From program to policy: expanding the role of community coalitions.

Background: Diabetes mortality at the United States-Mexico border is twice the national average. Type 2 diabetes mellitus is increasingly diagnosed among children and adolescents. Fragmented services and scarce resources further restrict access to health care.

Bringing health policy issues front and center in the community: expanding the role of community health coalitions.

Background: Systemic, environmental, and socioeconomic conditions create the context in which community members deal with their health concerns. Comprehensive, community-based chronic disease prevention interventions should address community-wide or regional policy issues that influence lifestyle behaviors associated with chronic diseases.

Context: In two communities along the Arizona-Mexico border, community coalitions that administered a comprehensive diabetes prevention and control intervention expanded their membership to become policy and advocacy coalitions with broad community representation.

Special action groups for policy change and infrastructure support to foster healthier communities on the Arizona-Mexico border.

As part of efforts to help stem the rising tide of diabetes among Hispanic Americans living in Arizona-Mexico border communities, the Border Health Strategic Initiative was launched to foster community-based approaches to diabetes prevention and control. A major thrust of the initiative was establishment of special community action groups (SAGs) to help stimulate policy change and sustain interventions designed to reduce the risk of diabetes and its complications. The SAGs met regularly for more than two years, focusing primarily on policies that encourage development of an infrastructure to support physical activity and healthier nutrition.