Addressing Health Inequities in Diabetes Care - Brook’s Chief Medical Officer Dr. Michael Merrill and Head Researcher Dr. Sarah LaPointe Discuss

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Brook's Chief Medical Officer Dr. Michael Merrill, and expert in Diabetes Management

Dr. Michael Merrill, CMO of Brook

"We're fighting this gale force wind of inequality that we can't make go away on our own. We're just trying to compensate for it."

Dr. Sarah LaPointe, Researcher at Brook

"Patients are more than satisfied with the care they're getting at Brook, and we're showing we can keep patients engaged and interested in managing their diabetes."

Diabetes management is affected by inequalities and inequities that contribute to poor outcomes. There are complex and multifaceted challenges when it comes to providing healthcare to those who desperately need it. Prevention of chronic conditions like type 2 diabetes must be a key factor in any plan to address our diabetes epidemic, and we must take barriers like cost, access, culture, and health literacy into consideration. 

Brook colleagues Dr. Michael Merrill and Dr. Sarah LaPointe were invited to discuss these issues and offer potential solutions on the Buffalo HealthCast podcast hosted by Sarah Robinson. This article summarizes their discussion and touches on the major causes of health disparities and how we can work together to mitigate them.

Defining Health Inequities in Diabetes Management

First we need to define health inequities in the context of diabetes management and care. Diabetes is a global concern, affecting millions of people across racial, ethnic, and socioeconomic groups. However, poor management and health outcomes are more pronounced among minority racial and ethnic groups, as well as individuals living in poverty or resource-limited areas, compared to their well-off counterparts.

Disparities arise due to differences in access to care, as patients from disadvantaged backgrounds often don’t get the timely and appropriate medical attention they need. We’re currently witnessing the domino effect of these challenges that lead to complications and worsening health outcomes.

Role of Social Determinants of Health

Social determinants of health are an important indicator of diabetes outcomes. Health and disease are deeply influenced by where people live, work, and their overall circumstances. Individuals with limited access to healthy foods, safe places to exercise, and proper and accessible healthcare face higher challenges in diabetes management. Cost and access can create insurmountable hurdles when it comes to prevention of chronic conditions like type 2 diabetes. 

Cultural, Linguistic, and Health Literacy Barriers

Cultural sensitivity is an important factor in health management, and healthcare providers play a pivotal role in addressing linguistic and cultural barriers. Staffing diverse medical professionals and leveraging translators can significantly improve patient outcomes. Involving family members or caregivers can also help bridge gaps in communication and understanding. Health literacy also plays a significant role in the patient’s ability and motivation to make lifestyle changes, and it’s up to our health systems, providers, and leaders to bridge that gap, educate, and motivate their patients.

The Brook+ Diabetes Prevention Program

Brook+ is a CDC-recognized Diabetes Prevention Program (DPP) that Dr. Michael Merrill and Dr. Sarah LaPointe study as a potential solution to limited healthcare access associated with diabetes prevention and management. Brook+ was adapted from the typical hybrid model that includes both online education and in-person classes to be fully digital in order to combat health inequities and remove access barriers. Participants use Brook+ on their smartphone, tablet, or computer to work with a dedicated Health Coach, track their diet, weight, and physical activity, and engage in the science-based lifestyle behavior change program. 

Brook+ DPP has seen remarkable health outcomes over the years. In a recent study of Brook+ outcomes, 94% of participants experienced weight loss, averaging 12 pounds, which is equivalent to a 5.93% reduction in starting body weight, which correlates to a BMI reduction of 2.0. Brook’s White Paper summarizes the study and its findings.

These results are particularly encouraging as they demonstrate positive effects across diverse populations, including those from disadvantaged backgrounds and those who qualify for Medicaid health insurance. Brook+ has optimized their fully digital program, removing barriers such as set class times, transportation, and local availability. 

Infographic showing the weight loss and physical activity results of participants using Brook+ Diabetes Prevention Program

The Bottom Line

There are complex and multifaceted challenges when it comes to providing healthcare to those who desperately need it. Prevention of chronic conditions like type 2 diabetes must be a key factor in any plan to address our diabetes epidemic, and we must take barriers like cost, access, culture, and health literacy into consideration. Brook+ DPP is seeing encouraging results when it comes to removing barriers and giving people who might have otherwise developed diabetes access to preventative care right on their smartphone, tablet, or home computer. While the complex systems that lead to health disparities need to be addressed on a broader scale, Brook is committed to advancing accessible interventions and improving health equity in diabetes care from prevention to management. 

About Brook

Brook is a healthtech company based in Seattle, Washington providing Remote Care services to partners across the country. Brook Remote Care is a suite of services including Remote Patient Monitoring for chronically complex patients, a fully digital CDC-recognized Diabetes Prevention Program, Telehealth dietitian services, chronic disease self management programs, and more. 

Learn more about Brook and what it can do for you by emailing us at 

Written by Kelsea Hoover, MS, RDN​

Updated December 1st, 2023. Kelsea is a Registered Dietitian with her Master's degree in Nutrition from Bastyr University in Kenmore, WA, and is the Senior Marketing Manager at Brook.