Health Inequalities In Relation To Diabetes Assignment Sample

Introduction Of The Extent To Which Social Determinants Of Health Explain Health InequalitiesIn Relation

The Extent To Which Social Determinants Of Health Explain Health Inequalities In Relation To Diabetes Mellitus Type 2 In Indian Adults

The context of “social determinants of health (SDH)" refers to the non-medical factors and conditions in terms of influencing health outcomes and shaping the conditions of daily lives (Who.int, 2023a). These conditions consist of financial systems, policies as well as developing and social agendas, norms and political aspects. The following essay is intended to address the primary context of social determinants and health inequalities along with the extent of these towards the prevalence of “Type 2 Diabetes Mellitus” (T2DM). This also includes identifying the target population of the identified disease conditions while addressing three specific social determinants for addressing the extent to create health inequalities.

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Discussion

The context of social determinants and health inequalities in India

Even though the importance of SDH in India has been recognised, the compilation regarding the status and inequalities on SDH across the country has not been met with the objectives. The gap regarding the level and trends of the SDH in India starts from 1990 onwards in terms of shading light on exploring inequities based on gender along with caste and urbanity (Hooten et al. 2022). This also includes changes in the multidimensional poverty index which helps in demonstrating the progress in each domain of SDH and explain the composite measure of health education and standard living. It also indicates the prevalence of indoor and outdoor air pollution along with malnutrition status of children, employment conditions along with gender inequality and sanitation are considered marked areas of public policy in regards to the identification of SDH in the country (Min et al. 2022). The country has the birth rate of 16.949 along with 2.05 births per woman (Ncbi.nlm.nih.gov, 2023a). While addressing the social economic inequalities in the country approximately 53.9% a population belongs to the richest wealth and urban place residence of 37.9% and individuals from the age group 45 to 65% of 33.3% in the case of non-communicable diseases (Ncbi.nlm.nih.gov, 2023a). The majority of the population in India uses indoor fuel alongside low sanitation for over 1/3rd of households that have children under the age of 1 year. This is followed by no measurable changes in terms of addressing gender biassed participation in governance, labour state alongside less than 25% of the population having no security for job and less than 15% of the population not having any social security (Ncbi.nlm.nih.gov, 2023a).

As per the explanation by WHO, it was also understandable that SDH in the Indian context have a strong influence on health equity and referred to the expense and protection from society alongside educational qualification, rate of unemployment, working life conditions and food accessibility and the availability of housing (Who.int, 2023a). These determinants have a strong impact on health in equities alongside maintaining disease control and prevention processes that are committed to achieve improvement in the population lives by reducing the unequal factors. On the other hand, the myopic view towards health in the country is considered a rendition of service or behaviour that explains the availability of non-discriminative and social inclusionary views and conflict on society structure to access payable and quality health services (Healthcareradius.in, 2023). This is followed by stating the SDH account between 30 to 55% of health outcome and reduction of mortality rate under the age of 5 while attributing 50% of investment outside the health sector (Healthcareradius.in, 2023).

Identification of three different social determinants that creates health inequalities

The “social model of health” emphasises on the factors that are capable of contributing towards health in the form of “social, cultural, environmental and political” (Neff et al. 2022). This model is effective in terms of identifying the influential factors that are capable of affecting health in society. Some of the crucial factors under this model refers to employability and social status along with the income possibility and work environment conditions and network on social support as well as gender issue, cultural context, development in early childhood and transportation, accessing education and literacy with health service, limiting social exclusions and practice in regards to personal help (Who.int, 2023a).

While India consists of a labour market compared to developed countries due to the presence of rapid changes regarding age distribution of population, the trends and pattern regarding financial growth does not guarantee the escalations in equal job opportunities (Oecd.org, 2023). This is followed by low growth productivity and fragmentation of the labour market in India alongside the presence of institutional and social barriers that have a crucial impact on labour market segmentation. This is one of the significant reasons that creates discrimination and diminishes the advantages of growth for the employees in lowly developed regions, small cities, rural areas and under privileged social financial distributions (Garcia, 2022). This is followed by the overall scenario of employment and unemployment for the working population declining over the years and reducing the power of unemployment affordability for a specific household. It also includes choosing hide education and frictional unemployment among the educational population and that reflects on the stability and changes in employment rate. This is followed by decreasing social security that covers less than 10% of the total workforce in India and is difficult for an organised worker (Oecd.org, 2023). This results in increasing poverty and lowering the financial stability among the population and leads to undermining poverty.

This is followed by addressing the role of other socioeconomic factors such as educational level to influence the health insurance status and inability to access primary and speciality health care providence that increases the prevalence of chronic illness such as diabetes, hypertension or cardiovascular disease (Dawes, 2020). It also includes unequal distributions of academic resources alongside limitation of school funding and absence of qualified and experienced teachers and access to books and technology for the socially excluded community. [Refers to appendix 1]

Gender bias is considered another significant recent event that creates inequality in India in terms of accessing education. Girls are openly sent to the government school, while male children are accessible to private school and the ratio of girls and boys regarding the access to higher studies after the intermediate school is poor (Insightsonindia, 2023). This is followed by caste discrimination and financial stress on parents that are capable of causing distress in child education and leaving the school early to work. On the other hand, race discrimination potentially limits the effect of education and thus increases health inequalities. This is followed by deduction of government spending on the adult learning process alongside influencing health in terms of decreasing uptake of preventive care among adult people that results in increasing health cost, accessing expensive medication, surgery and increasing chance of mental Health illness (Healthactioncampaign.org.uk, 2023).

Apart from that income and financial stability are considered significant factors that have a crucial impact on purchasing insurance of health, mitigating economic issues, diminishing poverty and increasing the accessibility of medicines from the perspective of a patient (Healthactioncampaign.org.uk, 2023). Financial stability is also effective in reducing the financial distress in diabetes and self-management while supporting the care process. The unavailability of financial stability and income impact non conclusive outcome and disease prevalence while limiting the axis of available medication and care strategy also address increasing cost of healthcare and medical care that have a crucial impact on affecting lifestyle management and maintaining patient and care provider communication (Hardeman et al. 2022). The absence of these can lead to the mismanagement of disease prevention and hampering lifestyle.

The extent to which social determinants of health lead to health inequalities for T2DM

The context of SDH in terms of health inequalities connects and interacts with the development of origin of health and disease and that influences the trajectory of the identified disease (Hill-Briggs et al. 2021). It includes the communities, access and affordability of nutritious food, generic health risks that are carried from past generations and falling the trap of advertising and a wide presence of junk food and many more. The role of the built environment is considered a significant factor that is directly correlated to health and part of SDH which affects the ability to be healthy in several ways. For the case of identified disease, this concept determines the exposures of population towards pollution, access of fast food, farmer market, grocery stores alongside workable area, quality of drinking water and stress factors (Schillinger, 2021). The link between T2DM and living in case of identified factors refers to the increasing prevalence and creates changes to the microbial that contribute to the disease. It also includes sex and genetics in the form of identifying the possibility of racial and gender factors for the identified disease. While men are at risk twice in comparison with women to have T2DM, women with polycystic ovary syndrome and insulin resistance are prone to developing this disease (Schillinger, 2021).

On the other hand, diabetes mellitus is considered the 6th largest cause of death and affects approximately 25.6 million individuals over the age of 20 (Ncbi.nlm.nih.gov, 2023b). The primary context of SDH in regards to the identified disease refers to the allocations of healthcare resources system of funding and paying for care process cultural attitude towards the overall healthcare process. It also causes serious long-term complications in the form of sightlessness, CVD, CKD, hypertension, MI and neuropathy, amputation of lower limb and premature babies (Oecd.org, 2023). Clinical approaches that are primarily focusing on the individuals in terms of improving self-management outcome and reduction of the disease leading to short-term improvement. However, the SDH factor relies on the social ecological factors that are severe for affecting health. It includes external or upstream determinants in the form of support from society and different community elements that potentially impact the health of individuals (Frier et al. 2020). That community infrastructure including transportation neighbourhood safety and the access capacity of healthy food are considered significant barriers in terms of individuals with diabetes while shedding light on the inadequate access of resources. Limited transportations in rural areas in India required travel outside the local community for accessing primary Health care and healthy food (Sai Ambati et al. 2020). On the other hand, urban residents face issues with transportation due to absence of sidewalks and this encourages individuals to choose walking as the part of managing physical activities. It also includes lack of neighbourhood safety that impacts on health disparity and high rate for food and medical care.

Apart from that, financial stability is another significant SDH that demonstrates the primary relationship between socioeconomic status and the availability of health outcomes. This entirely depends on the education level, employment, family income that are capable of affecting the social and financial status and therefore, health outcome for the disease (Brady et al. 2021). This also includes educational factors that have linked with the improvement of health outcomes. It also provides stability and access to a range of opportunities for better employment, eating healthy food, being physically active and avoiding disease such as diabetes and obesity (Hooten et al. 2022). It also includes access to medical care that causes disparities for the availability of healthcare resources and is entirely based on socioeconomic status of an individual. Cultural, social and community support also refers to the development of formal and informal relationships that help in supporting the care process emotionally in a specific situation such as employability to improve the overall health outcome. It also correlated with improvement of self-management outcome and perceptions of low level social support that increases the risk of self-management behaviour and thus reduces better health (Ncbi.nlm.nih.gov, 2023b).

Prevalence and risk groups of T2DM

While the non-modifiable factor of T2DM for the Indian population refers to the genetic predispositions and family history alongside the age more than 45 years; the modified risk factors include sedentary lifestyle, prone to obesity, unhealthy and unbalanced diet, stress factors altered in the environment, pollutant and inadequate sleep (Ncbi.nlm.nih.gov, 2023a). Approximately 77 million of people in the Indian context above the age of 18 years are suffering from T2DM and approximately 25 million of people are considered three diabetics or at higher risk of developing this disease in near future (Who.int, 2023b). However, 57% of individuals remain undiagnosed and in case of diabetes and there is curved diabetes in India is largely influenced by several factors such as physical inactivity, age factors, obese and unbalanced diet and demeanour of food consumption pattern in relation to the genetics (Ncbi.nlm.nih.gov, 2023c). This is followed by a fast transition from euglycemia to prediabetes and diabetes. It also includes high mortality and morbidity due to diabetic complications. Approximately 3.1% of all deaths in India are caused by the prevalence of diabetes and the rate is increasing from 1990 to 2020 by 131% (Healthcareradius.in, 2023).

The population who are living a sedentary lives and pregnant women are at risk of T2DM. Development of diabetes while being pregnant which is known as gestational diabetes is considered a significant factor that creates several health come applications for new moms and their babies (Ncbi.nlm.nih.gov, 2023e). This diabetes raises the risk of hypertension among mother's and preeclampsia which are contemplated to play a crucial role by creating life threatening situations during birth. This also includes putting the mother at high risk for type to diabetes later in life and developing risk for obesity after birth (Emeny et al. 2021). Besides, it also interpreted the risk of heart disease among mothers in the postnatal period.

On the other hand, while addressing SDH in terms of addressing developmental origins, it can be stated that focusing on biological changes and health outcomes are effective factors that result in nutritional, environmental and social exposure to disease. This factor is applicable for gestational diabetes where the baby is exposed to certain situations and nutritional aspects outside the uterus and more likely developed disease such as T2DM as an adult (Hooten et al. 2022). While addressing the potential cause and outcome of the identified disease, it can be stated that exposure of this disease for women of reproductive age may impact the health of the future babies. Approximately 6 to 9% of pregnant women have chances to develop gestational diabetes and the number has increased in recent years (Ohsu, 2023). Besides, one in 260000 babies are born with diabetes which may disappear within the first twelve weeks of life due to the presence of gestational diabetes of the mothers and have the chance of reoccurring in the future which is known as transient neonatal DM (Hooten et al. 2022).

Prevention strategies for T2DM related health inequalities in India

The rising rate of T2DM or associated complications both in urban and rural areas of India alongside the young children are concerning. The specific challenges in regards to the identified disease management or prevention refers to the lack of strong national partnership in terms of employing multisectoral action along with the absence of availability of strong impact and study information on DM (Schroeder et al. 2021). This is followed by lack of awareness among the population and absence of basic prevention processes in the case of primary healthcare settings. These are considered significant reasons that lead to the inability to access affordable medicine and leading to premature deaths (Ranasinghe et al. 2021). Apart from that, the presence of disproportionate fund allocation while addressing the diabetes program along with difficulties in terms of engaging industrial and private sectors increase the concerning factors for the prevalence of the disease. Besides, limitation of skilled population and incomplete group mobilisation and low harmonisation among societies and government agencies are significant reasons for difficulties to tackle the prevalence of DM in India (Ranasinghe et al. 2021).

However, prevalence strategy while reducing the exposure of the specific lifestyle for identified disease refers to the promotion of health and improving primary prevention aspect. This also includes early detections of the disease and the providence of timely treatment. This is followed by surveillant the trends in T2DM and included risk factors by using high level up dedication and multi-sectoral activities with the aim of reducing the growing burden of T2DM in India. This includes the use of the “National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)” in order to focus on the conscious generation, early diagnosis process and treatment (Bmj, 2023). It also includes improving national food policies with the aim of pointing out the availability and accessibility of nutritious food and managing food safety and standard and distribution for whole grain, fruits, legumes, nuts and vegetables. Monitoring health related policies to decrease damaging lifestyle behaviour such as alcohol, smoking, including trans-fat food in diet, and lowering physical actions and many more while aiming to increase the modifiable factor of diabetes (Ncbi.nlm.nih.gov, 2023d). It also includes the implementation of prevention policies such as “health information and communication” in order to improve the consciousness among the Indian population and policies to reduce the cost of essential medications and ensuring proper access for healthcare. This also requests the formation of collaboration between the informative health aspects, educational context and agricultural ministry level department to create consciousness and improve healthy lifestyle for the people (Ncbi.nlm.nih.gov, 2023d).

Conclusion

In terms of concluding the following essay it can be stated that India is one of the diabetic prevalent countries with a proper gap between different SDH and exploring health equities. This essay has successfully addressed the overall context of SDH inequalities along with the role of SDH that lead to the health inequalities in the case of T2DM. This is followed by discussing the prevalence and risk groups of the disease and prevention strategic planning for T2DM in India.

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