For my health promotion topic, I have chosen improving diabetes management in patients diagnosed with Type 2 diabetes living in Langley, BC.
What I know about diabetes is that the prevalence of diabetes amongst Canadians is increasing (Government of Canada, 2021). Currently one in 14 Canadians live with diabetes, many of whom will experience complications such as heart and kidney disease, amputation, neuropathy, poor wound healing, increased mortality and increased dependence on acute care services (Government of Canada, 2019). According to the Government of Canada (2021), diabetes has an increased prevalence amongst marginalized Canadians especially those patients who are First Nations or Metis, of African and South Asian decent and those with lower incomes and education levels. Fazli and Booth (2023) estimate that the cost of diabetes to the health care system is projected to reach $4.9 billion by the year 2030.
Thinking about my health promotion topic, I will use the Population Health Promotion Action Model to guide me to propose strategies and interventions to improve the health of those living with type 2 diabetes in Langley, BC. To help define the what, I will need to examine and address the social determinants of health that impact diabetes management. I will use the action strategies outlined in the Ottawa Charter to work through the how and be looking for evidence informed interventions at the individual, community, and system levels to figure out the who to involve.
I would like to learn how factors like income, education, and access to healthcare impact diabetes management and outcomes in my community. I would also like to gain an understanding of the role of policy in health promotion and learn how to advocate for policies that address health disparities and improve access to diabetes care for all people in my community.
I am most excited to learn how to apply the Population Health Promotion Action Model to the issue of diabetes management in my community. I want to learn about this because my career has been focused in acute care or on the reactive side of illness or it is complications. I am looking forward to learning how to utilize a framework that will help me lead future health promotion from a population health perspective and one that addresses health care inequities to improve the overall health of my community.
Everything about this health promotion learning journey makes me nervous, mostly because it is something I know little about given the acute care focus of my career. I am also nervous that my positionality as a white, middle class, educated female may create blind spots as I propose interventions and strategies aimed at improving the health of my community and reducing the health inequities experienced by marginalized groups in my community. I will need to be intentional in engaging in regular reflection to understand how my privilege and positionality may influence my perspectives and relationships with marginalized patients.
As I pursue this topic, I will be challenged to find evidence-based intervention at all levels of action especially at the community and system levels. To date, a sizable portion of the evidence I have found to support improved diabetes management supports interventions at the individual level only. I did find one article by Fazli and Booth (2023) that references several community diabetes programs that were co-designed with Indigenous people with proven success that I can draw on to find additional evidence to support my interventions at the community and systems level.
- Kimberly
References
Fazli, G. S., & Booth, G. L. (2023). Call for Action on the Upstream Determinants of Diabetes in Canada. Canadian Journal of Diabetes, 47(7), 618–624. https://doi.org/10.1016/j.jcjd.2023.05.011
Government of Canada. (2021, December 13). Diabetes in Canada in review. Canada.ca. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/diabetes-canada-review-2021.html
Government of Canada (2019, April 24). Infographic: Inequalities in diabetes in Canada. Canada.ca. https://www.canada.ca/en/public-health/services/publications/science-research-data/inequalities-diabetes-infographic.html
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