Diabetes represents the number one global health challenge, and an issue to which many multinational employers will be all too familiar as the combined costs of absence, medical and disability insurance take their toll. The International Diabetes Federation (IDF)* estimated that in Europe around 35 million adults had diabetes (both type 1 and type 2) and this is projected to increase by 23% to 43 million in 2030.
Recent research** is helping to shine a light on those most at risk globally, helping to inform health promotion, provision and urban planning. Today, 437 million people worldwide have type 1 or type 2 diabetes. New research by a coalition of experts entitled Bending the curve on urban diabetes reveals that three-quarters of a billion people could have the disease by 2045. The report examines what is being done in a coalition of major cities around the world – in partnership with healthcare leaders and community organisers - to help reverse this trend.
Work is being carried out to identify the social and cultural factors that present the greatest risk and vulnerability, including aspects such as employment status, long commutes, cultures around food and population, and migration dynamics.
Fieldwork has revealed that some of the most vulnerable groups weren’t just the poor, but also affluent members of societies who engaged frequently with the health system. For example, in Shanghai, middle-class families were concealing early symptoms, even from each other, because diabetes carries a social stigma in China.
Building on this early research, the coalition developed a risk-assessment tool, which provides an easy-to-use way of understanding what the priority areas of risk are for any population. This, in turn, allows for the creation of interventions likely to be most effective in a city. The partner cities in the research have begun to take action in four areas: health promotion policy; community involvement in health; urban planning; and strengthening health systems.
The end goal? To reduce obesity by 25% globally by 2045, preventing people developing the disease in the first place and allowing healthcare systems to focus on delivering the best outcomes for those with the disease.
*The diabetes epidemic and its impact on Europe, European Diabetes Leadership Forum Copenhagen 2012 https://www.oecd.org/els/health-systems/50080632.pdf
**This article is adapted from Cities are the front-line in the global diabetes epidemic, by Lars Fruergaard Jørgensen, Chief Executive of Novo Nordisk, published in Harvard Business Review https://hbr.org/2017/11/cities-are-the-front-line-in-the-global-diabetes-epidemic [Nov 2017]
