Gianna Kinsman, 2015 GHLI Fellow
This summer, living in St. Croix studying the challenge that non-communicable diseases pose to the United States Virgin Islands, I soon observed the carbohydrate- and fat-rich local diet that often includes bread, macaroni, pate, or yams. The reality of having to ship most goods to the islands by plane means that produce, like other healthful, perishable food, expires quickly. Many of the restaurants are fast food chains that also provide high fat foods which further impacts my areas of study — diabetes and hypertension.
Since the individual insurance mandate of the Affordable Care Act does not apply, USVI expanded Medicaid rather than establishing an insurance exchange, but nearly one third of the population remains uninsured. Even to insured citizens, health care costs can pose a significant problem. Although many educational programs about diabetes exist, efforts to implement such a program in the USVI have failed due to a lack of funding and because most citizens cannot afford repeated copays to attend classes. During my time in the USVI as a GHLI Fellow, I hope to help the delegation rectify challenges such as this and other NCD issues.
While working with Frederiksted Health Care and Governor Juan F. Luis Hospital & Medical Center, I collected data on patients with diabetes and hypertension, and also interviewed providers about existing options for management of diabetes and hypertension on the islands. From these interviews, I learned about past community-level programs to educate patients on diabetes management, the burgeoning development of a unified electronic health record, and initiatives to improve overall patient health and the patient-provider relationship, such as brown-bag medication reviews.
I’m enjoying my stay in the USVI and found my role as fellow rewarding as I help my delegation develop a strategy to reduce the prevalence of advanced complications of these widespread NCDs.