The Indiana University Diabetes Impact Project Is Aiding Local Communities

AMERICAN DIABETES DAY Day is March 24. But in the neighborhoods where Lisa Staten works—Haughville, Millersville, Stringtown, Crown Hill, and others—diabetes risk isn’t just something the residents may hear about in passing. It is a part of their daily lives, like a grating background noise that’s there 365 days a year.

“If you got the people in these neighborhoods together in a room and asked them to raise their hands if anybody in their families had diabetes, every single hand would go up,” Staten says.

Which is why she’s there with them. Staten, an associate professor at the Indiana University Indianapolis Fairbanks School of Public Health, is principal investigator for the Diabetes Impact Project—Indianapolis Neighborhoods (DIP-IN). That’s an ambitious, yearslong effort to help three Indianapolis urban residential areas, all with above-normal levels of diabetes, get the grassroots intervention needed to blunt the impact of the disease on the lives of the people who live there. Indiana has a statewide adult-diagnosed diabetes rate of 11.2 percent, on track with the national stat of 11.3 percent. However, the rates in the three areas DIP-IN focuses on (termed the Northeast, Near West, and Near Northwest, each of which comprises several distinct neighborhoods) are around 60 percent higher than that.

Staten earned her leadership position thanks to the years she spent working on diabetes prevention efforts along the United States-Mexico border in communities where lack of transportation, economic instability, and a dearth of access to fresh, healthy foods shape people’s health outcomes long before they ever set foot in a doctor’s office. “Oh, by the way, did you know this is exactly what I did in Arizona?” Staten remembers casually asking the dean of her department at Indiana University. “And the next thing you know, I’m leading the charge.”

DIP-IN wasn’t conceived as a silver bullet campaign that would breeze into target neighborhoods, dispense information from on high, and then disappear when the grant money ran out. From the beginning, Staten didn’t want to just offer temporary face-to-face interventions that shared practical diabetes solutions; she wanted to offer a program that hung around for a while to help those interventions take root. Happily, the original 2026 end date was recently extended by another year, cost-free.

Eli Lilly and Co. provided $12 million to finance the now near-decade-long project, intent on helping curb the disturbing rates of diabetes on its doorstep. By 2018, DIP-IN not only had the funding to proceed but also partners and a general idea of what its founders wanted to do—and what they didn’t, which was to simply parachute into the study areas, plunk down a ready-made plan, and wait for compliance. Instead, Staten and her team began by asking residents whether they wanted to participate in a program of this kind, and if so, what they wanted to get out of it. “We didn’t want to just go over and say, ‘Guess what! We’re coming!’” she recalls. “Instead, we talked with the different communities that we’re working with now and asked, ‘Do you want to be part of this?’” Enough said yes for the project to move forward.

One of DIP-IN’s most innovative approaches is also the most low-tech. In partnership with Eskenazi Health, the program enlisted community health workers who either lived in or were somehow connected to the target neighborhoods to get in touch with diabetes patients who were at risk of not receiving adequate care to get a sense of how they were doing, what issues they were facing, and what the program could do to help them battle the disease.

“The community health worker is someone who serves as a bridge between a community and the medical care it needs,” Staten says. “They notice when prescriptions don’t get picked up, when transportation falls through, when the food money runs out before the month does. And they’re usually an easier person to talk with about these problems than a health care provider.”

Community health workers encourage neighborhood residents to get screened for diabetes, help them understand their blood sugar numbers, and connect them with doctors and clinics. “We really wanted people to be more aware of what their health was like so they could take action on it,” Staten says. “Because you can’t do anything if you don’t know.”

Not surprisingly, prevention is a huge component of DIP-IN, and it follows an equally grassroots strategy there that gradually nudges people toward lifestyles that cut their diabetes risk. “If we just keep putting a Band-Aid on people with diabetes, it’s going to keep going forever,” Staten insists. “Our goal with primary prevention is how to make communities as healthy as possible so it never happens in the first place.”

Locals developed their own  strategies to accomplish this. Each neighborhood formed a steering committee that reviewed, refined, and voted on which projects DIP-IN dollars would support. For example, a few communities prioritized sidewalks so people could more easily take a walk on a nice day, while others rallied around youth projects and bringing fresh produce into food deserts. In short, they established things that would outlive DIP-IN and continue to pay dividends to the community.

In total, local committees have backed more than 80 projects during the program’s run thus far. Some of those, like the new sidewalks and other outdoor amenities, are easy to see. Others are less obvious, such as stress reduction programs, social connection efforts, and new neighborhood organizations that help underserved areas organize and assert their interests, even around topics not directly related to diabetes. “What’s been so inspiring is to see how committed people are to really making their communities the absolute best they can be,” Staten observes.

Sometimes, the work has changed the lives of residents in unexpected ways. Such was the case for Talia Shivers, president of the Arlington Woods Neighborhood Association, who got involved with DIP-IN out of a sense of civic obligation and community pride, not necessarily because she expected diabetes would threaten her personally. Until she got a checkup.

“I was surprised to be diagnosed with pre-diabetes,” she says. “It was like a full circle moment for me. I was glad that I was already participating in the program, because I knew a lot of the things that I needed to do to try to get out of the danger zone.” She made diet and lifestyle changes and worked with her physician, leaning hard on information she’d already received from DIP-IN. “I was able to get out of being in the pre-diabetic range, and I haven’t been in it since,” she shares.

Her neighborhood, like others in the program’s purview, spent years without a full-service grocery store. Shivers says DIP-IN helped bring in local growers and garden-to-table initiatives to bridge the fresh food gap until a grocery store finally opened in Arlington Woods.

With nearly 18 months still to go, Staten reflects that the program so far has been a success, “just by raising people’s awareness and providing them with a real solution.” Even so, DIP-IN has always been framed as a limited-run project, now with a fixed sunset date of September 2027, when it’ll come time to crunch the numbers and determine the data-supported effects of DIP-IN—or lack thereof. That makes academics nervous and neighborhood leaders somewhat skeptical. Staten knows that when the project ends, diabetes won’t. Which is why, at this late stage, she talks less about outcomes that attract publicity and more about whether the neighborhoods feel equipped to keep going without outside assistance. “What I wish is that they have some control over what’s happening,” she says. “It’s really about hoping that the things that we put in place continue to thrive.”

In the end, Staten will call the program a definite win even if it only manages to flatten the diabetes rate in the targeted areas. Yet there have been notable knock-on effects. For instance, long-moribund civic associations have sprung back to life in some neighborhoods; in others, residents are talking, getting to know one another, and working together instead of remaining  in isolation.

“That, to me, is the bigger story,” Staten insists.

No one at DIP-IN would argue the city’s diabetes problem has been solved. If anything, the project’s legacy may be that it has convinced people the battle against the disease is theirs to fight—and that they don’t have to do it alone. The project will end, but the many new relationships it birthed, Staten hopes, won’t. 

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