Logan will fight diabetes
CHAPMANVILLE, W.Va. -- A few weeks after Tim Harclerode started as chief operating officer at Logan Regional Medical Center, he picked up the newspaper and saw this headline: "Logan County: 6,000 diabetics and no diabetic education . . . yet."
"There it was on the front page: Logan County has the state's highest diabetes rate, but no programs to help people learn to control diabetes," Harclerode said. "I looked at that, and said to myself, 'Well, it's not going to stay that way. No way. We're getting out in front of this."
The next day, hospital officials contacted Shannon Meade, director of the county's Family Resource Network, and said Logan Regional wanted to join the effort to create a Logan Diabetes Coalition.
Harclerode and two of his staff members went to a diabetes coalition organizing meeting in Chapmanville on June 12. So did representatives of seven other organizations.
"I was so glad to see them all," Meade said. "This problem is too overwhelming for any one group to handle."
One indicator: In 2010, 39 percent of Logan County fifth-graders had high blood pressure, and 39 percent were obese, according to West Virginia University measurements. "Those children are at high risk of type 2 diabetes, which can be prevented by more physical activity and less consumption of things like soda pop," said Dr. Bill Neal, who directs the WVU project.
The Logan hospital is planning a "range of diabetes services for the public," Harclerode said last week. The coalition wants to help people prevent diabetes, as well as control it, he said. "We're in the infancy stage, but we plan to develop support groups and outreach groups and pull together a much broader effort for the public."
Logan County -- home of Gov. Earl Ray Tomblin -- is at least the 13th West Virginia county to create a diabetes coalition. These coalitions are homegrown, fueled by the diabetes explosion. "You can just look around and see the problem growing," Meade said.
Diabetes has tripled in West Virginia in the past 25 years, following a tripling in obesity.
The Logan group is not waiting for the state to help them. On June 12, they brainstormed for three hours, talking about what they could do for kids who sit around texting all day, seniors who never exercise, and young mothers who put Coca-Cola in their babies' bottles. They inventoried Logan County's resources and talked about the need to fight the widespread notion that, "if your relatives have sugar, there's nothing you can do."
They targeted three groups: inactive children under 18 at risk because of obesity and high blood pressure; young parents who pass on junk food/sedentary habits to their kids; and diabetics or prediabetics over 55 who could run up huge medical bills unless they learn to control their diabetes.
They talked about the $2.7 million grant the Mingo County diabetes coalition recently received. "We could do a lot with a tenth of that," somebody said.
The brainstormers included people from the hospital, Coalfield Health Center, the United Mine Workers union, Automated Health Systems, the WVU Extension Service, Chapmanville government, and the Family Resource Network.
In July, the Logan County Chamber of Commerce and Southern Community College plan to join the group. "This affects us all," Meade said, "and we need to work together."
Diabetes already costs West Virginia more than a billion dollars a year, according to the American Diabetes Association. The ADA expects it to double between 2008 and 2018.
Don't expect funding from the state
Gina Wood, manager of the West Virginia Diabetes Prevention and Control program, came to the June meeting. It was the first coalition meeting she'd attended.
The state did not help the coalitions get started or give them money, although most are scrambling for funds. "They're not the state's projects," Wood said. Twelve counties got a small startup grant from the Appalachian Regional Commission. "They're ARC projects," she said.
The state Bureau of Public Health does not keep track of diabetes coalitions or services, Wood said, even though West Virginia leads the nation in diabetes, according to Gallup Healthways. "We don't have enough staff" to do that, Wood said. Counting Wood, the state diabetes program has only three employees. "We don't have the troops" to organize programs statewide, she said. "It would be wonderful if we did."
County coalitions should not expect funding from the state, Wood said last week. "The biggest part of our funding comes from the federal Centers for Disease Control, and they are strict about what we can and cannot spend the money on. We're not allowed to say, 'Hey, let's spend some money to work with county coalitions.'"
The state's CDC funds have already been cut by 10 percent, with more to come, Wood said. "It gets very frustrating."
In 2012-13, the West Virginia Department of Health and Human Resources will take about $330,000 of the state's $1 million in federal and state diabetes money for salaries and services. The state plans to distribute about $700,000 to 14 projects that meet CDC guidelines.
There is no process for local groups to apply for any of those funds. Critics complain that the state funds the same projects year after year. "The state should help local people collaborate and pool their resources," said Pat White, who directs West Virginia Health Right, which serves 8,500 diabetics. "They could bring people together and give them examples of best practices and ideas about what they could do."
"The bottom line is, we need broad coordination of effort at the local level, with support and involvement from the state," said Krista Farley, director of health promotion for the Kanawha-Charleston Health Department. "We need to agree on a vision of where we're going so we can put the pieces in place and make every program play together."
"The school system's regional-wellness people could help," said Jorea Marple, state superintendent of schools. "I'd like to see them involved. We have a lot of children at risk of diabetes."
What are the local coalitions doing?
Of the 13 counties with diabetes coalitions, all but Hancock County have per capita incomes below state average. They all have too few diabetic services. They all express a sense of urgency.
With limited funds, each county is taking a different tack.
The Calhoun/Gilmer coalition has held "Help Yourself" classes in fire halls, senior centers, hospitals and clinics. "That's our big push now," said Barb McKown, outreach coordinator at Minnie Hamilton Health Center.
The Nicholas County group emphasizes Dining with Diabetes cooking classes, led by the WVU Extension Service. "We've taken cooking classes to remote areas and reached a lot of people who never had a chance for a class like that," said Jane Sherwood, of Friends R Fun health organization.
In Lincoln County, members run a summer FIT (Families in Touch) camp for children and parents and offer a free gym and aerobics class each weekday at Lincoln Primary Care. They want to create biking trails. "Maybe we can figure out how to do that at the July meeting," said Janet Sebert, coalition chairwoman.
Hundreds of Mingo County residents racked up thousands of miles in the coalition's walking program last year. They co-sponsored health fairs and a diabetes clinic and, with grant funding, will start a school physical activity program and rural outreach in the fall.
People in all counties say they need help. "We struggle to keep our coalition together. Our members have such full plates," said Nicholas County's Sherwood. "If we had somebody whose job was to facilitate coalitions, we could do a lot more."
Two coalitions are inactive. "The person who was spearheading ours moved," said Angel Green of Webster Memorial Hospital. "We could start up again if somebody else would do it."
If they were in Kentucky, they would have some resources. The statewide nonprofit Kentucky Diabetes Network has more than 200 member groups, including county coalitions. They hold annual meetings, produce a 16-page newsletter and mobilize hundreds to lobby the state Legislature when necessary.
"We're envious," said Richard Crespo, a Marshall University professor who helps organize coalitions.
Kentucky pays every local health department to offer diabetes self-management classes. Last year, Kentucky legislators put $3.4 million (77 cents a person) into diabetes care and prevention, compared to West Virginia's $108,000 (6 cents a person).
There's talk in West Virginia of a statewide coalition that could go after grants. Logan County plans to apply for private grants. "Funding possibilities go up when you've got a coalition," said Mingo County's Hatfield.
The new Hancock County coalition got a startup grant through the National Association of City and County Health Officials. Three months later, they're offering "Help Yourself" classes in two churches and one senior center.
"We're on a roll," said Jackie Huff, health department administrator. They're considering school programs, walking clubs and races, and a public-awareness campaign.
In Boone County, the health department, hospital and several agencies are working to create a business plan for a diabetes prevention/control program. "If we want a program that won't disappear when the grant money ends, we need a way to pay for it," said Julie Miller, health department administrator.
In 2010, about 29 percent of Boone fifth-graders had high blood pressure. About 45 percent were obese. "We've got to change that," Miller said. With federal funding being cut, she said, "joining forces just makes sense."
Reach Kate Long at 304-348-1798 or firstname.lastname@example.org. "The Shape We're In" was written with the help of the Dennis A. Hunt Fund for Health Journalism, administered by the California Endowment Health Journalism Fellowships at the University of Southern California's Annenberg School for Communication and Journalism.