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Read the following passage and mark the letter A, B, C, or D to indicate the answer to each of the question.
CDC strives to safeguard the health and improve the quality of life of all people with diabetes. Central to that effort is helping them prevent or reduce the severity of diabetes complications, including heart disease (the leading cause of early death among people with diabetes), kidney disease, blindness, and nerve damage that can lead to lower-limb amputations.
Diabetes self-management education and support (DSMES) programs help people meet the challenges of self-care by providing them with the knowledge and skills to deal with daily diabetes management: eating healthy food, being active, checking their blood sugar, and managing stress. These programs have been shown to reduce A1C levels (average blood sugar over the last 2 to 3 months), reduce the onset and severity of diabetes complications, improve quality of life, and lower health care costs.
Diabetes is about 17% more prevalent in rural areas than urban ones, but 62% of rural counties do not have a DSMES program. The use of telehealth (delivery of the program by phone, Internet, or videoconference) may allow more patients in rural areas to benefit from DSMES and the National DPP lifestyle change program. CDC funds state and local health departments to improve access to, participation in, and health benefit coverage for DSMES, with emphasis on programs that achieve American Association of Diabetes Educators accreditation or American Diabetes Association recognition. These programs meet national quality standards and may be more sustainable because of reimbursement eligibility
The word “lower” in paragraph 2 is closest in meaning to _______.
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