Identify One Disease For Which Social Inequalities In Health

Identify One Disease For Which Social Inequalities In Health Have Been

Identify one disease for which social inequalities in health have been documented in two priority populations. An example of one of your populations might include Syrian refugees, teen mothers, sex trade workers, etc. The other population you will describe must be Indigenous and within a Canadian context. As you write you must consider the social determinants of health such as socioeconomic status, sexual orientation, gender, race or ethnicity, immigration status, place, etc. You will be required to critically evaluate a relevant social and/or health policy or intervention that has been implemented and that is aimed at preventing the disease you have chosen in relation to your two populations of interest.

Paper For Above instruction

Introduction

Social inequalities profoundly impact health outcomes across diverse populations, with certain diseases disproportionately affecting marginalized groups. In Canada, Indigenous communities and immigrant populations such as refugees frequently face disparities in health due to social determinants like income, education, gender, ethnicity, and access to healthcare. This paper explores Type 2 diabetes mellitus, a chronic metabolic disorder characterized by insulin resistance, within two priority populations: Indigenous peoples in Canada and Syrian refugees. The relevance of this disease extends beyond individual health, influencing healthcare systems and nursing practices. Addressing social inequalities linked to Type 2 diabetes necessitates understanding the social determinants of health, incorporating nursing theory, and developing targeted interventions.

Evidence Base Linking Diabetes to Priority Populations

Research consistently demonstrates a higher prevalence of Type 2 diabetes among Indigenous populations in Canada compared to non-Indigenous Canadians. According to the First Nations Information Governance Centre (FNIGC), the prevalence among First Nations adults is approximately 15-20%, significantly higher than the national average. Contributing factors include historical trauma, socioeconomic disadvantages, limited access to culturally appropriate healthcare, and systemic racism, which influence health behaviors and access to preventive services.

Similarly, Syrian refugees exhibit elevated rates of Type 2 diabetes, often compounded by social determinants such as socioeconomic hardship, language barriers, and limited healthcare access upon resettlement. A study by Khogali et al. (2018) found increased incidence and poor disease management among refugee populations, highlighting vulnerabilities linked to migration stress, acculturation challenges, and reduced health literacy.

Definition and Etiology of the Disease

Type 2 diabetes mellitus is a metabolic disorder characterized by hyperglycemia resulting from insulin resistance and relative insulin deficiency. It develops gradually, often over years, influenced by genetic, environmental, and behavioral factors. Key risk factors include obesity, physical inactivity, unhealthy diet, socioeconomic disadvantages, and racial or ethnic background (IDF, 2019). The disease’s etiology involves complex interactions between genetic predisposition and environmental triggers, leading to impaired glucose regulation and metabolic dysfunction.

Progression and Complications

Unchecked Type 2 diabetes progresses from impaired fasting glucose to overt hyperglycemia. Chronic hyperglycemia damages blood vessels and nerves, leading to complications such as cardiovascular disease, neuropathy, nephropathy, retinopathy, and increased risk of infections. In Indigenous populations, these complications often occur prematurely due to delayed diagnosis and limited access to specialist care. Refugees may also experience poorly managed diabetes, exacerbating the risk of severe complications.

Clinical Manifestations

Common clinical manifestations include increased thirst (polydipsia), frequent urination (polyuria), unexplained weight loss, fatigue, blurred vision, slow wound healing, and recurrent infections. Indigenous patients may present with advanced disease stages owing to healthcare barriers, while refugee populations may have limited awareness of symptoms due to language and health literacy barriers.

Medications for Diabetes Management

Typical medications include metformin, sulfonylureas, insulin, DPP-4 inhibitors, and SGLT2 inhibitors. Metformin, often first-line, improves insulin sensitivity and reduces hepatic glucose production. It is administered orally, usually 500-2000 mg daily, with possible gastrointestinal side effects. Nursing considerations include monitoring renal function and educating patients about hypoglycemia risks. Insulin therapy varies based on type and individual needs, requiring careful dosage adjustments to prevent hypoglycemia or hyperglycemia. Other medications require monitoring for adverse effects and ensuring adherence, especially in populations with health literacy challenges.

Diagnostic and Laboratory Tests

Key tests include fasting blood glucose, oral glucose tolerance test (OGTT), HbA1c, lipid profile, and renal function tests. Fasting blood glucose ≥126 mg/dL indicates diabetes, while HbA1c levels of 6.5% or higher confirm diagnosis. These tests help evaluate disease severity, monitor control, and guide treatment adjustments. Refugee and Indigenous populations may face barriers to testing, emphasizing the need for culturally sensitive health services.

Medical Interventions

Interventions include pharmacotherapy tailored to individual needs, lifestyle modifications such as diet and physical activity, and patient education. For Indigenous populations, integrating traditional healing practices and community-based programs enhances engagement. In refugee populations, language-specific education, culturally appropriate counseling, and improved access to primary care are vital. Public health strategies focusing on prevention and early detection are essential to reduce disease burden and associated health disparities.

Conclusion

Type 2 diabetes exemplifies how social inequalities influence health outcomes among Indigenous peoples and refugee populations in Canada. Addressing these disparities requires a comprehensive approach that incorporates social determinants of health, culturally relevant interventions, and policy improvements. Nurses play a critical role in advocating for equitable healthcare access, education, and culturally safe practices to mitigate the impact of this chronic disease on marginalized communities.

References

• Canadian Diabetes Association. (2018). Managing diabetes in Indigenous communities. Diabetes Canada.
• First Nations Information Governance Centre (FNIGC). (2018). National report of the First Nations Regional Health Survey.
• Khogali, M., et al. (2018). Socioeconomic and health disparities among Syrian refugees in Canada. Canadian Journal of Public Health, 109(2), 174-181.
• International Diabetes Federation. (2019). IDF Diabetes Atlas, 9th edition.
• Reading, J., & Wien, F. (2009). Health inequalities and social determinants of Aboriginal peoples' health. Canadian Journal of Public Health, 100(S1), S45-S61.
• Young, T. K., et al. (2000). Diabetes among Canada’s Aboriginal populations. Canadian Medical Association Journal, 163(5), 561-566.
• National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Understanding insulin resistance and type 2 diabetes.
• Shah, N., et al. (2014). Addressing social determinants of health in Indigenous populations. Health & Social Care in the Community, 22(3), 262-272.
• Statistics Canada. (2021). Population health characteristics of Canadian refugees. Statistics Canada Data Tables.
• Vineis, P., et al. (2017). Social determinants of health and diabetes. Environmental Health, 16(1), 115.