Diabetes in Appalachia: “Just give me a pill”
BY FRANK BROWNING
PRESTONBURG, Ky. — Here in the heart of Appalachian coal mining country, where black lung disease and TB used to be major killers of men, a new epidemic is sweeping through the dogwood-dappled hollows that’s even deadlier than coal dust. The new threat is diabetes. Ads for diabetes counseling and testing clinics have replaced supermarkets as a major revenue source in local papers. Billboards urging middle-aged people to get tested appear almost everywhere there’s a straight stretch of highway.
Nationwide, diabetes affects 15 percent of all Americans; more than a quarter of all people over 65 are diabetic, while half are borderline. But in Kentucky and across the broad Appalachian region, a third of the population is believed to be diabetic, and health workers here believe that most diabetics don’t know it. Gilbert Friedell, who spent his life as a nationally known cancer specialist before founding a statewide health reform committee in Kentucky, however, rejects the conventional wisdom that diabetes prevention and care is a “health” problem.
“We used to say with cancer control in eastern Kentucky that if we were to apply what we now know about cancer, we could cut mortality by half in 10 to 15 years. The same thing is true with diabetes. We know what we have to do to prevent Type II diabetes and how to maintain a reasonable level of personal performance. We know these things. But, if we’re so smart, how come we haven’t fixed the diabetes problem? The answer is we’re still relying on individual approaches where it really requires community action and support.”
That insight led Friedell and the 25-member citizens committee that bears his name deep into the hollows of Kentucky, where strip miners have bulldozed off the tops of the mountains, and where earlier this year, a fierce tornado laid waste to thick forests of trees, blocked roadways and shredded the walls and roofs of gas stations, barns and mobile homes. That’s where the Friedell Citizens Committee launched the Tri-County Diabetes Partnership, drawing together an alliance of doctors, nurses, dietitians, teachers, church people, local health departments and even USDA farm extension agents.
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http://www.salon.com/2012/08/08/diabetes_in_appalachia_just_give_me_a_pill/
