Of 999 people who underwent free biometric screening for diabetes at Wal-Mart stores in five small towns between late September 2007 and early March 2008, many were found to be at high risk for the disease.
In fact, 78% of the participants had high blood pressure (greater than 140/90 mm/Hg), 56% had high cholesterol (greater than 240 mg/dL), and 41% had elevated blood glucose (greater than 101 mg/dL). In addition, 71% of participants were obese (26%-34% body fat measurement in men, 32%-39% in women) or morbidly obese (35% or more body fat for men, 40% or more for women).
“There were cases where a person's blood pressure was so high that we had to say, 'You probably should go to an emergency room today,' which was a reminder of how serious some of the health issues were,” Joe Quinn, senior director of state health care policy for Wal-Mart Stores Inc., based in Bentonville, Ark., said in an interview.
The screenings were one component of a diabetes awareness program that targets communities in the Delta Regional Authority, a federal-state partnership that serves 240 counties and parishes in parts of Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee. The events included free biometric screenings, free blood pressure screenings, and other health information.
The program illustrates several important points, said Dr. Donald A. Bergman, past president of the American Association of Clinical Endocrinologists (AACE) and a creator of AACE's Power of Prevention program. “First, people are ready for a change in the way they view health care,” he said. “Those attending this screening wanted to see if they had a medical problem before they were symptomatic; this means that people are ready to spend the time preserving health rather than restoring health. Second, this project shows that many people are very unhealthy and are not being identified before they become ill. And third, this project demonstrates that when business professionals and health care professionals join together, large numbers of people can be helped by early intervention.”
The program got started in 2007, when the Wal-Mart Foundation provided a gift of $500,000 to the Delta Regional Authority in support of its Healthy Delta diabetes initiative (http://www.healthydelta.com
The partnership kicked off in late September 2007 with a series of radio and television ads that ran in the eight-state region. The ads urged people with clinically confirmed diabetes—as well as people who thought they might have diabetes—to call a toll-free number for more information about management of the disease.
People who called the toll-free number spoke to a bilingual diabetes expert who asked the caller to answer questions from the American Diabetes Association Risk Test. The caller was then offered a free diabetes kit with a brochure called “Taking Control of Your Diabetes,” which included advice about how to talk to a physician or pharmacist about diabetes, as well as a list of affordable medications.
The diabetes experts followed up with the callers by phone at 60 and 120 days to check on their health status, asking questions such as: Are you getting some exercise? Have you changed how you're eating based on our previous conversation? Have you seen a physician? This same follow-up was offered to people who attended the health fairs.
Mr. Quinn likened the program to smoking cessation models in the United States. “What the person with diabetes really needs is someone to talk to on a regular basis—someone to remind them that there are behavior or diet changes that can play a large role,” he explained. “We're all aware that a busy physician in a small town has incredible demands on his time. So if there are other venues that are reminding people about healthy behavior, that certainly is a place where we can help.”
As of early March, 2,598 people—47% of them African American—have enrolled in the program, including 1,593 callers previously diagnosed with diabetes. In addition, 671 callers have received a free blood glucose monitoring kit.
Results of the biometric screening tests on 999 people who attended the first five health fairs were “somewhat worse” than what Mr. Quinn and his associates expected in terms of the high incidence of high blood pressure, elevated cholesterol rates, obesity, and high BMI.
“The Saturday morning health screenings in a Wal-Mart parking lot reinforce what most of us in America know right now: that wellness has to become part of the national health care discussion,” Mr. Quinn said. “The results we saw when we screened people backed that up and underlined the value of projects like this.”