healthy behaviors related to physical activity and nutrition are key in this lifestage. The reproductive years (ages 18-44 years) represent the life stage in which women experience significant personal growth and responsibility: additional schooling, marriage, career development, and child rearing. Diabetes during pregnancy, regardless of type, puts both a woman and her unborn child at risk for negative health outcomes. For those with few personal resources, diabetes during pregnancy can place them at high risk for negative outcomes and future economic hardship. The middle years (ages 45-64 years) are noted by major physiological events such as menopause. This is also a time when other chronic diseases or complications of diabetes most often first appear, along with many other social and psychological changes such as disability, death of a significant other or parent, divorce, and retirement. Because women are increasingly developing diabetes at younger ages, the development of complications will occur earlier as well. The older years (ages 65 years and over) are when women with diabetes become even more vulnerable to other chronic illnesses, disability, poverty, and loss of social support systems. The number of women in this age group is growing exponentially as the American population ages.

Categories of Recommendations
Many of the recommendations for public health action pertain to all women, regardless of life stage; others are life stage-specific. Presented in the following two sections of this report, these recommendations are divided into two categories. Strategy and policy recommendations address communication and education of families, health care providers, and other professionals who may serve patients; and services and programs to improve the effectiveness of interventions in schools, work sites, health care systems, and other community organizations and settings. Disease Tracking and research recommendations encourage further knowledge of the epidemiologic, socioenvironmental, behavioral, translational, and biomedical factors that influence diabetes and women’s health.

While the focus of these recommendations is to improve the health and well-being of women, adopting and implementing many of these recommendations will also benefit men and families.

Top of Page