Diabetes & Food Insecurity

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foodinsecurity2011-infographicThe World Health Organization, WHO, marks April 7th annually, as a day to engage in dialogue and otherwise consider issues related to global health. This World Health Day 2016, the WHO is calling for global action to halt rise in and improve care for people with diabetes. The number of people living with diabetes has almost quadrupled since 1980 to 422 million adults, with most living in developing countries.

Diabetes is a disease in which the body is unable to produce insulin (type 1 diabetes) or the body does not produce enough insulin or is unable to effectively use insulin (type 2 diabetes). Most adults (approximately 90%) with diabetes have type 2. Both type 1 diabetes and type 2 diabetes require ongoing clinical and self-care management to prevent or delay serious complications, including heart disease, kidney disease, blindness and nerve damage. Gestational Diabetes is also a concern, and is a temporary condition, resembling type 2 diabetes, occurring  only in women during pregnancy.

A person can’t look at the issue of Diabetes without also looking at Food Security, or rather Food Insecurity. In remote First Nation communities in Canada, it is widely reported, and hopefully, well understood by Canadians that health care, services, follow-up, and the travel for access to any of the aforementioned is a huge challenge. A barrier.  Nutrition factors  loom large in the Diabetes equation.

The National Aboriginal Diabetes Association Report, ‘ Preventing & Managing Diabetes and Your Health (2016), states:  ‘While diabetes was rare among the Aboriginal population in North America prior to 1940, the rates increased rapidly after 1950 and have now reached epidemic levels in some communities.’  (http://www.nada.ca/)

Aboriginal peoples living in Canada are among the highest risk populations for diabetes and related complications.

‘Around the globe, diabetes incidence and prevalence rates are several times higher among Indigenous peoples compared to the general population. In Canada, Aboriginal peoples are a heterogeneous population comprised of individuals of First Nations, Inuit, and Métis heritage living in a range of environments from large cities to small, isolated communities. National survey data have consistently shown that the national age-adjusted prevalence of diabetes is 3 to 5 times higher in First Nations than in the general population. Aboriginal women in Canada also experience gestational diabetes mellitus (GDM) rates 2 to 3 times higher than others’ (www.diabetes.ca)

According to a report, ‘PROOF, Household Food Insecurity in Canada, 2014, The University of Toronto’:  ‘Household food insecurity, inadequate or insecure access to food because of financial constraints, is a significant social and health problem in Canada. Not all provinces and territories chose to measure food insecurity in 2014 but among those that did, the problem appears to have remained persistently high. When the results for the participating jurisdictions – Alberta, Saskatchewan, Ontario, Quebec, New Brunswick, Nova Scotia, Prince Edward Island, the Northwest Territories, and Nunavut – are considered together, 12.0% of households experienced some level of food insecurity during the previous 12 months in 2014. This represents 1.3 million households, or 3.2 million individuals, including nearly 1 million children under the age of 18. More than 1 in 6 children under the age of 18 lived in households that experienced food insecurity.

Food insecurity was most prevalent in Canada’s North (especially Nunavut) and the Maritimes in 2014. In Nunavut and the Northwest Territories, the prevalence rose to the highest levels observed since monitoring began in 2005, 46.8% and 24.1% respectively. While food insecurity appeared to drop in the provinces, no changes in prevalence were large enough to be statistically significant.’ (Tarasuk, V, Mitchell, A, Dachner, N. (2016). Household food insecurity in Canada, 2014. Toronto: Research to identify policy options to reduce food insecurity (PROOF). Funded by the Canadian Institute of Health Research.  http://proof.utoronto.ca

Among the provinces and territories surveyed in 2014, the report states that  ‘There were no significant drops in food insecurity prevalence, and even indications of upward trends in the already vulnerable North. The geographic patterning of food insecurity, with the alarming rates in the North and the Maritimes and the density of affected households in our largest provinces, suggests that reducing the prevalence of food insecurity requires attention by provincial, territorial, and federal levels of government.’

Food insecurity is a serious public health problem because individuals’ health and well-being are tightly linked to their household food security. Recent research in Canada has shown that adults in food-insecure households have poorer physical and mental health and higher rates of numerous chronic conditions, including depression, diabetes, and heart disease. Once chronic diseases are established, their management is also compromised in the context of food insecurity. The toll that food insecurity takes on health is evident through the heightened health care costs among food insecure Canadians.

Professor Valerie Tarasuk,  Department of Nutritional Sciences at the University of Toronto and PROOF Principal Investigator said in a press release, “Understanding the personal and societal costs associated with this problem will, we hope, help to build the business case for more effective, targeted interventions to prevent food insecurity and inform the development of smart, responsible, cost-effective public policy. The cost of inaction is simply too high.”

The World Health Organization was born on April 7, 1948. It was decided this anniversary should be marked with a day educating people on an important global health issue. The first World Health Day was in 1950 and, since then, it has spread awareness on everything from food safety to blood pressure.

 

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