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Thursday, February 09, 2006New York City will create a registry of glycosylated hemoglobin test results - an estimated 1 million to 2 million results per year - that is linked to identifying information about the patients and about the physicians who ordered the test. The data will include the full name, date of birth, and address of the person tested and the date the test was performed. The registry, which will be funded by the health department, will be used to map the epidemiology of hyperglycemia and to monitor the epidemic. Says Frieden: 'We should know how many New Yorkers have diabetes that is badly out of control, where they are, and who cares for them. This knowledge should be very powerful for assessing how we are doing on a population basis and in reaching out to doctors and, through doctors wherever possible, to their patients to provide more support.' Starting in July 2007, the department also hopes to implement and evaluate a pilot intervention program in the South Bronx, which would be funded through grants. Eventually, there may be additional uses for the registry data. In other words, not only will diabetes be a reportable disease in New York City, it'll be a state-monitored one. Having done a good job of curbing the spread of infectious disease, public health officials are expanding out to other diseases. Their goal, apparently, to eventually eliminate death: The endeavor has aroused concern about patients' privacy and raised questions about the role of health departments. However, Thomas Frieden, the city's health commissioner, said the aim is to respond to an epidemic of a chronic disease with the type of surveillance and other tools that health departments routinely use to prevent and control communicable diseases. As he explained in an interview, "We have to get a better handle on what is really the only major health problem in the United States that is getting worse, and getting worse rapidly." There are an estimated 530,000 adults in New York City with diagnosed diabetes. About 9 percent of adults report having received a diagnosis of diabetes; in the South Bronx, the prevalence of diagnosed diabetes is 18 percent. When it comes to chronic diseases, says Frieden, public health officials have been "asleep at the switch." His view, as expressed in a 2004 editorial in the American Journal of Public Health, is that "local health departments generally do a good job of monitoring and controlling conditions that killed people in the United States 100 years ago. Yet noncommunicable diseases, which accounted for less than 20 percent of U.S. deaths in 1900, now account for about 80 percent of deaths. Our local public health infrastructure has not kept pace with this transition. Color me unconvinced. There's a vast difference between an communicable disease that spreads from person to person and thus causes a public health threat and a disease that remains in one person's body, largely under that one person's control. And the state has no business intefering in the latter. Where's the "keep your laws off my body" outrage? posted by Sydney on 2/09/2006 09:41:00 AM 9 comments 9 Comments:Although my libertarian parts of self are aghast that I'm saying this, it is a valid arguement that if the state is paying the costs of treating an illness or its sequella, then the state can claim the need to monitor and reduce the costs of such treatment. "He who pays the piper calls the tune." The tricky part is the balance between public health and individual liberties. I don't pretend to have an answer for that one. Another slippery slope to tread.
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But does the state pay all of the bills. This law will require all diabetics to be registered and subject to State control for their treatment.
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'Eventually, there may be additional uses for the registry.'
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Anonymous- Perhaps this is perpetuating another bureaucracy that should be allowed to die. Two weeks ago, I had a university MPA tell me that the cardinal rule of public health is never, ever stop or cut back a program.
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'Eventually, there may be additional uses for the registry.'
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I love the line about stopping death! I am absolutely amazed that people just do not get that people DIE!! They do- young old and in between. Some have no risk factors and die well before they should on paper. SOme have tonnes of them, and never stop living well into their nineties. And then the rest muddle in the middle somewhere. The words from an old song come to mind- Did you ever think as the hearse goes by, that you might b the next to die, they'll put you in a long white box, and there you will whither and decay and rot
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The fact is that neither the State nor the City of New York are incurring any major costs to care for diabetes. Bt the way, those concerned that this registry is being implemented without any challenge should rest assured. A website is already available at: www.stopnyca1crtracking.org.
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