In the last post, we reviewed the reasons for much lower heart disease rates in Minnesota compared with other states. Some counties in Minnesota have heart disease death rates that are one fourth that found in some counties in other states. But as you can see in the picture above, even in Minnesota, there is lots of variation in death rates from heart disease depending on where you live. Look at the upper left part of the diagram. The darker the county, the more people are dying each year from heart disease. You can see easily that the darkest counties are in Northwest Minnesota. Now let’s look at optimal diabetes care performance in Minnesota.
This map is very revealing. The highest rates of optimal diabetes care are in the Southeastern parts of the state where heart disease deaths are low. The lowest rates of optimal diabetes care are in Northwest Minnesota which is rural. The lowest best practice diabetes care in the state almost precisely overlays the Native American reservations in the state and there is a Indian Health Service regional office in Bemidji. Check out this map below.
This is how data and measurement help. Native Americans have much higher rates of heart disease deaths compared with other communities in our country. Their diabetes related mortality is three times greater. Their longevity is five years shorter than other Americans and they have the highest rates of diabetes in the country at almost 15%. Twenty-one percent of Native Americans have diabetes in the Southwestern US. Over three times as many Native Americans die of diabetes compared with the rest of us.
The increased heart disease death rate in Northwest Minnesota is probably due it’s rural status and increased population of Native Americans. We can fix this! Increased OMT performance can be achieved in rural communities and in other settings by nurse practitioners with the support they need to provide it. It is time to make high level OMT performance available to all Americans! How can we ethically continue our current system which condemns too many Americans to premature death and disability when we have a clear path to improvement?
The importance of collecting accurate data - and then comparing data for one disease with another. Very revealing.