title: The State of Diabetes Prevention Policy in the USA Following the Affordable Care Act.
abstract: Type 2 diabetes is a major public health problem in the USA, affecting over 12 % of American adults and imposing considerable health and economic burden on individuals and society. There is a strong evidence base demonstrating that lifestyle behavioral changes and some medications can prevent or delay the onset of type 2 diabetes in high risk adults, and several policy and healthcare system changes motivated by the Patient Protection and Affordable Care Act (ACA) have the potential to accelerate diabetes prevention. In this narrative review, we (1) offer a conceptual framework for organizing how the ACA may influence diabetes prevention efforts at the level of individuals, healthcare providers, and health systems; (2) highlight ACA provisions at each of these levels that could accelerate type 2 diabetes prevention nationwide; and (3) explore possible policy gaps and opportunity areas for future research and action.
authors.affiliation: Preventive Medicine Residency, Cook County Health and Hospitals System, 1900 W Polk Street, Room 901, Chicago, IL, 60612, USA.
authors.forename: Juleigh Nowinski
authors.initials: JN
authors.lastname: Konchak
authors.affiliation: Department of Medicine, Feinberg School of Medicine, 750 N. Lake Shore Drive, Suite 680, Chicago, IL, 60611, USA.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Moran
authors.affiliation: Department of Medicine, Feinberg School of Medicine, 750 N. Lake Shore Drive, Suite 680, Chicago, IL, 60611, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: O'Brien
authors.affiliation: Department of Medicine, Feinberg School of Medicine, 750 N. Lake Shore Drive, Suite 680, Chicago, IL, 60611, USA.|American Medical Association, Improving Health Outcomes, 330 N Wabash, Chicago, IL, 60611, USA.
authors.forename: Namratha R
authors.initials: NR
authors.lastname: Kandula
authors.affiliation: Department of Medicine, Feinberg School of Medicine, 750 N. Lake Shore Drive, Suite 680, Chicago, IL, 60611, USA. r.ackermann@northwestern.edu.
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Ackermann
mesh_terms: D003695:Delivery of Health Care; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D006801:Humans; D008019:Life Style; D058991:Patient Protection and Affordable Care Act; D012307:Risk Factors
keywords: Affordable Care Act; Diabetes; Health policy; Prediabetes; Primary prevention