Poverty, social factors increase risk of diabetes in large cities, study says

Tonia Venneri
Senior Reporter

A new study has found a link between poverty and diabetes in cities.

The international study by University College London was conducted in five cities – Copenhagen, Houston, Mexico City, Shanghai and Tianjin. It was headed by the Cities Changing Diabetes organization, and comes as it kicks off its 2015 Summit in Copenhagen.

Professor David Napier led the research team at UCL and said the study is meant to deepen the layers within diabetes research.

“We are trying to address the absence of quality database and evidence based on these social and cultural risk factors and indeed our focus is specifically on the cultural determinant,” said Napier.

Napier said factors such as economics, psychological disposition, race, ethnicity and gender are determinants in diabetes. Napier said financial determinants influence how people value their position in society and how they take care of themselves.

“We’re concerned not just about the question of poverty which we would say would be a concrete social determinant, but also people’s perceptions of what it is that they feel they can afford,” said Napier.

The study found that social and cultural factors are responsible for putting people at greater risk making them less likely to get diagnosed, seek out treatment and maintain good health. According to Napier the research process needs to be flipped and re-assessed in order to progress.

“We’ve got to take that path in reverse. We’ve got to look at people’s complex problems, and figure out the path that got them there and find out which of these risk factors are modifiable,” said Napier.

More than 550 face-to-face interviews were done with people who are vulnerable to, or have been diagnosed with diabetes.

Napier said traditional research “eliminates complexity” in an effort to identify the cause and effect relationship, which takes away from the “messiness of daily life”. He said this is not what diabetes is.

“Diabetes is something that creeps up from behind you that suddenly you have and then you look back and say how did I get there.”

Dr. Jan Hux, chief science officer at the Canadian Diabetes Association said the study brings light to the lack of resources in lower income communities, and the effects it can have on the health of an individual.

“There are some lifestyle choices that people can make to reduce the risk, but many people live in circumstances that really constrain their choices around healthy food resources and around accessible physical activity opportunities,” said Hux.

She adds that a development like this will encourage a shift in research.

“Studying the impact of interventions when governments make them, and understanding the impact of the current infrastructure and urban design on risks of diabetes is really important,” Hux said.

Cities Changing Diabetes along with the UCL, and other organizations are trying to open the dialogue on a global scale while learning from participating countries and cities.

Novo Nordisk, a global healthcare company in Denmark, announced a plan to invest $20 million in research funds to the program by 2020.

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