By Dr. CHRISTOPHER J. MORGAN
November is Diabetes Awareness Month and Friday, November 14 is World Diabetes Day. Around the world diabetes associations, public health units and community groups will organize community forums, risk assessment screenings and general information sessions on diabetes.
In Toronto, the Canadian Diabetes Association will host its annual Toronto Diabetes Expo on Thursday, November 13 at the Ontario Science Centre, 770 Don Mills Road (at Eglinton). The theme for the Expo is “Don’t Just Survive, Thrive with your Diabetes”, which will be presented by Dr. Ian Blumer, Diabetes Specialist and author of Diabetes for Canadians for Dummies.
The Caribbean Chapter of the Canadian Diabetes Association is currently planning its next meeting which according to the association’s President, Kathy Nelson, may be a lively discussion on eating well during the festive Christmas season. Similarly, information, education and discussions on preventing and living well with diabetes is available through Diabetes Programs at various community agencies such as TAIBU Community Health Centre (CHC) or Rexdale CHC. All of these events and programs are free to the community.
As I have said before, to those of you reading this article, either you are, or someone close to you is, living with diabetes. Diabetes is very prominent in the Black community and has reached epidemic proportions around the world and here in Canada. Today, more than nine million Canadians live with diabetes or pre-diabetes and according to Health Canada the number of people with diabetes is increasing by seven per cent, or more than two million, each year. Globally, every 10 seconds two people develop diabetes, resulting in more than 285 million people being affected and, based on current trends, it is expected that 380 million will be affected by 2025.
The human cost of diabetes is devastating. According to the World Health Organization (WHO), more than 80 per cent of diabetes deaths occur in low and middle-income countries. Over time, diabetes can damage the heart, blood vessels, eyes, kidneys and nerves. It significantly increases your risk of cardiovascular disease. In fact, 50 per cent of people with diabetes will die of heart disease or stroke. Due to damage to the nerves and small blood vessels diabetes is the leading cause of blindness for people over 20 and the number one cause of non-traumatic limb amputation. It is also among the leading causes of kidney failure, accounting for 10 – 20 per cent of diabetes deaths. Here is another alarming fact – the overall risk of dying among people with diabetes is at least double the risk of their peers without the disease. Diabetes is a chronic disease without a cure.
The recently released Vital Signs Report by the Toronto Foundation takes a close look at the overall health of the City of Toronto. It considers in a broad sense key factors that make a city desirable to live in, such as the economy and employment, the education and health care system, transportation, housing, safety, recreation, and so forth.
Whereas Toronto is the fourth-largest city in North America and has been rated as one of the top four cities in the World, there are some significant paradoxes and challenges. According to the Vital Signs Report, Toronto has the best education system in the world, yet youth unemployment is 20 per cent and even higher among racialized youth, not to mention the drop-out rate in this group. There have never been so many condominiums being built at the same time in Toronto’s history, yet over 90,000 families are holding their breath on the never-ending affordable housing waiting list.
The Vital Signs Report states the healthiest economies are those where the gap between the rich and the poor is the lowest (smallest). It is alarming to note that income inequality is rising faster in Canada than in any other developed nation in the world other than the United States. Income polarization creates a “widening achievement” and/or opportunity gap.
There are a number of areas for improvement highlighted throughout the Vital Signs Report. As I carefully read the Health and Wellness section, there were a number of facts relevant to the state of diabetes in Toronto. First and foremost, diabetes rates in Toronto have increased steadily each year over the last three years: 4.6 per cent in 2011, 6.0 per cent in 2012 and 6.2 per cent in 2013. Whereas the overall diabetes rate in Toronto is below the provincial average, it is higher than the provincial average in communities with low or lower incomes, with poor access to healthy fruits and vegetables, parks, bicycle and walking paths. Two-thirds of the people living in these same neighbourhoods are visible minorities.
Being overweight is another risk factor for developing diabetes. The number of obese Canadians has tripled since the mid-1980s. According to the Vital Signs Report, the percentage of overweight or obese adults in Toronto has been consistently beyond 40 per cent the last three years: 45.8 per cent in 2011, 43.8 per cent in 2012 and 46.2 per cent in 2013. Coupled with an aging population and changing demographics in which two-thirds of Torontonians are expected to be foreign-born within the next 10 years, many of those will be at risk of developing diabetes due to their ethnicity and family history or due to the challenging lifestyle and circumstances they find themselves in trying to make it in Toronto.
The ingredients are prime for the continued escalation of diabetes in Toronto and likely across Canada. What is required is a heightened personal responsibility regarding our health and that begins by becoming better informed and accessing the information and services that can help you to make the necessary changes that will improve and sustain your health. The second is effective public health policy that includes guidelines, legislation and health promotion campaigns that will support our quest for a healthy and fruitful life.
Dr. Christopher J. Morgan is the director of Morgan Chiropractic & Wellness, an interdisciplinary health centre in Toronto, and the Founder and Past President of the Black Health Alliance, a network of community organizations, health professionals and community members working in partnership to advance the health and well-being of the Black community. He can be reached at 416-447-7600 or firstname.lastname@example.org.