The Geography of Diabetes in London, Canada: The Need for Local Level Policy for Prevention and Management

Jordan W Tompkins,Stewart B Harris,Isaac N Luginaah,Gillian L Booth

doi:10.3390/ijerph7052407

Abstract

Recent reports aimed at improving diabetes care in socially disadvantaged populations suggest that interventions must be tailored to meet the unique needs of the local community—specifically, the community’s geography. We have examined the spatial distribution of diabetes in the context of socioeconomic determinants of health in London (Ontario, Canada) to characterize neighbourhoods in an effort to target these neighbourhoods for local level community-based program planning and intervention. Multivariate spatial-statistical techniques and geographic information systems were used to examine diabetes rates and socioeconomic variables aggregated at the census tract level. Creation of a deprivation index facilitated investigation across multiple determinants of health. Findings from our research identified ‘at risk’ neighbourhoods in London with socioeconomic disadvantage and high diabetes. Future endeavours must continue to identify local level trends in order to support policy development, resource planning and care for improved health outcomes and improved equity in access to care across geographic regions.

Highlights

Diabetes prevalence rates in Ontario have increased 69% in the past decade, rising from 5.2% in 1995 to 8.8% in 2005, exceeding the World Health Organization global projected prevalence of 6.4%by the year 2030 [1]
Recent reports aimed at improving diabetes care in socially disadvantaged populations suggest that, regardless of the city, interventions must be tailored to meet the unique needs of the local community—the community‘s geography
We adopted a population-based ecological design, involving principal component analysis (PCA), geographic information systems (GIS) and spatial-statistical techniques to examine diabetes rates and socioeconomic variables aggregated at the census tract level

Summary

Introduction

Diabetes prevalence rates in Ontario have increased 69% in the past decade, rising from 5.2% in 1995 to 8.8% in 2005, exceeding the World Health Organization global projected prevalence of 6.4%by the year 2030 [1]. Individuals of lower socioeconomic status have higher rates of diabetes and worse outcomes [2,3,4], and adoption of an innovative political agenda designed to target this high risk population is necessary, an agenda recognizing the unique contribution of socioeconomic determinants of health. Recent literature has placed an increased emphasis on reducing inequities across the socioeconomic hierarchy, and individual risk factors must not be ignored, awareness of the many factors clearly outside of an individual‘s control must be taken into consideration when designing innovative health policy [2,4]. The primary objective of this work was to examine the spatial patterns of diabetes in London and identify high-risk (socioeconomic) areas that may be in unique need for community-based program planning and interventions. We hypothesized that there would be a strong spatial concordance between diabetes and socioeconomic determinants of health

Objectives

Methods

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Discussion

Conclusion