A Problem of Diabetes
Low socioeconomic status has previously been associated with type 2 diabetes. Thus, health is not only affected by individual risk factors and behaviors, but also a range of economic circumstances. Primarily, this issue is caused by the underuse or reduced access of recommended preventive care in individuals from low socioeconomic backgrounds. The economical issues involved in diabetes stems from the fact that economically disadvantaged individuals do not have the support for healthful behaviors. Furthermore, economically disadvantaged individuals may not have access to clinical care. Lastly, economic and social factors determine the physical environment an individual lives in. Multiple research studies incorporated a diabetic patient’s socioeconomic status as a factor for the onset of diabetes. However, some researchers argue that childhood SES is not the only way to determine the onset of diabetes. Preventive care should become more available for individuals from lower socioeconomic statuses.
Keywords: diabetes, healthful, preventive, socioeconomic
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The Association of Low Socioeconomic Status and Diabetes
Low socioeconomic status has been associated with chronic conditions such as diabetes mellitus. It has persistently been reported that individuals from lower socioeconomic status groups are at a greater risk for diabetes than patients from higher socioeconomic status groups. The socioeconomic status of an individual is based on community access to resources and includes a combination of economic, social and work status. What are the economical issues involved? Health is affected not only by individual risk factors and behaviors, but also a range of economic conditions. The circumstances in which people are born and grow up are shaped by a variety of economic and social forces. How do these economical issues trigger diabetes and complications in individuals who are economically and socially disadvantaged? Social and economic factors drive one’s exposure to a healthy or unhealthy physical environment, which continues to form a cascade of complications for the diabetic patient, depending on the environment. Thus, certain risk factors implicated in the development of diabetes are known to be associated with socioeconomic status.
For example, obesity, physical inactivity, smoking and low birth weight have all been defined as risk factors for type 2 diabetes. In addition, these factors are associated with low socioeconomic status in Western societies. Hence, there is an inverse relation between prevalence of type 2 diabetes and socioeconomic status. Primarily, this problem is caused by reduced access to and underuse of recommended preventive care and poor metabolic control in individuals from low SES backgrounds (Rabi et al., 2006). These factors contribute to poor health outcomes and as a result, diabetes is correlated with low SES. Reduced access to healthcare, such as regular diabetes screening checks, have long term effects on individuals who are diagnosed with diabetes mellitus as the disease may advance to more complications such as eye problems, infections on feet and skin that may lead to amputations, damage of nerves, problems with pregnancy, and even depression (Rabi et al., 2006).
The economical issues involved in diabetes stems from the fact that economically disadvantaged individuals do not have the support for healthful behaviors. First, such individuals lack support of healthful behaviors. They are associated with low socioeconomic status and may not be able to incorporate a healthy diet in their lives, or even provide one for their families, which in turn is a risk factor for the family members. These economical issues trigger diabetes in individuals from low socioeconomic status backgrounds, since most individuals who are considered low SES live in neighborhoods where it may not be safe enough to permit their children to play outside and exercise, or even take walks. Other factors, such as work, school, child care and commuting schedules may also not allow enough time in the day to accommodate such healthful behaviors.
Furthermore, economically disadvantaged individuals may not have access to clinical care. Visiting a health care professional becomes difficult as these individuals may have work schedules that conflict with clinic hours, transportation issues, work sick-leave policies, and childcare issues. In addition, there is abundant evidence that shows that individuals from low SES, including lower education attainment, lower incomes, and people of color generally receive lower quality health care.
Lastly, economic and social factors determine the physical environment an individual lives in. As a result, factors such as education and employment choices influence each other and establish the lack of health-supporting physical environments for these individuals. For example, the education level of an individual essentially determines their employment choices, which in turn largely determines income level. Together, these factors greatly influence the probability of being able to afford to live in a health-supporting physical environment, such as a safe community.
An experimental study, part of the Moving to Opportunity (MTO) housing intervention, examined obesity and diabetes outcomes when households were given the opportunity to move from a high-poverty neighborhood to a low-poverty neighborhood. Individuals with the opportunity to move to a low poverty neighborhood were less likely to become obese or develop type 2 diabetes over the 14-year cohort study. This study concludes that “place matters” ??“ where people live can determine their health status. Thus, the place an individual lives can either be protective or detrimental for health behavior and outcomes. (Steve, et al., 2016)
According to the article, “Socioeconomic position and the incidence of type 2 diabetes: the ELSA study”, the authors state that although there are many studies on the association between socioeconomic position and type 2 diabetes, knowledge on how SEP might be related with the onset of diabetes in older people still remains limited. This is due to the fact that research usually uses mixed-age samples that include both younger and older people and focuses on the associations between incident diabetes and measures of SEP from earlier stages of the life-course like education and occupational class. Research hardly focuses on the associations between incident diabetes and measures of current SEP like wealth and subjective social status. Wealth is a measure of accumulation of assets and command over financial resources over the lifespan. Research suggests that it is one of the most appropriate SEP measure to use in studies of older people. Unlike education and occupational class, wealth refers to the current stage of the life-course and is thus more appropriate to characterize older people’s current SEP.
As a result, researchers must expand the variables they are testing to incorporate more individuals’ personal characteristics in order to accurately associate diabetes with socioeconomic status. In my opinion, although some scientists believe that including wealth helps us better understand this correlation, an individual’s upbringing and childhood SES has a greater impact on the individual, even as they age, as opposed to their current SES. The living situation of an individual during childhood and adolescents shapes the individual and impacts their health. There should be more available resources in communities with lower socioeconomic status that helps with preventive care for individuals who may not have the knowledge or resources for a healthful lifestyle.