Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, Maryland.
Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania.
Ann N Y Acad Sci. 2020 Feb;1461(1):5-24. doi: 10.1111/nyas.14270. Epub 2019 Dec 3.
Obesity and type 2 diabetes disproportionately impact U.S. racial and ethnic minority communities and low-income populations. Improvements in implementing efficacious interventions to reduce the incidence of type 2 diabetes are underway (i.e., the National Diabetes Prevention Program), but challenges in effectively scaling-up successful interventions and reaching at-risk populations remain. In October 2017, the National Institutes of Health convened a workshop to understand how to (1) address socioeconomic and other environmental conditions that perpetuate disparities in the burden of obesity and type 2 diabetes; (2) design effective prevention and treatment strategies that are accessible, feasible, culturally relevant, and acceptable to diverse population groups; and (3) achieve sustainable health improvement approaches in communities with the greatest burden of these diseases. Common features of guiding frameworks to understand and address disparities and promote health equity were described. Promising research directions were identified in numerous areas, including study design, methodology, and core metrics; program implementation and scalability; the integration of medical care and social services; strategies to enhance patient empowerment; and understanding and addressing the impact of psychosocial stress on disease onset and progression in addition to factors that support resiliency and health.
肥胖和 2 型糖尿病在美国的种族和少数民族社区以及低收入人群中不成比例地高发。为了降低 2 型糖尿病的发病率,正在实施有效的干预措施(即国家糖尿病预防计划),但在有效扩大成功干预措施的规模并覆盖高危人群方面仍然存在挑战。2017 年 10 月,美国国立卫生研究院召开了一次研讨会,旨在了解如何:(1)解决导致肥胖和 2 型糖尿病负担不平等的社会经济和其他环境条件;(2)设计可及、可行、文化相关且不同人群群体都能接受的有效预防和治疗策略;(3)在这些疾病负担最大的社区实现可持续的健康改善方法。描述了理解和解决差异以及促进健康公平的指导框架的共同特征。在许多领域确定了有前途的研究方向,包括研究设计、方法和核心指标;计划的实施和可扩展性;医疗保健和社会服务的整合;增强患者赋权的策略;以及了解和解决心理社会压力对疾病发病和进展的影响,以及支持韧性和健康的因素。