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Review
. 2016 Jun;16(6):55.
doi: 10.1007/s11892-016-0742-6.

The State of Diabetes Prevention Policy in the USA Following the Affordable Care Act

Juleigh Nowinski Konchak  1 , Margaret R Moran  2 , Matthew J O'Brien  2 , Namratha R Kandula  2   3 , Ronald T Ackermann  4
Affiliations
Review

The State of Diabetes Prevention Policy in the USA Following the Affordable Care Act

Juleigh Nowinski Konchak et al. Curr Diab Rep. 2016 Jun.

Abstract

Type 2 diabetes is a major public health problem in the USA, affecting over 12 % of American adults and imposing considerable health and economic burden on individuals and society. There is a strong evidence base demonstrating that lifestyle behavioral changes and some medications can prevent or delay the onset of type 2 diabetes in high risk adults, and several policy and healthcare system changes motivated by the Patient Protection and Affordable Care Act (ACA) have the potential to accelerate diabetes prevention. In this narrative review, we (1) offer a conceptual framework for organizing how the ACA may influence diabetes prevention efforts at the level of individuals, healthcare providers, and health systems; (2) highlight ACA provisions at each of these levels that could accelerate type 2 diabetes prevention nationwide; and (3) explore possible policy gaps and opportunity areas for future research and action.

Keywords: Affordable Care Act; Diabetes; Health policy; Prediabetes; Primary prevention.

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Conflict of interest statement

Compliance with Ethics Guidelines Conflict of Interest Namratha Kandula discloses that she receives salary support from the American Medical Association and honoraria from Patient-Centered Outcomes Research Institute for serving as a grant reviewer. Juleigh Nowinski Konchak, Margaret Moran, Matthew O’Brien, and Ronald Ackermann declare that they have nothing to disclose. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
The Diabetes Prevention Care Continuum. Policies, systems, and environmental changes are conceptualized as having the potential to influence diabetes prevention via beneficial behavioral changes that occur by two major pathways. The first pathway, depicted by the rectangle at the top of the figure, involves changes in the social, cultural, economic, or physical environment that function either to make healthy behaviors more accessible or desirable and unhealthy exposures more difficult or prohibited. The second pathway involves improvements in the functions or activities of health systems and the interfacing of those systems with public health agencies or community organizations to raise awareness and expand delivery of evidence-based diabetes prevention interventions. This second pathway, depicted in the middle of the figure with the large, solid arrows moving from left to right, is the primary focus of this review. The thin solid arrows indicate other forces, namely, the first pathway and innovation, which influences this second pathway. The dotted arrow represents the effect of the first pathway on the adoption of healthy behaviors at the individual level. See text for further description.
See this image and copyright information in PMC

References

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