Emerging Data Could Begin to Redefine how Cities Address the Growing Diabetes Epidemic

First Glimpse of Research Findings from Cities Changing Diabetes Unveiled

Nov 10, 2015, 11:00 ET from Novo Nordisk

HOUSTON, Nov. 10, 2015 /PRNewswire/ -- New research conducted in collaboration with the University of Texas Health Science Center at Houston (UTHealth) School of Public Health finds that social and cultural factors are likely to play a larger role in a person's risk of developing diabetes than previously believed, and that Houstonians who have insurance, standard economic advantages and few clinical risk factors can still be vulnerable to the disease.

Researchers identified four profiles of persons who may be vulnerable to developing diabetes, based on 10 key social and cultural factors, beyond the standard biomedical predictors and economic conditions. Among the vulnerable are:

  • Isolated Skeptics: Higher biomedical risk, economically disadvantaged, disconnected from their community and lacking trust in the health care system.
  • Financially Pressured Caregivers: Lower biomedical risk, but economically disadvantaged, and having caregiver responsibilities and long commutes.
  • Concerned Seniors: High biomedical risk, economically secure, but dealing with change and transition in their neighborhood and low health literacy.
  • Time-pressured Young Adults: Lower biomedical risk, economically secure, but facing serious time pressure and peer influence on appearance and health decisions.

These findings are based on extensive, prior data analyses and in-depth interviews with 125 Houston households, as part of Cities Changing Diabetes, a global program of Novo Nordisk in which several cities around the world are learning how to improve diabetes detection and care in their communities.  Houston is the only American city participating, and stakeholders from across the city will mark the initiative's one-year anniversary on November 10, 2015.

"The emphasis in the Houston research is on moving upstream, before the clinical risk factors for diabetes develop. Our aim is to identify vulnerable groups who might benefit from new, early prevention efforts.  From this perspective, vulnerability to the disease involves much more than one's biology and economic situation. The research shows it is also rooted in the interaction of social and cultural factors that diminish opportunities for well-being and the ability to do anything about one's health," says Stephen Linder, Ph.D., Director of the Institute for Health Policy, UTHealth School of Public Health and lead researcher with Cities Changing Diabetes in Houston.

"So the early warning conditions for developing diabetes are more far-reaching than previously believed. Even well-informed people with health insurance, who do not consider themselves vulnerable may face certain stressors and have ways of coping that place them at risk of developing the disease in the future," said Linder.

"Traditional methods in promoting the prevention and detection of diabetes have gotten us far, but we can no longer solely rely on these methods to have an impact on this serious disease. These emerging data could transform how people think about diabetes and chronic diseases as a whole. This could lead to organizations joining forces with new prevention strategies that use more than just health factors to find patients with diabetes," says Faith E.  Foreman, Dr. PH., MPH, LVN, Assistant Director, Houston Health Department.

One year ago, the Cities Changing Diabetes program in Houston kicked off with a comprehensive analysis of the major gaps and vulnerabilities associated with diabetes. The results are being used in coordination with input from local stakeholders to identify efforts that will have the greatest impact on prevention and management of diabetes.

This research marks the beginning of the initiative's next phase, where the coalition of Houston's community, faith-based, business, academic and health care leaders will take on five key issues:

1.   Change the way we understand prevention, based on attention to social and cultural factors.

2.   Improve interventions to address the unique sources of stress in urban settings.

3.   Increase collaboration by providers, insurers and employers to improve and re-target prevention efforts.

4.   Help people prioritize personal health by addressing opportunities for health and the ability to pursue them.

5.   Improve the connections between those who are vulnerable to diabetes and educators, caregivers and their communities.

On November 16, 2015, Houston's results are being shared with cities around the world at a global Cities Changing Diabetes summit taking place in Copenhagen, Denmark.

Novo Nordisk, a global health care company with more than 90 years of innovation and leadership in diabetes care, sponsored the study.


Houston is the fourth largest city in the United States. There are 2.1 million people living in Houston and 4.3 million in Harris County.[i]  Approximately one in 10 adults in Houston/Harris County have diabetes.[ii]

Obesity is the most common chronic condition in Houston, affecting 32 percent of adults. [iii]  Obese men and obese women have a 7- and 12-fold risk, respectively, of developing diabetes.[iv]

About Urban Diabetes and Cities Changing Diabetes

Of the estimated 382 million people worldwide who have diabetes, nearly two-thirds live in urban areas.[v] Globally, those who live in cities are 2 to 5 times more likely to have diabetes.[vi] By 2035, it is estimated that more than half a billion people will have diabetes. Today, nearly two-thirds of all people with diabetes live in cities, and people who move to cities have a significantly higher risk of developing diabetes than those who remain in rural settings.[vii]

Cities Changing Diabetes is a first-of-its-kind collaboration developed to stem the tide of urban diabetes by providing practical, long-term solutions. The partnership aims to tackle the challenge by first understanding the driving factors behind the rise in diabetes in cities and use that knowledge to share concrete, real-world solutions.

The aim of Cities Changing Diabetes is to map the problem, share solutions and drive concrete action to fight the diabetes challenge in selected focus cities across the world.

The Houston Health Department and UTHealth School of Public Health serve as core partners on the project and lead the research for Cities Changing Diabetes – Houston. Other local partners include the American Diabetes Association Houston, Clinton Foundation Health Matters Initiative, Houston Business Coalition on Health, City of Houston HR Department, Harris County Public Health & Environmental Services, Gateway to Care, The Fountain of Praise and Harris County Medical Society. Globally, the program is supported by University College London (UCL) and Steno Diabetes Center, Denmark, a world-leading institution in diabetes care and prevention, and Novo Nordisk. 

For more information, visit Cities Changing Diabetes. Also, visit Cities Changing Diabetes on Twitter and Facebook.

About Novo Nordisk
Headquartered in Denmark, Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. The company also has leading positions within hemophilia care, growth hormone therapy and hormone replacement therapy. For more information, visit novonordisk.us or follow our news in the US on Twitter: @novonordiskus.

About UTHealth

Established in 1972 by The University of Texas System Board of Regents, The University of Texas Health Science Center at Houston (UTHealth) is Houston's Health University and Texas' resource for health care education, innovation, scientific discovery and excellence in patient care. The most comprehensive academic health center in The UT System and the U.S. Gulf Coast region, UTHealth is home to schools of biomedical informatics, biomedical sciences, dentistry, medicine, nursing and public health and includes The University of Texas Harris County Psychiatric Center and a growing network of clinics throughout the region. The university's primary teaching hospitals include Memorial Hermann-Texas Medical Center, Children's Memorial Hermann Hospital and Harris Health Lyndon B. Johnson Hospital. For more information, visit www.uth.edu.

[i] The State of Health in Houston/Harris County 2012. Harris County Healthcare Alliance, Houston, Texas.

[ii] Health of Houston Survey. HHS 2010 A First Look. Houston, TX: Institute for Health Policy, The University of Texas School of Public Health, 2011.

[iii] Health of Houston Survey. HHS 2010 A First Look. Houston, TX: Institute for Health Policy, The University of Texas School of Public Health, 2011.

[iv] Guh DP et al. The incidence of comorbidities related to obesity and overweight. BMC Pub Health.  2009; 9:88.

[v] IDF Diabetes Atlas. International Diabetes Federation. 2013. 6th edn.

[vi] Mbanya JC et al. Diabetes in sub-Saharan Africa. Lancet 2010; 375(9733):2254-2266

[vii] Mbanya JC et al. Diabetes in sub-Saharan Africa. Lancet 2010; 375(9733):2254-2266

Logo - http://photos.prnewswire.com/prnh/20110414/NY80976LOGO


SOURCE Novo Nordisk