Examining social determinants of health and diabetes in Black and South Asian-origin populations in Ontario: A scoping review 

Overview

Diabetes is one of the most common chronic conditions in Ontario. Black and South Asian-origin populations in Ontario experience some of the highest rates of diabetes and related complications. They also have higher exposure to social factors that have been linked to diabetes including poverty, discrimination, food insecurity and inadequate housing. 

Using a scoping review methodology with a stakeholder consultation, this paper identifies the scope, range and characteristics of research linking social determinants to diabetes outcomes in Black and South Asian-origin populations. 

Some key findings

• The social determinants of health are very important when discussing diabetes. This includes food security, access to safe outdoor spaces, education, income and healthcare access. Disparities in exposure to these social determinants of health increase the risk of diabetes. They also reduce the ability of those with diabetes to both manage their blood sugar levels and avoid complications. 
• Thriving workplaces are important for potentially reducing the burden of diabetes and associated complications within Black and South Asian-origin populations. Underemployment, long working hours, lack of transportation and other financial constraints hindered access to diabetes healthcare, medications and self-management practices like glucose monitoring, exercise or healthy eating. 
• Having access to a family doctor and high-quality healthcare clinics for diabetes prevention and management is important. 
• The food environment and social context also play a role in diabetes prevention and management for Black and South Asian-origin populations. For instance, the existence of “food swamps,” coupled with high costs of healthy foods and lack of culturally appropriate foods, limited access to nutritious food options and heightened food insecurity. 
• Studies also raised concerns about healthcare workers’ cultural insensitivity, particularly regarding food insecurity and dietary recommendations. 

Policy implications

There is a need for targeted interventions that address not only the healthcare access barriers but also the sociocultural, environmental and economic factors that contribute to diabetes risk among these populations. While progress is being made, particularly in cities like Mississauga, further research is required to better understand the intersectionality of these factors and to improve approaches for effective diabetes prevention and management. 

We are grateful for funding from the Ministry of Health of the Province of Ontario, which enabled this study.