BILL ANALYSIS Ó
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SENATE THIRD READING
SCR
134 (Pan)
As Introduced April 25, 2016
Majority vote
SENATE VOTE: 37-0
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|Committee |Votes |Ayes |Noes |
|----------------+------+----------------------+---------------------|
|Health |16-0 |Wood, Maienschein, | |
| | |Bonilla, Campos, | |
| | |Chiu, Lackey, | |
| | |Nazarian, Olsen, | |
| | |Patterson, | |
| | |Ridley-Thomas, | |
| | |Rodriguez, Santiago, | |
| | |Steinorth, Thurmond, | |
| | |Waldron, Gordon | |
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SUMMARY: Urges the California Department of Public Health (DPH)
to endorse the "Screen at 23" campaign to screen all adult Asian
Americans with a body mass index (BMI) of 23 or higher for type
II diabetes. Specifically, this resolution:
1)Finds that approximately 2.5 million Californians, or 9% of
the population, are diagnosed with diabetes, 46% are estimated
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to have prediabetes, and residents of Asian American heritage
compromise 14% of the State of California.
2)Finds that diabetes is the fifth leading cause of death among
Asian Americans.
3)Finds that Asian Americans are 30% more likely to have
diabetes than white Americans and are also at greater risk of
developing prediabetes, diabetes, and associated risks at a
lower BMI than white, Hispanic, Black, or Native Americans.
4)Finds that the per capita health care cost of diabetes in
California is $14,800 per year and the annual cost for
diabetes in California is $37.1 billion, including $27.6
billion in medical costs.
5)Finds that screening Asian American patients at a BMI of 23
instead of 25 would unmask over 67,000 diabetes cases, and
many thousands more prediabetes cases in California, thereby
initiating treatment or early interventions to reduce negative
co-morbidities like heart diseases, kidney diseases, and limb
amputation.
6)Finds that the World Health Organization recommends screening
Asian patients at a lower BMI than non-Hispanic whites, and
the 2015 official guidelines of the American Diabetes
Association recommend that Asian Americans should be tested
for type II diabetes at a BMI of 23.
7)Finds that the Asian American, Native Hawaiian, and Pacific
Islanders (AANHPI) Diabetes Coalition has coordinated the
"Asian BMI" efforts of over 15 national and regional
organizations, culminating in the launch of the "Screen at 23"
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campaign.
8)Urges DPH to endorse and support the "Screen at 23" campaign's
efforts to increase awareness of diabetes among Asian American
communities, including the use of appropriate screening
measures for Asian American patients and to eliminate
disparities; and, urges DPH to encourage all public and
private health providers and facilities to also participate in
these efforts.
FISCAL EFFECT: According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS: According to the author, approximately 2.5 million
Californians, or 9% of the population, are diagnosed with
diabetes; however, Asian Americans are often not screened for
diabetes but are 30% more likely to develop diabetes than white
Americans. The author notes that diabetes is the fifth leading
cause of death among Asian Americans, and since Asian Americans
can develop diabetes at a lower BMI, the current guidelines for
diabetes screening miss 36% of Asian American diabetes
diagnoses, or approximately 116,000 individuals in California.
The author concludes that this resolution raises much needed
awareness to screen all Asian American adults for diabetes at a
BMI of 23 kg/m2 or greater versus the standard 25 kg/m2.
1)Diabetes. Diabetes is a chronic medical condition marked by
high levels of blood glucose (a form of sugar) resulting from
defects in insulin production, insulin action, or both. Type
I diabetes, previously known as juvenile diabetes, is an
autoimmune disease in which the body does not produce the
hormone insulin. Type II diabetes (previously called
non-insulin-dependent diabetes or adult-onset diabetes),
accounts for about 90% to 95% of all diagnosed cases of
diabetes. It usually begins as insulin resistance, a disorder
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in which the cells do not use insulin properly. As the need
for insulin rises, the pancreas gradually loses its ability to
produce it. Gestational diabetes occurs in pregnant women who
have never had diabetes before, but have higher than normal
blood glucose levels during pregnancy. Prediabetes is a
condition in which individuals have blood glucose levels
higher than normal but not high enough to be classified as
diabetes. People with prediabetes have an increased risk of
developing type II diabetes, heart disease, and stroke.
Without intervention, about one out of four people with
prediabetes will develop diabetes within three to five years.
Ethnic minorities and those who are poor or disadvantaged have
especially high rates of diabetes.
2)The California Wellness Plan (Plan). In February 2014, DPH's
Chronic Disease Prevention Branch published the Plan, the
result of a statewide process led by DPH to develop a roadmap
for DPH and its partners to promote health and eliminate
preventable chronic disease in California. The Plan aligns
with the Let's Get Healthy California Taskforce priorities and
includes 26 priorities and performance measures developed in
2012 that are based upon evidence-based strategies to prevent
chronic disease and promote equity. The Plan contains short,
intermediate, and long-term objectives with measurable effects
on a variety of chronic diseases, of which diabetes is a major
focus. The Plan also contains 15 objectives specific to
diabetes, including objectives to increase utilization of
diabetes prevention and self-management programs, as well as
broad objectives to reduce the prevalence of obesity and
diabetes among children and adults. DPH's chronic disease
programs plan to collaborate with local and state partners,
including the Office of Health Equity, that are engaged in
diabetes prevention to implement the objectives. DPH intends
to monitor the progress of Plan objectives and publish regular
reports on outcomes.
3)BMI. According to the Centers for Disease Control and
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Prevention (CDC), BMI is a person's weight in kilograms
divided by the square of height in meters. A high BMI can be
an indicator of high body fat. BMI can be used to screen for
weight categories that may lead to health problems, such as
diabetes, but it is not diagnostic of the body fat or health
of an individual.
The AANHPI Diabetes Coalition are the sponsors of this
resolution and note that over half of all Asian Americans with
diabetes are undiagnosed, according to the National Institutes
of Health and the CDC. AANHPI Diabetes Coalition notes that the
"Screen at 23" campaign is meant to raise awareness and lead to
more diabetes and prediabetes diagnoses of Asian Americans, as
well as promote the understanding that Asian Americans
experience diabetes disparities.
There is no opposition to this resolution.
Analysis Prepared by:
Lara Flynn / HEALTH / (916) 319-2097 FN:
0005004