Systemic, long-term changes to the UK’s health system are required to tackle ‘unacceptable’ inequalities in diabetes care, according to a new report.
The report, from the Diabetes UK Tackling Inequality Commission, was informed by the experiences of more than 100 people with diabetes, aged 18-80, from all corners of the UK. It sets out a series of recommendations for healthcare professionals and policymakers to deliver the change that is needed – and is being launched today at an event at the People’s History Museum in Manchester.
Diabetes does not affect everyone equally. A person’s ethnic group, where they live and their income all affect their chances of developing type 2 diabetes, the care they receive for any type of diabetes and their long-term outcomes. For example, access to diabetes technology can be life-changing – yet if you are from an ethnic minority or living in deprivation you are far less likely to be able to benefit from it.
The Commission’s report concludes that racism is ‘a public health issue’ and calls for a ‘bold’ approach to reduce its impact. It recommends examining the systems, policy and practices that act as barriers to equality, and working with communities to change them.
It calls for all organisations that support people living with diabetes to commit to practices that are anti-racist and sensitive to the needs of people experiencing deprivation.
The importance of working in partnership with local community organisations in a sustained way, through procurement, inclusion and consultation was a strong theme that emerged during the Commission’s work.
Being from a deprived area increases your risk of developing type 2 diabetes – particularly in the under 40s who have much higher rates of complications. This is linked to the high cost of healthy food, relative lack of investment in areas of deprivation – which reduce opportunities to access healthy food or space to exercise – and working conditions.
The Commission argues there is a need to continue to lobby for changes to reduce deprivation, address the unhealthy food environment and improve the benefits system. Diabetes services must ensure they are proactive and recognise and support with the hidden costs of diabetes, it adds.
The Diabetes UK Tackling Inequality Commission was set up in January. It is co-chaired by Dr Faye Ruddock, Chair of the Caribbean & African Health Network, and Director of the health Equity and Social Justice Institute, University of Bolton and Professor Linda Bauld, Bruce and John Usher Chair in Public Health in the Usher Institute, College of Medicine at the University of Edinburgh, and Chief Social Policy Adviser to the Scottish Government.
Between January and June this year, the Commission heard from the people most affected by health inequalities in diabetes and those working to ensure everyone has the same chance to fair care. A total of 131 people, aged between 18 and 80, and with all types of diabetes, joined focus groups and one-to-one interviews to talk about their experiences.
Colette Marshall, Chief Executive at Diabetes UK, said: “We are honoured to launch our Tackling Inequality Commission report in Manchester today. Many people and communities have contributed to make it the powerful call-for-action that it is. Together we have created a series of practical, but ambitious, recommendations aimed at tackling inequality in diabetes care: for healthcare professionals, for services, for government, and crucially, for us as the largest diabetes charity in the UK.
“We’ve listened to people affected by inequality and now we’re determined to put those learnings into action, both in our own house and in partnership with others.”
Professor Linda Bauld said: “This report shows us how much where you live, work, grow and age affect your risk of diabetes and your ability to access the care and support you need. We need policy makers to listen to the people most affected and commit to the long-term changes needed to remove the unacceptable inequality we currently see in diabetes.”
Dr Faye Ruddock added: “I am delighted that this report amplifies the voices of communities experiencing racial inequalities, along with those facing deprivation, which often go hand in hand. We must now work with communities and system leaders to ensure that the calls in this report are backed by action and accountability and lead to the change needed to address systemic and structural racism through our policies, practices, guidance and research.”