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$2 million grant spurs new effort to fight diabetes

by Jon Weiner

The Keck School of Medicine and Childrens Hospital Los Angeles will begin a new initiative to identify and address the interrelated factors that lead to obesity and diabetes in East Los Angeles and South Los Angeles.

Organizers announced the initiative at a press conference at the Edward Roybal Comprehensive Health Center in East Los Angeles on June 9.

The Keck Diabetes Prevention Initiative will begin its work with a $2 million grant from the W.M. Keck Foundation to support a two-year planning process to identify the factors that contribute to decisions about diet, physical activity and health care within these communities, develop strategies to prevent diabetes and promote healthy lifestyle choices that are appropriate for the populations in these communities, as well as engage and mobilize experts, government officials, community leaders, businesses and residents.

The initiative has the support of the Los Angeles County Department of Health Services.

Organizers hope the planning process for the Keck Diabetes Prevention Initiative will lead to an eight-year intervention in partnership with the Edward Roybal Comprehensive Health Center in East Los Angeles and the Hubert Humphrey Comprehensive Health Center in South Los Angeles.

“The number of overweight and obese individuals in the United States has reached epidemic proportions, resulting in serious medical, economic and quality-of-life issues,” said Anne Peters Harmel, professor of medicine at the Keck School of Medicine and director of the USC Clinical Diabetes Program, adding that about 65 percent of the nation’s adult population and 15 percent of its youth are overweight, with nearly one in three Americans considered obese.

While the growing incidence of obesity is a national problem, studies indicate that Los Angeles County is at the epicenter of the problem, with 55 percent of its adult population overweight or obese. The highest rates of adult obesity are found in East Los Angeles, South Los Angeles and the Antelope Valley.

“The increase in obesity is associated with higher mortality rates, and it increases the risk for numerous medical conditions, including type 2 diabetes, stroke, arthritis, coronary heart disease and certain types of cancer,” Harmel said, adding that obese adults are five times more likely to develop type 2 diabetes. Diabetes afflicts 17 million people in the nation and has become the sixth leading cause of death nationwide.

“In the past 25 years, the percentage of children ages 6-11 who are overweight has doubled and the percentage of overweight adolescents, ages 12-19 has tripled,” said Francine R. Kaufman, head of the division of endocrinology and metabolism at Childrens Hospital Los Angeles and director of its Center for Endocrinology, Diabetes and Metabolism. Kaufman is professor of pediatrics at the Keck School of Medicine and the immediate past president of the American Diabetes Association.

Physical fitness test results in 2001 for youngsters in grades 5, 7 and 9 indicated that 40 percent of children in Los Angeles County were either obese or at risk of becoming obese. The fitness tests indicated that children in East Los Angeles and South Los Angeles were more likely to be obese than children in other parts of the county.

“Diabetes is now among the most common chronic diseases of childhood,” Kaufman said. A recent study by the Centers for Disease Control and Prevention predicts that one in three children born in 2000 will develop diabetes during their lifetime.

The Keck School and Childrens Hospital Los Angeles have nationally recognized diabetes programs. Harmel and Kaufman will direct the Keck Diabetes Prevention Initiative.

“This bold initiative will give us the knowledge and experience we need to not only improve the health and well-being of all residents in East Los Angeles and South Los Angeles, but design a viable, sustainable approach that can be replicated in other high-risk communities throughout California and the United States,” said Kaufman.

The Roybal CHC serves the Boyle Heights neighborhood, as well as the unincorporated neighborhoods of City Terrace and East Los Angeles. The population of the area is 173,772, of which 95 percent are Latino.

“Understanding the multiple factors that lead to of obesity and, eventually, diabetes—as well as finding ways to work with the community and individuals to prevent these chronic diseases—is as important to the personal and public health systems in our country as childhood immunizations and sanitation have been in preventing acute infectious diseases,” said Michael Roybal, medical director, Edward R. Roybal Comprehensive Health Center. “The involvement of the County of Los Angeles and the Department of Health Services in this effort is a testament to the significance of these issues.”

The Humphrey Center has a service area that includes the communities of Watts and Athens in South Los Angeles, as well as the unincorporated neighborhood of Florence Firestone; the area has a population of 271,659, of which 42 percent are African-American and 56 percent are Latino.

“Hubert Humphrey Comprehen-sive Health Center serves some of the poorest and most medically underserved populations in Los Angeles County,” said Mayer B. Davidson, principal investigator of the diabetes clinical trials at the Hubert Humphrey Center.

The multidisciplinary nature of the Keck Diabetes Prevention Initiative also will involve other USC graduate schools: the Annenberg School of Communication; the School of Policy, Planning and Development; and the School of Social Work. It will also involve the Division of Research on Children, Youth and Families at Childrens Hospital.

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$2 million grant spurs new effort to fight diabetes

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