Making Time for Health Equity in Diabetes
November 21, 2024
By Marco Campana, Knowledge Mobilization and Social Action Coordinator, Access Alliance
Making Diabetes Programming Inclusive by Design
Access Alliance Multicultural Health and Community Services (Access Alliance) researches how chronic diseases like diabetes affect marginalized communities disproportionately and how to build their self-efficacy for self-management of diabetes. We engage peer researchers to study the unique cultural determinants and to disseminate the generated evidence in a culturally appropriate way. This is the strength of Access Alliance’s Community-Based Research practice.
We reported over 10 years ago in research on migration and diabetes that it is important to do intentional and continuous work on equity-focused planning to make people aware of diabetes prevention and support them to manage their body sugar. Our work on diabetes ranges from a focus on identifying the unique factors for diabetes among immigrants to the importance of peer- and community-engaged health promotion support for culturally appropriate self-management of diabetes. Many Access Alliance clients face numerous social, financial, and chronic health challenges that may impact their ability to self-manage chronic conditions such as diabetes.
Diabetes is labelled a “colour coded” health condition. Research suggests that immigrants of specific ethnic groups, such as South Asian and Black immigrants, develop diabetes at a higher rate, at an earlier age, and with lower ranges of body mass index (BMI). Over the past decade the cases of diabetes among Black Canadians have seen a twofold increase. Only South Asian men currently experience a higher rate of diabetes.
Culturally safe, relevant, and community-focused engagement is essential to success in preventing and managing diabetes. A health equity approach that intentionally involves communities being served by healthcare providers is essential for successful health promotion initiatives. These communities have diverse needs, and approaches to engagement must reflect that diversity. Word-of-mouth continues to be an important part of communication strategies to help diverse communities avoid and manage diabetes. Healthcare providers, community organizations, and policy makers need to allocate resources for culturally appropriate diabetes education and services. This includes involving peer delivery of public health information and service interventions.
Our Ongoing Diabetes Research
We continue our research on diabetes from an equity perspective to ensure richness of data, precision in outreach, and knowledge gaps are filled in culturally competent ways. We know that diabetes impacts African and Caribbean Black (ACB) communities disproportionately. ACB individuals may not be aware of their vulnerability to diabetes. We know that food behaviour and preferences require culturally competent health promotion strategies that consider the unique behavioural and dietary patterns of ACB individuals.
With this contextual information, our recent Screening for Diabetes and Risks among Black African and Caribbean Residents in Toronto research connects us with previous research in our agency and elsewhere in the world. The research identifies unique information about this population and makes recommendations for both improved testing diabetes as well as cultural interpretation of the findings to better serve ACB communities. One key recommended practice is increasing health promotion efforts that target lifestyle modifications (e.g. diet and physical activity) to mitigate diabetes risk among ACB populations.
While our findings are specific to ACB communities, they are also useful when approaching diabetes promotion and services for all other equity-deserving populations. The focus should be on the most at-risk groups identified through community-specific outreach and education initiatives. It is important to ensure that the populations we serve are engaged in the analysis and use of data to develop, deliver and monitor services.
We continue to do research and health equity advocacy to create and improve culturally competent outreach and services. We also continue to work closely with our Community Health Centre partners, the Public Health Agency of Canada, and Diabetes Action Canada to ensure a collective culturally appropriate approach. Together we make time to support each other and our communities to raise awareness about avoiding and managing diabetes.
Diabetes Services and Support at Access Alliance
In our clinical and community work, we provide diabetes services and supports for the diverse communities we serve. The West Toronto Diabetes Education Program helps improve the quality of life of adults living with type 2 diabetes, pre-diabetes, or those at risk of developing type 2 diabetes. Group sessions offer participants tools and resources to support diabetes self-management.
Our Registered Dietitians are available support our communities and partners. They provide information sessions internally at Access Alliance programs and externally in the community.
Our Food Programs help build nutrition knowledge, cooking skills, and confidence to make healthy decisions about food and create healthy habits. Our Community Dining Programs offer a free weekly home-cooked, healthy and nutritious meal to community members facing food insecurity.
Our Peer Outreach Workers are effective supports for community members to self-manage their health at Access Alliance. These women reach out to immigrant and refugee families in their own communities. Through shared experiences, language, and culture, they link families to community and health services. Their work helps to overcome barriers, increases access to health opportunities, and nurtures social support networks.
November is Diabetes Awareness Month in Canada
Diabetes Canada’s “Let’s Make Time” campaign aims to inspire more understanding, awareness and empathy for people living with diabetes. Diabetes Canada is encouraging Canadians to learn more about this complex condition, and share that knowledge with their communities.
Our work aligns with this campaign goal. We believe that while raising awareness about diabetes in general, we must also make time to discuss and implement health equity in diabetes awareness and care.