Diabetes and Social Determinants - Term Paper Example

Diabetes and the social determinants Assignment 1: research plan {Insert student’s name} {Insert university’s name} {Insert university's name] March 24, 2012 Diabetes and social determinants Introduction Diabetes is one of public health concerns worldwide. It is prevalent in both developing and developed nations and there are new emerging cases on a daily basis (Health Direct Australia, 2010).According to report released by world health organization (2010), there were over 220 cases of diabetes in the world. The same report indicated that in 2004, there were 3.4 million death cases and if caution is not taken the number is likely to double by 2030. In Australia, it has been estimated that approximately 275 people develop diabetes on a daily basis. Another report further indicates that approximately 1.7 million Australians are diabetic but half the number has remained undiagnosed (WHO, 2010).diabetes is a long term illness which is as a result of the body not producing enough insulin (WHO, 2011).This particular research will focus on 3 key diabetes social determinants and the target group is individuals over 21 years living in Western Australia. The research will be divided into a number of sections and these will include: the introduction, literature review, research questions, research methodology and design, definitions of concepts and the reference list. Literature review A study carried out by Australian national health survey between 2004 and 2005 revealed that type 2 diabetes was more prevalent in men than women by 1%. Another quantitative study carried out by Women’s Health Victoria (2010) in South Australia however indicated that there have been increased rates of diabetes in both men and women between 1991 and 2005 by 3.5% and 6.7% respectively. The aforementioned study further revealed that there was increase in the relative percentage in young people between ages 21 and 39. Jakicic, Lang, Polley, Venditti, & Wing (1998) in their study argued that gender/sex difference regarding diabetes cases is justifiable. WHO (2010) report indicated that young women are likely to develop type 2 diabetes as compared to their male counterparts. This is attributed to the effects of gestational diabetes on both the baby and the mother pertaining to risk of having type 2diabetes in future. Additionally, older women have been reported as likely to develop the disease due to their increased life expectancy (WHO, 2010). Another qualitative study on the same revealed that there are risk factors in women than in men. For instance, the mentioned study indicated that women with diabetes are at risk of developing cardiovascular diseases, blindness, ischaemic heart diseases. Magliano, Zimmet, Williams, et al (2010) in their study argued that their life quality and survival rate is likely to be poorer. However, Bloomgarden (2004) argued that the study had limitations on its methodology as the data was based on self-report and men are unlikely to admit problems in particularly problems that are not physically limiting such as diabetes. Lifestyle: physical activity According to WHO (2011), a person’s lifestyle is one of the key determinants of ones health. Therefore in order to prevent diabetes it is essential for people to have a healthy lifestyle. A study carried out by on the impacts of physical inactivity and sedentary life on obesity and glucose metabolism indicated that the same also increases chances of one having diabetes. In is study on sedentary lifestyle pointed out that overweight and obesity significantly contributes to increased rate of diabetic cases in Australia. LaMonte (2007) pointed out the importance of physical activity for treatment and prevention of type 2 diabetes mellitus. Bloomgarden, (2004) in his observational study using 3450 male Australians reported that the risk of having diabetes is lowered by about 6% if 500 kilocalories are lost every week due to physical activities. Another quantitative study carried out on the relationship between prevention of diabetes and physical activity revealed that diet plus exercise is likely to reduce diabetes as compared to exercise or diet alone. Lifestyle: healthy diet Physicians and medical researches have emphasized the importance of healthy diet not only in preventing but also in treating diabetes (Bloomgarden, 2004). Therefore, it is important that patients adopt healthy diets as a means of treating and preventing diabetes. According to Cohen (2001) the main therapy for diabetes has been healthy diet and it has been before insulin came into use 55 years back. Jakicic, Lang, Polley, Venditti, & Wing (1998) used experimental study among 123 Australians with 73 being females and 80 males. All the individuals in the aforementioned study were not only obese but also had type 2 diabetes. The control group was subjected to a diet of 133g proteins, 300g carbohydrates and 149g fat while the other group was given 160g fat, 150g proteins and 20 carbohydrates everyday. After a period of two weeks, the findings indicated that the daily level of calories dropped from 3012 to 2178 with considerable weight loss. Additionally, insulin sensitivity improved as well as plasma cholesterol decrease and glycemic control (Magliano, Zimmet, Williams, et al, 2010). Socioeconomic status impact Type 2 diabetes development is a multi-factorial process that occurs over a person’s lifetime. According to WHO (2011) glucose metabolism early risk factors contributes to later risk factors which causes diabetes. According to Mukherjee (1999) socioeconomic factors impact on the life of an individual at very early stages resulting in development of behavior patterns that are unhealthy. The aforementioned can result into health problems such as obesity and diabetes. Health Direct Australia, (2010) carried a study to test the impacts of socioeconomic factors on progression of diabetes. The findings of the study indicated that smoking and physical activity can partly provide an explanation for relationship between diabetes and economic diversity. Mukherjee (1999) in his study pointed out that education level in one way or the other contributes to diabetic cases in Australia. This is due to the fact that an individual’s level of education is likely to influence ones knowledge and understanding of importance of preventive measures. A study carried out by Magliano, Zimmet, Williams, et al (2010) also pointed out that income and occupation in one way of the other contribute to increased risks of diabetes. This is because the aforementioned socioeconomic status impacts on ones diet and lifestyle. Conclusion However, the mentioned studies have failed to use sufficient mediation analyses as well not including objective measures for the status of diabetes. The obtained results have not been consistent making the studies not to be reliable. Additionally, the studies seemed to have generalized their samples across populations of similar socioeconomic and ethnicity range. Furthermore there are inadequate studies on type 2 diabetes particularly on Western Australia, making this study to be of significance. Lastly some of the studies relied of the self-report recording as a means of recording data ma king the used variables to be inaccurate or unreliable. The aim of the study The aim of this particular study is to investigate the incidence of type 2 diabetes in 21 above individuals in western Australia from 1999 up to date using case studies, by socioeconomic and region status using social determinants such as physical activities, diet, and the role of gender. Research questions 1) Do economic factors influence the choice of diets and lifestyles among Western Australians? 2) What is the role of education, gender, occupation and income level in diabetes in Western Australia? 3) Does urban western Australians at risk of having type 2 diabetes than their rural counterparts? 4) Does urban Western Australian women at risk of type 2 diabetes than their rural counterparts in the same region? 5) Does men and women in Western Australia faces the same risk factors in developing type 2 diabetes and how does social determinants contribute in each gender? Research questions significance As aforementioned in the earlier sections of this paper, approximately 1 million people are diabetic in Australia and more than half of the same number is an unaware of their condition an aspect that results into loss of lives. Hence, this study aims to create an awareness of diabetes among Western Australians. The study will add to the existing knowledge and make physicians to be in a position to be aware of the role of social determinants and socioeconomic factors in development of diabetes. Moreover, the study is likely to make physicians to come up with new programs for controlling and managing type 2 diabetes in Australia. Research design summary This study will be qualitative research as a result of the complexity of the phenomena. Qualitative research is also recommended for this particular study based on the above highlighted research questions. The study will be longitudinal as it will rely on repeated cases over a certain period of time. Additionally, it will assist in uncovering the predictors of type 2 diabetes in Western Australia. The advantage of this particular method is that it’s hard to manipulate phenomena and hence it is suitable for this particular study. Lastly there are long term phenomena which need to be studied in relation to diabetes in Western Australia. The study will be comparative in that it will compare data on cases of diabetes in rural and urban set up in Western Australia. Additionally, comparison will be between various socioeconomic factors and social determinants as well as the rate of diabetes between western Australian males and females. Type of data collection: Case studies The study will use four case studies in answering the outlined research questions as well as attaining its aim. To ensure credibility of this study, the case studies used will be drawn from the years 2005 and 2010. The cases will be drawn from Western Australian Diabetes Register and also from the western Australian Hospital Morbidity Data System. Address system will be used to group the selected cases into rural and urban as well as using five socioeconomic groups. In this case, the index of relative socioeconomic will be used. The limitation of this particular method is that the denominator data that will be used will be obtained from Australian Bureau of Statistics. In data analysis, Poisson regression will be used to analyze the incidence rates by socioeconomic status and area. Definition of concepts Diabetes: Is a type of metabolic disease whereby a person has high blood sugar, because the body fails to respond to produced insulin or does not produce sufficient insulin. Type 1 diabetes is as a result of body not producing enough insulin while type 2 diabetes is because of insulin resistance (Health Direct Australia, 2010). Health social determinants: According to WHO (2010), these are conditions in which persons are born, age, live, grow and work as well as the health system. The aforementioned circumstances are shaped by either distribution of power, resources and money at local, national and global levels which are as a result of policy choices. Physical activity: Physical activity is any type of body movement that works the muscles and uses more energy as compared to resting. Physical activities include: dancing, running, yoga and swimming among others (Schrauwen, 2007). Healthy eating: this is the act of eating a variety of foods that provide the necessary nutrients needed not only to maintain ones health but also to have energy and feel good. The nutrients include: water, minerals, fat, carbohydrates and proteins (WHO, 2011). Lifestyle: it is a way in which societies, households and individuals live which is manifested in the way in which they cope with their economic, physical, social and psychological environments on a daily basis. Socio-economic status: Is the total measure of a group or individuals standing in the society. It is usually measured in terms of educational achievements, income level, wealth and occupation among others (Mukherjee, 1999). Reference: Bloomgarden, Z. T. (2004). Diet and diabetes. Diabetes Care, 27(11), 2755-2760. Cohen, S. N. (2001). Diet and diabetes. The Western Journal of Medicine, 126(1), 31-31. Diabetes Australia [DA]. (2010). National policy prioties 2010. Retrieved from http://www.diabetesaustralia.com.au/en/Recycle-Bin/Media-Releases/National-Diabetes-Policy-Forum-2010/ Diabetes Western Australia [DWA]. (2011). About diabetes type 2. Retrieved from http://www.diabeteswa.com.au/About_Diabetes/Type_1 Health Direct Australia [HDA]. (2010). Diabetes Statistics 2010. Retrieved from http://www.healthinsite.gov.au/topics/Diabetes_Statistics Jakicic, J. M., Lang, W., Polley, B. A., Venditti, E., & Wing, R. R. (1998). Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care, 21(3), 350-359. LaMonte, M. J. (2007). Physical activity and diabetes prevention. Journal of Applied Physiology, 99(3), 1205-1213. Magliano, D. J., Zimmet, P. Z., Williams, E. D., et al (2010). Health behaviours, socioeconomic status and diabetes incidence: The Australian diabetes obesity and lifestyle study (AusDiab). Diabetologia, 53(12), 2538-2545. Mukherjee, D. (1999). Socio-economic status and school system enrolments. Sydney, Australia: Australian Centre for Equity through Education. Schrauwen, P. (2007). Physical activity and diabetes: Current considerations. Applied Physiology, Nutrition, and Metabolism, 32(3), 535-536. Women’s Health Victoria [WHV]. (2010). Women and Diabetes Report 2010. Retrieved from http://whv.org.au/static/files/assets/abec140a/Women_and_diabetes_GIA.pdf World Health Organization [WHO]. (2011). Diabetes [Fact sheet]. Retrieved from http://www.who.int/mediacentre/factsheets/fs312/en/ World Health Organization [WHO]. (2010). Global recommendations on physical activity for health. Retrieved from http://whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf Read More