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服务提供者视角下的加拿大皮尔地区影响南亚成年人 2 型糖尿病管理的社会决定因素探索。

Service Provider Perspectives on Exploring Social Determinants of Health Impacting Type 2 Diabetes Management for South Asian Adults in Peel Region, Canada.

机构信息

Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada. Electronic address: Chelsea.D'

Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada.

出版信息

Can J Diabetes. 2022 Aug;46(6):611-619.e1. doi: 10.1016/j.jcjd.2022.05.011. Epub 2022 Jun 2.

DOI:10.1016/j.jcjd.2022.05.011
PMID:35843835
Abstract

OBJECTIVES

Individuals from South Asian communities are known to have a higher likelihood of developing type 2 diabetes (T2D), which is often attributed to individual lifestyle and behavioural factors. This focus on individual responsibility can position communities as complicit in their illness, compounding stigmatization and systemic discrimination. In this article, we explore the social determinants of health (SDOH) that influence health behaviours among South Asian adults with T2D from a service provider's perspective.

METHODS

Using a qualitative descriptive design, we conducted semistructured interviews with 12 community, social and health-care service providers. We used thematic analysis and the analytical concept of intersectionality to explore how different social locations and SDOH impact T2D management for South Asian adults.

RESULTS

Three themes were identified: 1) managing challenges with settlement process, labour policies and job market disparities take priority over T2D management; 2) poor working conditions and low socioeconomic status reduce access to health care and medication; and 3) there are social, economic and cultural barriers to implementing diet and exercise recommendations.

CONCLUSIONS

Service providers identified social, economic and systemic factors as influencing the higher prevalence of T2D among South Asian individuals. They also identified their important roles in providing culturally appropriate supports to address SDOH and described advocacy for changes to policies and practices that reinforce systemic racism. The providers further suggested that more equitable employment policies and practices are needed to address the systemic factors that contribute to the higher risk of T2D among South Asian adults in the Peel Region.

摘要

目的

南亚社区的个体患 2 型糖尿病(T2D)的可能性更高,这通常归因于个体的生活方式和行为因素。这种对个体责任的关注可能会使社区成为他们患病的同谋,加剧污名化和系统性歧视。本文从服务提供者的角度探讨了影响南亚 T2D 成年患者健康行为的社会决定因素(SDOH)。

方法

我们采用定性描述设计,对 12 名社区、社会和医疗保健服务提供者进行了半结构式访谈。我们使用主题分析和交叉性的分析概念,探讨了不同的社会地位和 SDOH 如何影响南亚成年人的 T2D 管理。

结果

确定了三个主题:1)管理移民过程中的挑战、劳动力政策和就业市场差距优先于 T2D 管理;2)工作条件差和社会经济地位低会减少获得医疗保健和药物的机会;3)实施饮食和运动建议存在社会、经济和文化障碍。

结论

服务提供者确定了社会、经济和系统因素对南亚个体 T2D 患病率较高的影响。他们还确定了在提供文化上适宜的支持以解决 SDOH 方面的重要作用,并描述了倡导改变政策和做法以加强系统性种族主义的情况。提供者还建议,需要制定更公平的就业政策和做法,以解决导致皮尔地区南亚成年人患 T2D 风险较高的系统性因素。

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