Asssigment

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Health Problem Proposal

Antonio Estremera

Florida National University

Health Promotion & Role Development in Adv. Nursing Practice

Dr. Nora Hernandez-Pupo

May 17, 2025

Health Problem Proposal

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder marked by insulin resistance and the inability of the body to effectively regulate blood glucose levels. It presents a major public health challenge due to its rapidly increasing prevalence and significant impact on mortality and morbidity. T2DM typically leads to severe complications, including cardiovascular disease, kidney impairment, blindness, and peripheral neuropathy. Complications drain medical systems and reduce the quality of life for tens of millions of people worldwide. Despite the treatable nature of T2DM through lifestyle modification and timely interventions, inequality in receiving education, resources, and treatment accelerates its spread and prevalence, particularly in low-income and minority populations and the underserved. Identification and management of T2DM in global, national, and local settings are key components of sound public health planning and health equity promotion.

Global Relevance of Type 2 Diabetes

Globally, the prevalence of Type 2 Diabetes has reached startling proportions. According to the International Diabetes Federation (IDF), in 2021, close to 537 million adults aged 20–79 years had diabetes worldwide, and the number is estimated to increase to 643 million by 2030 and 783 million by 2045 (Yameny, 2024). This rising phenomenon is attributed to fast-paced urbanization, less active lifestyles, poor diets, and aging populations. Most of these cases are categorized as T2DM. Low- and middle-income nations have the highest burden, with close to 75% of all cases of diabetes across the world. For instance, in the Western Pacific countries of China and India, T2DM prevalence has experienced rapid rises in line with economic progress and diet and lifestyle changes (Sun et al., 2022). Additionally, diabetes takes the lives of more than 6.7 million people yearly, further emphasizing the global public health issue it poses and the demand for concerted prevention efforts and policy responses.

Aside from the human impact, T2DM has huge economic implications for global healthcare. IDF estimates global health expenditure on diabetes at USD 966 billion in 2021, representing 316% growth in the last 15 years (Recica & Naumovska, 2024). These costs stem from hospitalizations, complications management, and long-term care, often consuming significant portions of national health budgets, especially in resource-constrained settings. Thus, tackling T2DM requires international collaboration, investment in primary care infrastructure, and widespread public health campaigns focusing on prevention and lifestyle interventions.

National Relevance in the United States

In the United States, T2DM is one of the most prevalent chronic diseases. According to Chen et al. (2025), over 37.3 million Americans had diabetes in 2022, and about 90–95% of these cases were type 2. Additionally, around 96 million adults were identified as having prediabetes, placing them at high risk for developing T2DM. The economic impact is substantial, with total direct and indirect costs of diagnosed diabetes reaching $327 billion in 2017, a number that continues to grow (Khavjou et al., 2024). T2DM is also a leading cause of kidney failure, lower-limb amputations, and adult blindness in the United States.

The burden of T2DM is not evenly distributed across populations. Non-Hispanic Black, Hispanic, and Native American communities exhibit disproportionately higher prevalence rates due to systemic social and economic inequalities, limited access to healthcare, and cultural or behavioral risk factors. For instance, the CDC reports that American Indian and Alaska Native adults are 2.5 times more likely than white adults to have diagnosed diabetes. The disparities stem from structural determinants, which include poverty, food insecurity, and insufficient access to preventive care. The statistics demonstrate the urgent requirement for diabetes prevention and management strategies, which must be culturally appropriate to address both behavioral and social determinants of health.

Local Relevance and Community Perspective

The T2DM prevalence and outcomes between different communities across the nation become evident through the example of Los Angeles County. The Centers for Disease Control and Prevention (2024) reports that 10% of Los Angeles adults have diabetes, while another 30% show signs of prediabetes. The diabetes prevalence in low-income areas reaches higher levels, particularly among Latino and Black communities. The South Los Angeles area, which serves as a historically underserved community, reports a diabetes diagnosis rate of 20%, which exceeds the county average by half. The population faces multiple obstacles to healthcare access because they lack insurance coverage, experience transportation problems and language challenges, and have restricted access to nutritious food choices. The Los Angeles community health assessments reveal that diabetes patients receive insufficient disease management education while experiencing delayed medical diagnoses because they infrequently visit healthcare facilities (CDC, 2024). Public health initiatives such as mobile health clinics, culturally competent health educators, and partnerships with local organizations have been launched to address these gaps. However, these efforts remain underfunded and fragmented. To mitigate the impact of T2DM locally, consistent investment in community-based health promotion programs, early screening, and chronic disease self-management education is essential.

Justification for Multilevel Health Promotion Strategies

Global, national, and local data evidence indicates that Type 2 Diabetes Mellitus needs comprehensive health promotion strategies at multiple levels. Health systems worldwide must invest in early detection, universal healthcare access, and international partnerships to promote healthy lifestyles. U.S. policymakers must tackle structural inequalities and boost preventive service funding nationally, particularly for marginalized communities. Local outreach programs combined with education campaigns that respect cultural backgrounds will enable people to choose better health options, receive timely care, and effectively manage their condition. A unified response between health systems and governance levels will decrease T2DM prevalence while minimizing this disease's avoidable human and economic costs. Reducing T2DM outcome disparities is a medical necessity and a moral and social requirement to achieve health equity and quality of life for everyone.

References

Centers for Disease Control and Prevention. (2024). National Diabetes statistics report. Diabetes. https://www.cdc.gov/diabetes/php/data-research/index.html

Chen, X., Zhang, L., & Chen, W. (2025). Global, regional, and national burdens of type 1 and type 2 diabetes mellitus in adolescents from 1990 to 2021, with forecasts to 2030: a systematic analysis of the global burden of disease study 2021.  BMC medicine,  23(1), 48. https://doi.org/10.1186/s12916-025-03890-w

Khavjou, O. A., Sun, M., D’Angelo, S. R., Neuwahl, S. J., Hoerger, T. J., Cho, P., ... & Zhang, P. (2024). Economic Costs Attributed to Diagnosed Diabetes in Each US State and the District of Columbia: 2021.  Diabetes Care, dc240832. https://doi.org/10.2337/dc24-0832

Recica, V., & Naumovska, Z. (2024). Diabetes in the Republic of North Macedonia: epidemiology and economic burden, 2018-2021.  Archives of Public Health,  16(1). https://doi.org/10.3889/aph.2024.6117

Sun, P., Wen, H., Liu, X., Ma, Y., Jang, J., & Yu, C. (2022). Time trends in type 2 diabetes mellitus incidence across the BRICS from 1990 to 2019: an age-period-cohort analysis.  BMC Public Health,  22, 1-14. https://doi.org/10.1186/s12889-021-12485-y

Yameny, A. A. (2024). Diabetes Mellitus Overview 2024.  Journal of Bioscience and Applied Research,  10(3), 641-645. https://doi.org/10.21608/jbaar.2024.382794