Abstract
Randomized Controlled Trial (RCT) to study the interaction between labor force participation and health in the diabetic population of the San Antonio, Texas, MSA. Data from a 2019/2020 San Antonio Metropolitan Health District (Metro Health) report confirms that this community has a higher diabetes hospitalization rate than the rest of the state; an increasing child diabetes hospitalization rate; higher hospitalization rates for diabetic amputations; and a higher age-adjusted mortality rate for diabetes than the state and the country. Black and Hispanic/Latinx populations have the highest incidences of diabetes in the city. We plan a collaboration with three local NGOs that already provide both access to and continuing care for undeserved and uninsured diabetic populations in the greater MSA. Our proposal follows the principles of the Oregon Health Insurance Experiment that examined Medicaid expansion and its impact on health outcomes in Oregon. We plan to leverage existing administrative data from the NGOs’ diabetes programs to establish a baseline on the wage/salary status of participants. The three NGOs will participate in an RCT to expand the reach of diabetes care through new schemes that include community health advocates and technology for online education and care management. Data from the RCT will be analyzed to determine if providing care using these community care workers, technology or a combination thereof improves labor force participation, engenders economic stability, and fosters upward economic mobility for the diabetic population.