Team Effort to Help Hispanic Community Members Confront Diabetes

Hoag Health Fairs and Researchers Join Forces to Provide Screenings and Care

At two recent community health fairs sponsored by Hoag’s Community Benefit Program, dozens of Hispanic men and women lined up to take free blood tests to measure their risk of diabetes.

The results were alarming.

Of all those who either received a finger-prick blood test (to assess their average glycemic control) or completed a risk assessment for pre-diabetes, up to 40 percent of individuals were found to have pre-diabetes.

“The numbers are staggering,” says Harsimran Singh, PhD, a health psychologist and clinical research scientist at Hoag’s Mary & Dick Allen Diabetes Center. “Imagine the influx of patients we will see in five to 10 years if and when their pre-diabetes symptoms progress into full-blown diabetes.”

Diabetes was once thought to affect primarily affluent populations. But studies from across the world have consistently shown that minority populations (e.g., Asian, Hispanic, and African American) have a much higher rate and prevalence of the disease.

“We know from previous research that Hispanics are 65 percent more likely to develop diabetes and 45 percent more likely to die from this condition compared to their Caucasian counterparts, said Singh. “In this day and age, and with all the technological and clinical advancements we have access to, these numbers are just unacceptable.”

Singh says the people who were confirmed with high risk for diabetes at the two free events were immediately connected to free and low-cost health services and programs available through the Melinda Hoag Smith Center for Healthy Living.

Michaell Rose, director of Community Benefit at Hoag, says the fact that these people are now receiving potentially life-saving services – ranging from dietary counseling, to free yoga classes, to a health nurse – underscores the critical need for the types of programs Hoag’s Community Benefit Program makes possible.

“Because of these two community health fairs, more than 160 Orange County residents are on the path to healthier lives,” Rose says. “Health fairs like these let residents learn more about their health and ways to improve it in safe, accessible, welcoming settings. This is a critical part of Hoag’s community outreach and our determination to help residents benefit from quality health care.”

Singh, who is a published researcher on patient-reported outcomes in diabetes, says health fairs like the two recent ones play an important role in helping her and other Hoag researchers identify specific at-risk populations in the community and develop interventions to support these populations effectively.

“If we hope to make progress in stemming the tide of pre-diabetes and diabetes in the Hispanic community, we have to gain their trust and meet them where they are,” she says. “When Michaell and the Hoag Community Health team invited me and my colleagues to offer screenings at the health fairs, we jumped at the opportunity.”

Indeed, Singh says she and her colleagues from the Mary & Dick Allen Diabetes Center didn’t want “to leave participants hanging. Michaell and the community organizations at the Center for Healthy Living were the perfect partners, because their involvement enabled us to immediately connect those at risk with Hoag’s wide range of services.”

In addition to basic screening and a blood test – known as an HbA1c test – Singh and her colleagues asked participants several key questions including how secure they felt about their access to nutritious food. One of the questions was, “In the last 12 months, were you ever hungry but didn’t eat because there wasn’t enough money for food?”

The answers were distressing.

Sixty percent said they would be out of food before they received their next paycheck. Almost half said they lacked enough money to purchase an adequate supply of food.

Understanding the inseparable correlation between diet, access to healthful food and diabetes risk is paramount to helping those battling the disease, Singh explains.

“We have to be very thoughtful and creative in our approach when it comes to the subject of diet,” she says. “Right off the bat, people become disengaged when they’re told they should be eating a more balanced diet or fresh, healthy meals — which unfortunately are more expensive and less filling than processed foods. Their budgets simply don’t allow them to buy fresh fruits and vegetables.”

“You immediately lose them from staying engaged because they don’t see it as realistic, and they often come to the conclusion that the health community doesn’t understand their situation.”

Singh and her team are currently leading a formal diabetes study, called “Viviendo Saludable” or “Healthy Living” involving a lifestyle based, psycho-educational intervention specifically designed for Hispanic women with pre-diabetes. The results have been extremely encouraging. The team is currently writing up the results for submission to a peer-reviewed, scientific journal.

To learn more about classes, programs and services offered at Hoag’s Mary & Dick Allen Diabetes Center, as well as patients’ personal stories, visit