Chronic Disease


Diabetes is one of the leading causes of death and disability in the United States. Through federal funding, all 50 states and the District of Columbia receive funds to support chronic disease prevention programs, including diabetes control programs. State chronic disease or diabetes plans identify priority areas for action around prevention, identification, and control of diabetes. States can strengthen diabetes prevention and control efforts by leveraging a systems framework adapted from the ASTHO Million Hearts State Learning Collaborative. ASTHO aims to support state efforts by strengthening key systems change levers including policy and financing change, data-driven action, and evidence-based programs.

Innovative State Strategies for Diabetes Prevention

A comprehensive ASTHOConnects webinar that featured three state case studies on innovative diabetes prevention initiatives. Two came from Illinois and Texas, discussing their activities as part of ASTHO’s diabetes prevention project supported by Merck, and a third came from Rhode Island’s implementation of the ASTHO President’s Challenge on building healthy and resilient communities. This webinar also featured an ASTHO staff presentation on Healthy People 2030 and what this decade will look like for diabetes prevention and control across the country.

Access the slide deck.

ASTHO Diabetes Demonstration Project


ASTHO convened a demonstration project from December 2016-August 2017 with two states, Illinois and Nevada. Through the demonstration project, ASTHO worked with state teams and their multi-sector stakeholders to develop a Diabetes Action Plan incorporating data-driven action, multi-sector partnerships, evidence-based programs, community-clinical linkages, financing, and policy change. ASTHO hosted a national webinar in December 2017 to highlight the states’ progress.

Key Findings: How State Health Agencies Can Support Diabetes Prevention and Control Initiatives

ASTHO compiled key findings of best practices and promising strategies for state and territorial health agencies to consider in their diabetes prevention and control efforts. The findings demonstrate the strengths of public health and highlight areas where state and territorial health agencies can coordinate and integrate with healthcare partners and other stakeholders.

Case Studies

These state case studies document how broad systems initiatives to improve diabetes prevention and control are translated, implemented, and measured across the state and local communities.

Oregon Works to Improve Type 2 Diabetes Metrics through Legislation and Strategic Partnerships
As part of Oregon’s approach to reduce the burden of obesity, diabetes, and other chronic diseases, the state has developed and incentivized new healthcare delivery systems such as coordinated care organizations, shifted state-provided insurance programs to value-based payment methods, and funded the development of closed-loop referral systems to evidence-based self-management programs. Read the case study »

North Dakota Improves Diabetes through a Cross-sector Approach to Prevention and Commitment to High-Quality, Guideline-based Care
This case study describes North Dakota’s strategy to strengthen systems for diabetes prevention and control. The sections provide background, key partners, pillars of approach, outcomes, spread and sustainability, next steps, lessons learned and recommendations. Read the case study »

America's Diabetes Challenge

America’s Diabetes Challenge: Get to Your Goals is an initiative from Merck, the American Diabetes Association, and iHeart Media that urges people with type 2 diabetes to commit to working with their doctors on setting and reaching their A1C (average blood glucose over the past 2-3 months) goals. The program also encourages people to learn about low blood glucose (hypoglycemia) risk assessment and reduction.

ASTHO's Diabetes Toolkit

ASTHO has compiled tools and resources from states, national organizations, and federal agencies to drive the work of states and territories toward reducing the burden of diabetes. Click each lever in the image below (i.e. Policy Change, Data-driven Action) for resources and strategies for lowering the incidence of diabetes in your state.

Click each policy lever in the image below (i.e. Policy Change, Data-driven Action) for resources and strategies for lowering the incidence of diabetes in your state.