Long before the coronavirus pandemic put a spotlight on health disparities faced by African-Americans, South Carolinians were plagued by the epidemic of diabetes, which also disproportionately affects vulnerable populations. While there are existing stakeholders hoping to reduce the incidence of diabetes, The Alliance for a Healthier SC is joining with a variety of organizations well-established in the trenches of diabetes care, including BlueCross BlueShield of South Carolina and the Department of Health and Environmental Control, to launch Diabetes Free SC (DFSC), a long-term, multi-million dollar, statewide initiative dedicated to addressing these disparities in care in three strategic directions: improved pregnancy outcomes in women with diabetes; reduced lifelong risk of diabetes in children; and the prevention of diabetes and its complications in adults. The BlueCross Foundation has recently awarded $11.6 million in three- to-five year grants to Prisma Health, the Medical University of South Carolina (MUSC), the Alliance for a Healthier Generation and FoodShareSC to support efforts in each of these categories.
Admittedly, according to Dr. Timothy Lyons, BlueCross’ executive medical director for DFSC, an endocrinologist and professor of medicine at MUSC, the effort is an ambitious undertaking, but one that has enormous quality of life implications and profound economic consequences for health care expenditures in our state.
That’s because, according to the American Diabetes Association (ADA), more than 500,000 adults in the state have diagnosed diabetes while an additional 120,000 are unaware that they have the disease. Another 26,000 people in South Carolina will be diagnosed this year with diabetes. In addition, nearly 35% of the state’s adult population has prediabetes. And, African-Americans have a two times higher death rate from the disease than white adults. Moreover, diabetes is also a significant factor in other conditions such as kidney and cardiovascular disease, which disproportionately affects African-Americans.
In 2017, the most current numbers available, the ADA estimates that the annual cost of care for adult South Carolinians with diagnosed diabetes is estimated at $5.89 billion.
Lyons said, “The three strategic directions will run concurrently with detailed tactics employed to meet established success metrics. Improvement will be measured in multi-year increments.”
Here are high-level examples of DFSC’s goals:
To improve pregnancy outcomes in women with diabetes, the DFSC initiative expects to reduce unplanned hospital admissions for pregnancy complications by 50%.
To reduce lifelong risk of diabetes in children, the DFSC initiative expects to establish at least one evidence-based intervention in every school district in South Carolina to reduce risk of diabetes in students.
To prevent diabetes and its complications in adults, the DFSC initiative expects to demonstrate reduced prevalence of diabetes in a defined intervention population.
According to David Pankau, president and CEO of BlueCross BlueShield of South Carolina, this effort reflects the organization’s commitment to improving the health of South Carolina communities. He said, “We believe that we can play a meaningful role in reducing disparities of care. Our vision for making a difference in this space has been under discussion for a long time. There is even more urgency now as diabetes brings additional risk in the midst of skyrocketing COVID-19 rates. As we build upon the good work already being done, we are putting a stake in the ground with our commitment.”
Below is the text of the July 2, 2020 open letter to Governor McMaster from the Alliance for a Healthier SC:
Dear Governor McMaster,
We are writing you on behalf of the Alliance for a Healthier South Carolina, a multi-sector partnership of businesses, healthcare providers, public institutions and other organizations working collectively to improve the health and well-being of our state.
We appreciate the work of accelerateSC and everything your administration is doing to get our economy moving again. As you know, the wearing of masks is now being heralded as a key strategy to salvage the U.S. economy in the face of additional lockdowns. According to recent findings from Goldman Sachs, a national mask mandate could help the U.S. avoid a 5% hit to GDP. The Alliance believes the most effective way to support the reopening of more South Carolina businesses is to promote social distancing and the wearing of masks statewide and thereby slow the spread of COVID-19. We understand your focus on urging all South Carolinians to participate and we want you to know the Alliance stands ready to help.
The Alliance works to ensure that all South Carolinians have equal access to care and equal opportunity to resources and policies that support healthy living. While several of the state’s major metropolitan areas like Charleston, Columbia and Greenville have passed mask mandates within their city limits to protect local citizens, there are many rural, unincorporated areas throughout South Carolina that will not benefit from those policies. This is yet another example of how social demographics have adversely impacted underserved communities in the fight against COVID-19.
It has been reported across the nation that low-income areas and communities of color have been hit especially hard by COVID-19, and South Carolina is no different. While African Americans make up 27% of the state’s population, reports have shown they account for more than 50% of South Carolina’s deaths from COVID-19. Statewide mask-wearing would ensure that all communities have the best available protections against this deadly virus – especially rural areas with socioeconomic challenges.
We would be happy to meet with you anytime to talk about how we can work together to improve the health of all South Carolinians. We want to work with you to encourage all South Carolinians to wear masks in public. If you know of ways we can support this effort, please let us know.
Juana S. Slade, CDM Monty Robertson, MHA
Chief Diversity Officer, AnMed Health Director, Alliance for a Healthier SC
Chair, Alliance for a Healthier SC
We, as members of the Alliance for a Healthier South Carolina, came together over 8 years ago with a collective commitment to align our efforts to improve the health and wellbeing of everyone in South Carolina. This commitment was built on the foundation of pursuing health and racial equity together. However, recent events have placed a bright light on the racial inequities and social injustices that have resulted in much poorer health and quality of life for people and communities of color. The COVID pandemic has disproportionately impacted African American and Latino people, with a markedly higher death rate in the black communities in both SC and the nation. Now, we have witnessed the senseless killings of George Floyd, Breanna Taylor and Ahmaud Arbery by people in positions of power resulting in protests and demonstrations across the country, including several SC cities. While we do not condone the violence and destruction of lives and property that have occurred in the wake of these protests, we have to acknowledge that the health inequities and social injustices due to systemic and institutional racism can no longer be accepted or tolerated.
As key public and private sector leaders in the state, it is time for us to stand up together with the people and communities in SC most impacted by these injustices and say, NO MORE.
- NO MORE to not openly acknowledging structural and institutional racism and associated racial biases as the root causes of major health, education and economic disparities for communities of color across SC;
- NO MORE just talking solely about pursuing health equity, but also take and encourage meaningful action at the policy, program and practice levels to achieve racial equity and justice;
- NO MORE taking actions to and for communities of color but rather work with
those communities as equal partners in identifying and implementing solutions;
- NO MORE accepting racial disparities in health and wellbeing as inevitable, but rather embrace that these disparities are preventable by speaking with one voice and taking action with one purpose- a healthier SC for all.
This day, we renew our common commitment to achieving health equity, racial equity and social justice across our state. We will not rest until every person and family in SC, regardless of the color of their skin or where they live, learn, work or worship, have the opportunity to achieve their optimal level of health and wellbeing.
Juana Slade, Chair, Alliance for a Healthier SC
Monty Robertson, Director, Alliance for a Healthier SC
Below is the text of the op-ed by Alliance chair Juana Slade that was printed in the Greenville News and the Anderson Independent-Mail.
As an administrative leader at one of South Carolina’s hospital systems, I am humbled and inspired by the brave frontline health care workers across our state who continue to care for patients every day in the face of COVID-19. They are the true heroes of this pandemic.
I’m honored to support them as chief diversity officer and director of diversity and language services at AnMed Health, a role that has provided me with a unique perspective on how this virus is disproportionately impacting communities of color.
It has been reported in areas across the country and recognized by the U.S. Surgeon General that African American and Hispanic/Latin communities have been hit especially hard by COVID-19. And South Carolina is no different.
While the African American population makes up just 27% of our state and 36% of confirmed cases, 57% of South Carolina’s deaths from COVID-19 have been African American. This statistic speaks specifically to the health status that often persists in marginalized racial and ethnic minority communities and serves as a stark reminder of the health inequities that we must work together to address.
For me, conversations that have been brought to light about racial health disparities in the wake of COVID-19 are nothing new. As a member and now chair of the Alliance for a Healthier South Carolina, I know that this virus is only holding up a mirror to inequities that have existed in our state for far too long.
From 2010-2013, a diverse cross-sector group of state leaders came together to address social determinants that often result in higher health care costs and worse outcomes for vulnerable communities. In 2014, the Alliance for a Healthier South Carolina was officially established as the nation’s first public-private partnership dedicated to coordinating action on shared goals for all people in the state.
In 2020 we’ve doubled-down on our commitment to addressing racial and socioeconomic health disparities by releasing South Carolina’s first health equity action plan. This five-year road map provides collaborative strategies to build awareness of the root causes of health inequities and to support systemic policy changes that remove barriers to health for our most vulnerable citizens.
The Alliance for a Healthier South Carolina is a based on a “collective impact” model that recognizes that no single organization has the ability to solve any major social problem at scale by itself. That’s why we applaud and support recent efforts by Rep. Rosalyn Henderson-Myers and other legislative leaders who are requesting that the state establish a Minority Health Task Force so that we can work together to improve health and well-being in our minority communities.
While COVID-19 will continue to be a trove of lessons learned for health care providers and countless other industries, we cannot overlook what the data are telling us about how this virus disproportionately impacts our most vulnerable South Carolinians – and how it exposes racial and socioeconomic health disparities that have long impacted our state.
The Alliance for a Healthier South Carolina is committed to advancing health equity and is ready to partner with state leaders on a plan to make it happen.
Juana Slade is chief diversity officer and director of diversity and language services at AnMed Health and 2020 chair of the Alliance for a Healthier South Carolina.