Program uses lessons from developing world to fight diabetes at home

A health program in south King County is using lessons learned battling diseases in developing countries to help immigrant communities in SeaTac and Tukwila fight major health problems, such as diabetes.

When Aisha Dahir moved to the United States from Somalia in 1996 her lifestyle changed dramatically. Seattle was a much colder and larger city than her former home, so her family stopped walking from place to place and started driving. Her new community was also filled with processed foods, unlike the whole foods she was used to eating. When Dahir's family needed medical care, they struggled to understand the local health care system.

But today, Dahir is helping other Somali families fight these and other major health challenges as a Community Health Promoter.

In 2006, Seattle King County Public Health reported that south King County residents experience higher rates of several serious health conditions, including diabetes.

In response, public health developed the Global to Local (G2L) program in partnership with Swedish Health Services, Washington Global Health Alliance and HealthPoint to research the programs and technologies being used to improve health care in developing countries and apply those solutions in SeaTac and Tukwila.

"In Washington we are home to some of the leading thinkers on global health," said Adam Taylor, G2L program manager. "There is a great amount of effort put into creative ways to address health disparities around the world, but there have not been a whole lot of efforts to help those under-served at home."

This winter, G2L hired five Community Health Promoters from various immigrant communities in the area to fight the common causes of diabetes - decreased exercise and poor diet. The promoters are not health experts, they are people who are who are deeply embedded in the local Latino, Eritrean, Bhutanese, Burmese and Somali communities.

"We've discovered that the lay person can serve many health needs in their community," Taylor said. "We know they will leverage their experience and relationships to build a healthier community in south King County."

Dahir is member of the Abu Bakr mosque in Tukwila and has also worked as a medical interpreter for Harborview Medical Center.

"People know me," Dahir said. "I cherish that trust. I want to be sensitive to the needs of the community and be respectful of their boundaries."

Though she was hired just four months ago, Dahir is already addressing the cultural barriers that prevent her community members from living healthy lives. After talking to local Somali women, Dahir learned they did not feel comfortable exercising in front of men. She has since organized a gym session just for women at the Tukwila Community Center every Saturday. Dahir also arranged childcare and offers transportation to the community center. In just a month, the sessions are already drawing more than 25 women each week.

"We're providing them with a safe place where they feel comfortable and are able to be themselves and get the same services as everybody else," Dahir said.

Community Health Promoters are also leading cooking classes and monthly "Community Cafes" where local residents can discuss health concerns and propose solutions.

"We don't always have the answers, but in many cases the community does," Taylor said.

G2L is also developing a pilot program that will use mobile technology to fight diabetes. The program will give 250 diabetes patients at the HealthPoint clinic a free mobile phone with an app designed to support people who are fighting diabetes. G2L will then track the users for a year to see if their blood glucose levels decrease.

"We hope to create a model that can be used in other communities," Taylor said. "If we can help people be healthy and reduce other medical services it's good for the health care system and the community."