November 14 is World Diabetes Day, an opportunity to reflect on how people living with diabetes can thrive and live a healthy, engaged life.
Diabetes is one of the most common diseases in Ontario, and its prevalence is highest in individuals of South Asian origin and in Black populations. Sixteen per cent of South Asian-origin people and 13 per cent of the Black population in Ontario have the disease. We need to dig deeper to understand their experiences with diabetes to ensure they can thrive.
There are many factors which influence a person’s risk of diabetes, including genetics, but more and more research points to social factors like food security, access to safe outdoor spaces, access to healthcare, income and education as crucial to the development and progress of the disease.
Poverty rates are high in the Black and the South Asian-origin populations of Ontario.
Discrimination, racism and other barriers faced by Black populations and people of South Asian origin negatively impact their education, employment, food security and housing. All these factors increase the risk of diabetes and reduce their ability to both manage their blood sugar levels and delay the onset of disease complications.
For instance, people with lower incomes may have difficulty with medication costs as well as the costs for transportation to attend diabetes education programs and medical appointments.
Rising food costs, the lack of culturally appropriate food options, and the abundance of “food swamps” (unhealthy food options that are easy to access) in neighbourhoods with significant Black and South Asian-origin communities make it difficult for families to prioritize healthy food options. This leads to unstable eating patterns and elevated stress.
When Black and South Asian-origin populations receive inadequate information on their diabetes diagnosis and culturally insensitive treatment plans from their healthcare providers, it can be challenging for them to follow recommendations to manage their disease and prevent complications.
One size does not fit all for diabetes interventions.
Diabetes interventions may overlook the specific challenges faced by racialized populations, and miss the important cultural, social and economic factors that impact diabetes risk factors and complications among the Black and South Asian-origin populations. For example, transportation costs, family responsibilities, language barriers and the lack of culturally appropriate recommendations have been shown to reduce participation in programs among racialized populations.
We must work with communities to develop real and relevant solutions to decrease health inequities and improve the effectiveness of prevention and treatment of diabetes. Working to decrease the rates of diabetes and the progression of diabetes to serious medical complications may require action on the social factors that increase risk and decrease the ability of people to regulate their blood sugar.
Wellesley Institute is currently conducting research that dives deeper into the relationships between social determinants of health and diabetes outcomes for Black and South Asian-origin populations. This includes examining the effectiveness of interventions that address the social determinants of health and how they impact diabetes prevention and management for these populations.
We believe there could be important health and health equity gains to be made with increased attention to the link between social determinants of health and diabetes care. By prioritizing initiatives that address these social determinants, we can improve diabetes management among Black and South Asian-origin communities.