Advocacy to Impact Population Health

Identify
To Representative Kim Schrier,
My name is Fana Hailemichael and I am a registered nurse undertaking a DNP program. As an RN, I have worked with patients suffering from chronic problems, including diabetes, and access to medical services, including self-management training, is always essential to health outcomes for a population. Therefore, I wish to express my support for H.R. -Expanding Access to Diabetes Self-Management Training Act of 2021.
Situation
My concern is the high diabetes prevalence among Somali Americans. The population is more susceptible to diabetes because they face higher unemployment rates, poor housing, and low education levels (Lincoln et al., 2021). Such factors reduce their ability to access diabetes care, increasing the risk of adverse outcomes such as diabetes-related complications. I support the H.R. -Expanding Access to Diabetes Self-Management Training Act of 2021, a bill seeking to expand Medicare coverage of diabetes outpatient self-management training and the testing of a model where the training can be provided virtually. Passing the bill will significantly impact vulnerable communities such as Somali Americans. Failure to enact the bill with data may limit its ability to meet the needs of minority groups, increasing health disparities, especially on the part of virtually providing training. The decision must incorporate technological utilization in the community.
Background
I believe we share a similar concern on the need for increased access to diabetes-related care, especially self-management care to improve diabetes outcomes and reduce related costs. As a DNP nurse who has worked with patients diagnosed with chronic illnesses for a significant period, self-management is an important aspect of care for any chronic disease, including diabetes. I have also researched significantly on the issue. My experience with patients with social determinant risks is that they are more likely to suffer negative health-related outcomes (Lincoln et al., 2021). For example, low-income and uneducated patients are more likely to suffer health-related complications due to a lack of self-management practices.
Assessment
Diabetes is a significant public health concern and burden, with vulnerable populations bearing a higher burden in terms of health outcomes, costs, and productivity. Studies indicate that patients’ lack of skills to manage their conditions is a major barrier to improved patient outcomes (Thanh & Tien, 2021). The self-management policy will effectively reduce the existing disparities in outcomes and self-management behaviors. According to the Centers for Disease Control and Prevention (2018), self-management training helps in learning management skills such as regular blood sugar monitoring, healthy eating, engaging in physical exercises, taking medications, and managing stress. It has been linked to lower medical expenses, fewer complications, and improved quality of life. The training can be tailored to individual needs, life experiences, and goals. Community health workers, community members, community health facilities, and healthcare providers recognize the need for self-management training in improving diabetes outcomes and decreasing the existing health disparities.
Recommendation
The policy is of great significance to diabetes-related outcomes among vulnerable populations, especially those with limited access to training. Consider gaining support from other representatives and advocacy from relevant stakeholders to hasten the bill’s passing. Thank you very much for your time, and I trust that you will consider the significant aspects highlighted. I am ready to offer my expertise in any area to facilitate passing the bill.
Salutation
Fana Hailemichael
A registered nurse. Currently a DNP program student.
• Contact information

References
Centers for Disease Control and Prevention (2018). Managing Diabetes. Retrieved from https://www.cdc.gov/learnmorefeelbetter/programs/diabetes.htm#:~:text=Participating%20in%20a%20self%2Dmanagement,Lower%20A1C%20levels
Lincoln, A. K., Cardeli, E., Sideridis, G., Salhi, C., Miller, A. B., Da Fonseca, T., … & Ellis, B. H. (2021). Discrimination, marginalization, belonging, and mental health among Somali immigrants in North America. American Journal of Orthopsychiatry, 91(2), 280. https://psycnet.apa.org/record/2020-93281-001
Thanh, H. T. K., & Tien, T. M. (2021). Effect of group patient education on glycemic control among people with type 2 diabetes in Vietnam: A randomized controlled single-center trial. Diabetes Therapy, 12, 1503–1521.
https://link.springer.com/article/10.1007/s13300-021-01052-8