From time to time, most strategic grant-making organizations review their programmatic priorities, assessing the needs and opportunities in a given area and figuring out what role a foundation could play in it. When the New York State Health Foundation’s (NYSHealth’s) board and staff began reviewing its strategic priorities in 2014, we grappled with how we could have the most impact given our modest resources. (Our annual grants and operations budget is approximately $15 million—a modest sum in a state expected, by 2020, to spend more than $300 billion annually on health care!)
One question for us was how best to tackle challenges outside of the medical care delivery system that have an impact on New Yorkers’ health. Doing so meant taking a hard look at our work to address the diabetes epidemic to see whether we were targeting the right populations to achieve the most impact.
An important priority for NYSHealth since our inception in 2006 had been reducing the toll of Type 2 diabetes in New York State. We singled out this type of diabetes (which primarily affects adults) for two key reasons: (1) its incidence and prevalence were increasing (while for some other chronic conditions, like asthma, rates were actually declining) and (2) it could be both prevented and managed, so we could use both community-based and clinical interventions.
Initially, we focused most of our attention on improving primary care and outcomes for patients with diabetes. By the end of 2013, we had helped more than 3,000 health care providers achieve National Committee for Quality Assurance (NCQA) recognition for excellent diabetes care and outcomes; these providers care for approximately 600,000 of the 1.8 million New Yorkers with diabetes.
We felt good about our clinical work, but we also saw needs and opportunities for the prevention—not just treatment—of diabetes. The need is great: more than 4 million New Yorkers have prediabetes, a condition that puts them at high risk for developing diabetes and its complications (including cardiovascular disease, kidney disease, nerve damage, and complications with their eyes and feet). And a key opportunity is to ensure that more New Yorkers with prediabetes have access to the National Diabetes Prevention Program (NDPP), a lifestyle modification program that has been shown to help participants lose 5–7 percent of their body weight and reduce their risk of developing diabetes by 50 percent.
One question for us was how best to tackle challenges outside of the medical care delivery system that have an impact on New Yorkers’ health. Doing so meant taking a hard look at our work to address the diabetes epidemic to see whether we were targeting the right populations to achieve the most impact.
An important priority for NYSHealth since our inception in 2006 had been reducing the toll of Type 2 diabetes in New York State. We singled out this type of diabetes (which primarily affects adults) for two key reasons: (1) its incidence and prevalence were increasing (while for some other chronic conditions, like asthma, rates were actually declining) and (2) it could be both prevented and managed, so we could use both community-based and clinical interventions.
Initially, we focused most of our attention on improving primary care and outcomes for patients with diabetes. By the end of 2013, we had helped more than 3,000 health care providers achieve National Committee for Quality Assurance (NCQA) recognition for excellent diabetes care and outcomes; these providers care for approximately 600,000 of the 1.8 million New Yorkers with diabetes.
We felt good about our clinical work, but we also saw needs and opportunities for the prevention—not just treatment—of diabetes. The need is great: more than 4 million New Yorkers have prediabetes, a condition that puts them at high risk for developing diabetes and its complications (including cardiovascular disease, kidney disease, nerve damage, and complications with their eyes and feet). And a key opportunity is to ensure that more New Yorkers with prediabetes have access to the National Diabetes Prevention Program (NDPP), a lifestyle modification program that has been shown to help participants lose 5–7 percent of their body weight and reduce their risk of developing diabetes by 50 percent.
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