Written by Vincent Dinh
Low-income in Canada is an ongoing issue, with a yearly rise in the entry rate of 5.1%. Low-income is a threat towards health as a fundamental right, resulting in an increased risk of developing diseases. Diabetes is an important disease to monitor in low-income households because of the significant costs associated with treatment. Therefore, the lack of health insurance that comes with job insecurity results in prioritizing food and rent over medication. If unmanaged, diabetes can result in the occurrence of other diseases, further increasing burden. According to a Canadian study, diabetes in low-income households had a prevalence of 9.1%, compared to 2.2% in high-income counterparts. Thus, low-income populations are more likely to develop diabetes by 414%.
The root cause of high diabetes prevalence associated with low-income is food insecurity, defined as the inaccessibility to a sufficient quality diet. Food insecurity in Canada impacts about 12.5% of households, with a strong association to low-income. A survey conducted in low-income neighbourhoods in Toronto showed that 79% of residents experienced difficulty accessing healthy foods. As a result, these households often consume greater amounts of sugar and trans fats from inexpensive foods, which is strongly associated with developing diabetes. Further, a diet of this nature may lead to excessive weight gain, a significant risk factor for developing diabetes.
Another cause to this health need in low-income communities is physical inactivity. Physical inactivity is common as households may not have the necessary funds to afford safe means for physical activity, such as proper equipment. Further, those living with low-income may not have time to meet the recommended amount of exercise due to working overtime or multiple jobs. Similar to food insecurity, a lack of exercise may lead to excessive weight gain, which is highly correlated to diabetes, with a study showing approximately 61%-74% of diabetes prevalence in Canada was related to obesity.
Additionally, high stress has been linked to diabetes in low-income communities. Studies reveal that low-income living leads to chronic stress, which has a negative effect on health. Chronic stress in these populations often stems from having insecure employment and constant worrying about budgeting to afford basic living essentials. This stress can lead to a spike in cortisol levels, the primary stress response hormone of the body. High cortisol levels lead to secondary effects of the hormone, including high blood sugar and high blood pressure, which are associated with a greater risk for diabetes.
Nevertheless, there have been government initiatives to help these communities combat diabetes. The Canadian government has shown willingness to provide funding into prevention programs for diabetes, committing $4.5 million over 4 years towards providing dietary education in 2019, along with hundreds of millions spent on past preventative programs.
However, there are often barriers that prevent low-income communities from fully benefiting from government intervention. One of the major deterrents of government intervention is a possible language barrier that may exist. Each year, approximately 16.6% of new immigrants in Canada are considered ‘low-income’, suggesting part of the low-income population is separated by a language barrier. Resultantly, this would prevent part of the population from accessing necessary education regarding healthy living and diabetes prevention. Furthermore, a study suggested that some may lack the motivation to change their habits and thus, would be reluctant to change their diet regardless of government aid. Lastly, intervention success may be low due to the higher prevalence of disease in the younger population. A report indicated that children in poverty likely experience adverse circumstances starting from birth, placing them at a higher risk for developing diabetes. Therefore, as the risk begins at a young age, intervention targeted towards working adults may not be effective enough to prevent the development of the disease.