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Global Public Health Burden Of Diabetes
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  • Course Code:
  • University: Birmingham City University
  • Country: United Kingdom

Introduction

Diabetes: a persistent metabolic condition.
Caused by insulin inefficiency or deficiency (Chudhary et al., 2020).
Type 2 diabetes: linked to genetics and lifestyle (Galicia-Garcia et al., 2020).
Global health challenge affecting millions (Khan et al., 2020).
Socioeconomic determinants influence prevalence.

Diabetes mellitus, a chronic metabolic disorder, arises due to the body's inability to produce or effectively utilise insulin, resulting in elevated blood glucose levels. Type 2 diabetes, distinct from Type 1 which is inflammation-driven, is predominantly rooted in an individual's genetic predisposition combined with lifestyle choices.

The global magnitude of this health concern is influenced by factors such as obesity, sedentary lifestyles, and poor dietary practices. It stands as a testament to the broader challenges in global health, where issues transcend national borders and affect populations indiscriminately.

Furthermore, the issue of diabetes underscores the existing inequities in global health, with socio-economic determinants playing a pivotal role in its prevalence and management.

Impact of globalisation

Neoliberalism: reduced government regulation, increased outsourcing (Barnett and Bagshaw, 2020).
Commercialisation of healthcare: heightened disparities (Koofreh and Anyatang, 2022).
Globalisation: rise in processed food consumption (Ampofo and Boateng, 2020).
Urbanisation: altered dietary habits and reduced physical activity (Al-Shihabi et al., 2023).
Policy coordination: potential for improved healthcare accessibility.

Globalisation, coupled with the rise of neoliberal ideologies, has undeniably influenced the prevalence and management of diabetes on a global scale. The reduced governmental regulation and the pervasive commercialisation of healthcare systems often place individuals with limited financial resources at a disadvantage, restricting their access to quality diabetic care.

Furthermore, the global surge in the consumption of processed foods, driven by economic and globalisation-related factors, exacerbates the diabetes epidemic. Urbanisation, another by-product of globalisation, has reshaped lifestyles, leading to reduced physical activity and increased intake of calorie-rich foods.

However, on the brighter side, global actions also offer an avenue for coordinated policies, fostering scientific research, enhancing healthcare access, and promoting healthier lifestyles.

This duality highlights the intricate interplay between global actions and the diabetes phenomenon.

Global nature of the public health issue

Scope: Impacts 463 million individuals aged 20-79 in 2019 (Xi and Xu, 2021).
Scale: Expected rise to 700 million by 2045 (Crasto et al., 2021).
Regions: Highest incidence in Europe, the Western Pacific, and Southeast Asia (Gomes et al., 2019).
Unawareness: 50% of diabetics unaware of their condition (Ogurtsova et al., 2022).
Mortality: 4.2 million deaths in 2019 due to diabetes (Saeedi et al., 2020).

Diabetes stands prominently as a global public health concern, with its vast scope and profound impact evident in the staggering statistics. In 2019 alone, the ailment afflicted an estimated 463 million individuals between the ages of 20 to 79, a number predicted to soar to 700 million by 2045.

Geographically, the regions of Europe, the Western Pacific, and Southeast Asia are most severely impacted, demonstrating its widespread nature. An alarming revelation is that approximately half of the diabetic population remains oblivious to their condition, heightening the risk of severe complications.

Furthermore, the sombre toll it exacts on lives is evident, with diabetes attributing to the demise of around 4.2 million individuals in 2019. Such figures unequivocally establish diabetes as a critical issue in the domain of global public health.

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Social Determinants Of Health Related To The Issue

Socioeconomic status: Higher incidence in low socioeconomic groups (Deng and Liu, 2020).
Education: Limited educational attainment correlates with greater diabetes prevalence (Higa et al., 2021).
Accessibility: Disproportionate diabetes burden due to inadequate medical care access.
Neoliberalism: Exacerbates health disparities through commercialisation (Nestle, 2019).
Cultural background: Influences perception and response to diseases (Peimani et al., 2020).

The prevalence and management of diabetes are intricately tied to various social determinants of health. Individuals from lower socioeconomic brackets, often coupled with limited educational attainment, face a heightened risk of developing the condition.

This correlation can be attributed to challenges in maintaining a nutritious diet and engaging in regular physical activity, both paramount in preventing type 2 diabetes.

Furthermore, inadequate access to essential medical care adds to the disproportionate burden of the disease among these demographics. The neoliberal approach, advocating reduced governmental intervention and heightened commercialisation, potentially exacerbates these health disparities.

Additionally, cultural nuances play a pivotal role, with different backgrounds influencing not only perceptions of diabetes but also responses and management practices. Such determinants underscore the multifaceted nature of diabetes as a global health concern, rooted deeply in societal constructs and disparities.

Health inequalities of issue

Disproportionate burden: Greater impact on individuals with low socioeconomic status.
Limited resources: Challenges in accessing nutritious meals and medical care (Barnard-Kelly and Cherñavvsky, 2020).
Commercialisation: Hinders diabetic care for financially constrained individuals.
Socioeconomic determinants: Influence diabetic treatment accessibility (Mujahid et al., 2023).
Cultural disparities: Varying perceptions and disease management practices.

Diabetes starkly illuminates the pervasive health inequalities prevalent in the global landscape. The disease disproportionately burdens those with lower socioeconomic status, amplifying the challenges they face in accessing adequate medical care, nutritious meals, and necessary medications.

The commercialisation of healthcare, an offshoot of neoliberal ideologies, further exacerbates these inequalities, placing quality diabetic care out of reach for many with limited financial means. Socioeconomic determinants, extending beyond mere financial constraints, play a pivotal role in shaping the accessibility and effectiveness of diabetic treatments.

Moreover, cultural disparities further compound the issue, as varying perceptions and disease management practices influenced by cultural norms can lead to differential health outcomes among diverse populations. In essence, diabetes serves as a glaring representation of the manifold health inequities ingrained in the fabric of global health systems.

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Social factors that influence the issue and its impact:

Lifestyle choices: Sedentary behaviours and unhealthy dietary habits.
Urbanisation: Leads to reduced physical activity and increased caloric intake.
Educational attainment: Knowledge gap affects disease awareness.
Neoliberalism: Direct implications on healthcare accessibility.
Cultural norms: Shape disease perceptions and responses.

The complex interplay of various social factors profoundly influences the prevalence and impact of diabetes. Sedentary lifestyles, exacerbated by urbanisation, have become commonplace, contributing significantly to the onset of Type 2 diabetes.

Urbanised regions witness diminished levels of physical activity and a propensity towards diets rich in processed foods. Additionally, the level of educational attainment can engender a knowledge gap, affecting disease awareness and subsequent management.

The neoliberal approach, emphasising reduced governmental oversight and increased market freedom, directly impacts healthcare accessibility, often to the detriment of those with limited means. Furthermore, cultural norms and practices across different societies shape perceptions, attitudes, and responses towards diabetes. These factors, individually and collectively, underscore the broader societal influences that modulate the trajectory and impact of this global health concern.

Economic factors that influence the issue and its impact:

Globalisation: Drives increased consumption of processed foods (Galicia-Garcia et al., 2020).
Healthcare costs: Impacts disease management effectiveness (Khan et al., 2020).
Economic disparities: Affect access to nutritious meals and medications (Barnett and Bagshaw, 2020).
Urban development: Influences lifestyle choices and disease prevalence.

The economic landscape plays an instrumental role in shaping the global trajectory of diabetes. Neoliberal ideologies, which promote reduced governmental regulation and heightened commercialisation, have direct implications for healthcare accessibility and affordability.

Globalisation, another potent economic force, has driven the surge in processed food consumption, contributing to dietary shifts linked with diabetes onset.

The escalating costs associated with healthcare, from obtaining nutritious meals to procuring essential medications, impact the effectiveness of disease management, particularly among economically disadvantaged populations. These disparities often result in suboptimal care, exacerbating health outcomes.

Moreover, economic strategies focusing on urban development inadvertently influence lifestyle choices, often promoting sedentary behaviours and unhealthy dietary patterns.

Collectively, these economic determinants exemplify the intricate nexus between financial frameworks and the burgeoning diabetes epidemic, underscoring the need for economically informed interventions.

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Environmental factors that influence the issue and its impact

Urbanisation: Alters physical activity levels and food choices (Xi and Xu, 2021).
Accessibility: Determines availability of nutritious food options.
Environmental pollutants: Linked to increased diabetes risk (Ogurtsova et al., 2022).
Urban development: Influences lifestyle habits.
Physical environment: Affects opportunities for exercise and healthy living (Deng and Liu, 2020).

Environmental factors play an undeniably significant role in shaping the prevalence and management of diabetes. The process of urbanisation has led to lifestyle alterations, with urban dwellers often leading more sedentary lives and opting for calorie-dense diets.

Additionally, the local environment can determine the accessibility and availability of nutritious food options, with some areas being food deserts devoid of healthy choices. Growing evidence also points towards certain environmental pollutants as potential risk factors in diabetes onset.

Moreover, the physical design of urban developments, including the availability of parks and recreation areas, directly influences opportunities for physical activity. Collectively, the environment in which individuals reside, work, and socialise deeply modulates their health behaviours, choices, and outcomes. Thus, to effectively address the diabetes epidemic, it is essential to consider and address these environmental determinants.

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Application of structural violence theory on the issue

Systemic barriers: Economic and social structures limit healthcare access (Harvey et al., 2022).
Socioeconomic determinants: Shape health outcomes and disease prevalence.
Education and awareness: Inequitable distribution perpetuates knowledge gaps.
Cultural norms: Institutional biases influence disease perception and management (Mackintosh and Armstrong, 2020).

Structural violence theory posits that systemic and institutionalised social structures can indirectly cause harm to individuals by preventing them from meeting their basic needs. In the context of diabetes, economic and social structures often create barriers that limit individuals' access to quality healthcare, nutritious foods, and essential medications.

The rise of neoliberal ideologies, advocating for reduced governmental intervention and heightened commercialisation, represents a form of structural violence by widening health disparities. Socioeconomic determinants, deeply ingrained in societal fabric, shape the health outcomes of individuals, with those in disadvantaged strata bearing a disproportionate burden.

Furthermore, the inequitable distribution of education and awareness perpetuates knowledge gaps, leaving many unaware of their condition. Diabetes management and perception are further shaped by institutional biases and cultural norms. This structural violence perspective provides a comprehensive knowledge of the various issues that diabetes poses in the field of global health.

Conclusion

Diabetes: A global epidemic influenced by multifaceted determinants.
Socioeconomic and cultural factors: Major contributors to disease prevalence.
Neoliberal ideologies: Exacerbate healthcare disparities.
Structural violence: Highlights systemic barriers affecting health outcomes.
Global coordination: Imperative for effective prevention and management.

It is clear from the thorough examination and analysis of the literature that diabetes has become a worldwide pandemic influenced by a wide range of interrelated factors. Primarily, socioeconomic and cultural variables are responsible for determining the occurrence and treatment of the disease in a variety of populations.

Many people cannot afford appropriate diabetes treatment due to the unintentional exacerbation of healthcare inequities caused by the emergence of neoliberal ideas. The use of structural violence theory emphasises the systemic obstacles that impede people' ability to achieve optimal health outcomes, especially those from poor socioeconomic backgrounds.

Global collaboration in preventive, control, and research activities is essential to addressing this complex issue. But the extent of effectiveness depends on fair distribution of resources and compliance with laws, highlighting the necessity for a comprehensive, well-informed strategy to address the diabetic dilemma.

 

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References

Al‐Shihabi, F., Moore, A. and Chowdhury, T.A., 2023. Diabetes and climate change. Diabetic Medicine, 40(3), p.e14971.
Ampofo, A.G. and Boateng, E.B., 2020. Beyond 2020: Modelling obesity and diabetes prevalence. Diabetes Research and Clinical Practice, 167, p.108362.
Barnard-Kelly, K.D. and Cherñavvsky, D., 2020. Social inequality and diabetes: a commentary. Diabetes Therapy, 11, pp.803-811. 
Barnett, P. and Bagshaw, P., 2020. Neoliberalism: what it is, how it affects health and what to do about it. The New Zealand Medical Journal (Online), 133(1512), pp.76-84.
Chudhary, H.R.Z., Amin, A., Malik, M.H., Hafeez, M.M., Rana, M.A. and Malik, A., 2020. Risk assessment of non-conventional contributory factors in onset of diabetes mellitus type II. Biological and Clinical Sciences Research Journal, 2020(1). 
Crasto, W., Patel, V., Davies, M.J. and Khunti, K., 2021. Prevention of microvascular complications of diabetes. Endocrinology and Metabolism Clinics, 50(3), pp.431-455.
Deng, Q. and Liu, W., 2020. Physical exercise, social interaction, access to care, and community service: mediators in the relationship between socioeconomic status and health among older patients with diabetes. Frontiers in public health, 8, p.589742. 
Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K.B., Ostolaza, H. and Martín, C., 2020. Pathophysiology of type 2 diabetes mellitus. International journal of molecular sciences, 21(17), p.6275.
Gomes, M.B., Rathmann, W., Charbonnel, B., Khunti, K., Kosiborod, M., Nicolucci, A., Pocock, S.J., Shestakova, M.V., Shimomura, I., Tang, F. and Watada, H., 2019. Treatment of type 2 diabetes mellitus worldwide: baseline patient characteristics in the global DISCOVER study. Diabetes research and clinical practice, 151, pp.20-32.
Harvey, M., Neff, J., Knight, K.R., Mukherjee, J.S., Shamasunder, S., Le, P.V., Tittle, R., Jain, Y., Carrasco, H., Bernal-Serrano, D. and Goronga, T., 2022. Structural competency and global health education. Global public health, 17(3), pp.341-362.
Higa, C., Davidson, E.J. and Loos, J.R., 2021. Integrating family and friend support, information technology, and diabetes education in community-centric diabetes self-management. Journal of the American Medical Informatics Association, 28(2), pp.261-275.
Khan, M.A.B., Hashim, M.J., King, J.K., Govender, R.D., Mustafa, H. and Al Kaabi, J., 2020. Epidemiology of type 2 diabetes–global burden of disease and forecasted trends. Journal of epidemiology and global health, 10(1), p.107. 
Kooffreh, B.E. and Anyatang, B.F., 2022. Pandemics and health equity issues: effects of disparities and social health determinants. International Journal of Private Law, 10(2-4), pp.115-129.
Mujahid, M.S., Maddali, S.R., Gao, X., Oo, K.H., Benjamin, L.A. and Lewis, T.T., 2023. The impact of neighborhoods on diabetes risk and outcomes: centering health equity. Diabetes Care, 46(9), pp.1609-1618.
Nestle, M., 2019. How neoliberalism ruins traditional diets and health. The Lancet Diabetes & Endocrinology, 7(8), p.595.
Ogurtsova, K., Guariguata, L., Barengo, N.C., Ruiz, P.L.D., Sacre, J.W., Karuranga, S., Sun, H., Boyko, E.J. and Magliano, D.J., 2022. IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021. Diabetes research and clinical practice, 183, p.109118.
Peimani, M., Nasli-Esfahani, E. and Sadeghi, R., 2020. Patients’ perceptions of patient–provider communication and diabetes care: A systematic review of quantitative and qualitative studies. Chronic illness, 16(1), pp.3-22.
Saeedi, P., Salpea, P., Karuranga, S., Petersohn, I., Malanda, B., Gregg, E.W., Unwin, N., Wild, S.H. and Williams, R., 2020. Mortality attributable to diabetes in 20–79 years old adults, 2019 estimates: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice, 162, p.108086.
Xi, Y. and Xu, P.F., 2021. Diabetes and gut microbiota. World Journal of Diabetes, 12(10), p.1693.

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