Joseph R. Betancourt, MD, MPH


President, The Commonwealth Fund, New York, NY







Latino Diabetes Program Structural Assessment: A report to the DHHS on Latino Diabetes Programs in the Region


The health outcomes disparities between majority and minority Americans have been well documented, and there is currently a national mandate to bridge this “health gap”.  The President’s Initiative on Race has targeted several areas as part of its mission to diminish health disparities among Americans, one such chronic disease being diabetes. Diabetes is a major public health problem which disproportionately affects the Latino population in this country.  According to the National Institute of Health’s Diabetes in America report of 1995, “Diabetes in Hispanic Americans is a serious health challenge because of the increased prevalence of the disease in this group, the greater number of risk factors, the greater incidence of complications, and the growing population of people of Hispanic ethnicity in the United States”.

The Latino Health Initiative is an action plan (under the auspices of the regional office of the Department of Health and Human Services {DHHS} serving MA, NH, ME, VT, RI and CT) designed to convene government officials, health professionals, and community representatives to address public health problems specific to the Latino population. In essence the LHI is an answer to the President’s call to action.  As part of the LHI, a Diabetes Work Group was organized to devise ways to decrease the burden of diabetic complications among Latinos in the region by improving diabetic outreach, diagnosis/screening, and treatment to this population. The first step in this process requires a structural assessment of already existing programs with the aforementioned components of outreach, screening/diagnosis and treatment as their mission.  The goal of this program structural assessment would be to determine what methods may be already successful, and what resources and infrastructure already exist in New England, to achieve our end of improving Latino diabetes outcomes.  It is the ultimate hope of the LHI that either some parts of already existing programs, or a successful program itself, can be piloted and expanded throughout the region in an attempt to affect Latino diabetes care.

A structural assessment of four programs that specifically target Latino diabetics in Boston, Massachusetts, Providence, Rhode Island, and Hartford, Connecticut was completed using an organizational and outcome measure based framework.  This assessment is to be used by the DHHS LHI to establish new operational policy which would foster the development and piloting of new programs whose goals are to improve care to Latino diabetics within the region.

Faculty Preceptor:

Sam Shekar, MD, MPH, Regional Health Administrator
Department of Health and Human Services, Region 1