How to help diabetics survive Brooklyn’s ‘food swamps’

Fast food is convenient, inexpensive and, let’s face it: it tastes good. Those are the selling points that have turned it into a $200 billion-plus industry.

That’s good news for the Burger Kings and Popeye’s of the world, but those same three factors — convenience, low cost and taste — make it all too easy for low-income families to fall into the trap of depending on fast food way too much.

It seems the chains themselves know this as well. A recent study found that in New York, fast food restaurants aren’t most common in high-traffic areas such as Times Square, but rather low-income areas of Brooklyn.

These areas have been dubbed “food swamps,” locations where unhealthy options such as fast food are easier to obtain than healthy foods. Not surprisingly, obesity and other associated health risks are also more common in these areas.

In fact, a recent study published in the Journal of the Endocrine Society found that adult type 2 diabetes is 2.5 times more common in New York CIty’s food swamps than areas with fewer fast food options, while adult type 1 diabetes is 1.5 times more common.

It’s unlikely that fast food chains will leave these low-income areas. It’s also unlikely that low-income families will significantly cut back on fast food consumption, for the reasons previously discussed. So the challenge that presents itself is how to help these populations remain healthy, even with the prevalence of diabetes.

The answer to that problem? Patient engagement. There is evidence that through regular engagement, low-income diabetics are more likely to take healthy actions, such as A1c testing, diabetic eye exams and annual wellness visits.

NovuHealth recently examined a sample of Medicaid patients in these same low-income areas of Brooklyn that have been designated as food swamps. In New York and across the country, the perception is that low-income patients don’t care to engage in their own health care. But the data indicates this is not the case if health plans engage with their members and encourage them to take action.

In our data, members who were encouraged to take advantage of incentives for performing healthy activities increased engagement by 92 percent. Incentives could include a $25 gift card for taking part in a healthy activity, such as a diabetic eye exam.

In the sample of Brooklyn Medicaid members, 16.2 percent of diabetic members who received promotions about the incentives engaged in the program. While it would be great if that number were even higher, it compares to just 5.9 percent of members who engaged in the program after receiving no promotions about the incentives at all.

In all, 41.4 percent of the members who participated in the program attested to completing at least one healthy activity.

There is no doubt a long way to go, but the impact of engagement on this relatively small slice of low-income Brooklyn residents is an encouraging sign. It’s quite clear that when health pans engage with their members and offer them incentives for taking care of their health, those members are much more likely to do so.

Even more encouraging is the fact that this data only examined low-income diabetic members living in Brooklyn. If engagement and incentives were enough to shift behavior in this instance, there is a good chance similar strategies will also work in other regions and with members facing other various chronic conditions.

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