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Capella University
NURS FPX 8014 Global Population Health
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Diabetes is a chronic condition that impairs the body’s ability to process sugar (glucose) in the blood. Glucose serves as a vital energy source for cells, requiring insulin—a hormone produced by the pancreas—to facilitate its transportation from the bloodstream into the cells (Sneha & Gangil, 2019). The incidence of diabetes has been rising globally, with approximately 463 million adults aged 20-79 affected by the disease in 2019 (Porwal et al., 2020). This condition is associated with increased morbidity and mortality rates, reduced life expectancy, and significant economic burdens on individuals and healthcare systems, thereby presenting a critical public health challenge. Various factors, including genetics, sedentary lifestyles, unhealthy diets, and obesity, contribute to the risk of developing diabetes (Kaur & Kumari, 2018). This assessment centers on creating an evidence-based intervention aimed at improving outcomes for the entire community while focusing on the diabetes issue in Mauritius.
Diabetes constitutes a major international health concern, impacting millions of individuals worldwide. The World Health Organization (WHO) estimated that 463 million people were living with diabetes globally in 2019, with projections suggesting this number may escalate to 700 million by 2045 (WHO, 2019). This chronic condition, characterized by impaired glucose metabolism, manifests as elevated blood sugar levels (Kaur & Kumari, 2018).
The impact of diabetes is felt universally; however, low- and middle-income countries (LMICs) bear a disproportionate burden. In 2019, over 75% of diabetes cases were reported in LMICs. Marginalized groups, including indigenous peoples and economically disadvantaged individuals, are particularly susceptible to diabetes, exacerbated by unhealthy lifestyles characterized by sedentary behavior and diets high in sugar and fat (Mogre et al., 2019). The five countries with the highest prevalence of diabetes include:
| Country | Diabetes Prevalence |
|---|---|
| Tokelau | 29.7% |
| Mauritius | 24.3% |
| Nauru | 23.8% |
| Cook Islands | 21.1% |
| Marshall Islands | 21.1% |
Diabetes-related disparities across nations encompass inequities in healthcare access and preventative measures, including education and early detection efforts. Furthermore, socioeconomic factors such as poverty and educational attainment significantly influence diabetes prevalence and management. Individuals with lower incomes often face barriers to accessing quality food and healthcare services, placing them at a higher risk for developing diabetes and experiencing complications. Historical injustices and systemic discrimination have further contributed to diabetes disparities, particularly among marginalized and indigenous populations. Addressing these inequities is essential for achieving fair and sustainable diabetes prevention and management on a global scale (Kaur & Kumari, 2018).
The inability to produce or effectively use insulin leads to elevated blood sugar levels, which can have profound social and political consequences if not properly managed (Hill-Briggs et al., 2020).
Socially, individuals with diabetes may face stigma and discrimination, resulting in social exclusion and diminished quality of life. Their health condition may hinder employment, educational opportunities, and income potential. Kaur and Kumari (2018) note that diabetes can adversely affect mental health, leading to increased stress, anxiety, and depression.Furthermore, uncontrolled diabetes can lead to serious complications such as neuropathy, vision impairment, and amputations, which significantly impact the patient’s quality of life (Abilities et al., 2020). Commonly perceived as a result of poor lifestyle choices, diabetics often face stigma related to their dietary habits and physical activity levels (Mogre et al., 2019). The restrictions imposed by diabetes can lead to feelings of social isolation, as individuals must adhere to specific dietary and activity regimens (Mogre et al., 2019).
The financial implications are substantial; diabetes management can be costly, placing a financial burden on patients and their families (Kaur & Kumari, 2018). Healthcare access disparities are pronounced in low-income and minority groups, further exacerbating the problem (Kaur & Kumari, 2018).Politically, the economic burden of diabetes treatment can significantly affect a nation’s economy, straining healthcare systems, increasing absenteeism from work, and reducing overall productivity. Governments may need to invest heavily in policies for prevention and management, which can be financially taxing (Hill-Briggs et al., 2020). Rising healthcare costs due to diabetes may overwhelm healthcare budgets (Powers et al., 2020).
Moreover, uncontrolled diabetes can result in decreased productivity and increased absenteeism, adversely affecting economic performance (Powers et al., 2020). The costs associated with social services for those experiencing complications can strain government resources, including disability benefits and healthcare systems (Kaur & Kumari, 2018).
Diabetes also leads to increased health insurance costs, affecting premiums and the overall insurance industry (Powers et al., 2020). A study published in Diabetes Care estimated the annual economic burden of diabetes in the United States to be nearly $327 billion (Ali et al., 2020). Additionally, research highlights the link between diabetes, reduced productivity, and increased absenteeism (Ali et al., 2020). Disproportionate impacts of diabetes are observed among marginalized groups, including racial minorities, low-income populations, and those with limited educational backgrounds (Baptista et al., 2019).
The demographic most affected by diabetes in Mauritius consists of middle-aged adults, particularly men. In 2019, 22.3% of adults aged 20 to 79 in Mauritius had diabetes, according to data from the International Diabetes Federation (IDF) (Saeedi et al., 2019). Social determinants such as education, income, and employment status play crucial roles in influencing diabetes prevalence in Mauritius. Rates of diabetes are associated with low educational levels, poverty, and limited access to nutritious food and physical activity opportunities.Economic factors, notably high urbanization rates, significantly contribute to the rising prevalence of diabetes. The World Bank reports that over 40% of the population resides in urban areas, often leading to sedentary lifestyles and unhealthy dietary choices. Furthermore, the high poverty rate in Mauritius exacerbates the issue, as individuals with diabetes may struggle to afford healthy food or adequate healthcare (Baptista et al., 2019).
Data from Gapminder indicates that socioeconomic, political, and cultural influences impact diabetes prevalence in Mauritius. The correlation between the country’s economic development and rising diabetes rates is evident, as well as the fact that 8.6% of the population lived below the poverty line in 2017, suggesting poverty’s role in the diabetes epidemic. Additionally, traditional Mauritian cuisine is often high in salt and fat, contributing to dietary factors associated with diabetes (Ali et al., 2020).Cultural attitudes toward diet and exercise may also influence the onset of diabetes. Traditional Mauritian meals frequently consist of high-fat and high-carbohydrate foods, coupled with sedentary lifestyles, which increase diabetes risk. Geographic factors such as urbanization and access to healthcare further affect diabetes rates. Urbanization has altered diets and lifestyles, while rural areas may lack access to diabetes care, raising the likelihood of complications (Mogre et al., 2019).
Diabetes prevalence is significantly influenced by socioeconomic status, with individuals of lower education and income levels at a greater risk of developing the condition. Moreover, policies that promote healthy lifestyles and enhance healthcare access can potentially reduce diabetes rates in Mauritius. The government has implemented national diabetes screening programs and introduced a sugar tax. Nevertheless, addressing the socioeconomic and cultural factors contributing to diabetes is imperative for effective intervention. Overall, socioeconomic, political, and cultural elements heavily influence diabetes prevalence in Mauritius, necessitating targeted strategies and policy changes to alleviate this public health burden (Porwal et al., 2020).
Various socioeconomic, political, and cultural factors are expected to influence diabetes prevalence in Mauritius due to upcoming changes. If policymakers and stakeholders focus on improving access to healthy foods, healthcare, and physical activity while addressing income disparities, the national prevalence of diabetes may decline (Porwal et al., 2020).Potential economic growth could lead to increased income levels, enhancing access to nutritious foods and healthcare, which may subsequently lower diabetes prevalence (Mogre et al., 2019). Conversely, persistent income disparities could hinder access to healthy foods and healthcare for lower-income individuals, potentially raising diabetes rates (Mogre et al., 2019).
Urbanization may contribute to more sedentary lifestyles, further increasing the risk of obesity and diabetes (Porwal et al., 2020). However, if the government enacts policies to enhance healthcare access and promote healthy living, diabetes prevalence could decrease (Porwal et al., 2020). Trade agreements that favor unhealthy food imports over local produce may lead to rising diabetes rates (Porwal et al., 2020).Moreover, the continuation of traditional Mauritian diets could contribute to higher diabetes prevalence if they are replaced by a Westernized diet rich in processed foods and sugars (Porwal et al., 2020). Lastly, if traditional physical activities like walking and cycling are replaced by sedentary habits, this could further increase diabetes rates (Porwal et al., 2020).
Diabetes is a global health issue that has been addressed through various strategies over the years, including prevention, treatment, education, research, and policymaking. However, the effectiveness of these strategies has varied across regions and populations.
Historically, prevention strategies have primarily focused on lifestyle changes, including diet and exercise, to reduce diabetes risk (Ali et al., 2020). Studies have shown that lifestyle interventions, such as the Diabetes Prevention Program (DPP) in the United States, effectively lowered diabetes incidence by promoting healthy behaviors (Mogre et al., 2019). Similarly, public health campaigns aimed at raising awareness about diabetes risk factors have gained traction, encouraging early detection and intervention (Porwal et al., 2020).
However, many interventions have fallen short due to limited access to resources, especially in low-income and marginalized communities. Efforts to address diabetes through educational initiatives often overlook the socioeconomic barriers that hinder individuals from adopting healthier lifestyles (Baptista et al., 2019). Furthermore, research funding has not consistently prioritized diabetes, leading to gaps in understanding the disease’s complexities and effective treatment approaches (Powers et al., 2020).
Policymaking related to diabetes has seen progress, with governments implementing regulations to improve food labeling and promote healthier food options (Ali et al., 2020). For instance, the introduction of sugar taxes has been effective in some countries, reducing sugary beverage consumption and subsequently impacting diabetes rates (Powers et al., 2020).
However, disparities in healthcare access and quality persist, particularly in marginalized communities, hampering the overall effectiveness of historical strategies (Hill-Briggs et al., 2020). To enhance future efforts, a multi-faceted approach addressing the social determinants of health is essential. Integrating education, access to resources, and policy changes will be crucial in reducing diabetes prevalence and improving outcomes across populations (Mogre et al., 2019).
In Mauritius, the prevalence of diabetes among adults exceeds 20%, signaling a significant public health challenge. This increasing rate is associated with several social determinants of health, including poor dietary choices, physical inactivity, and obesity. The Mauritian government has initiated several programs, such as the Non-Communicable Diseases (NCDs) Strategic Plan and the National Diabetes Program, aimed at mitigating the impact of diabetes. However, to effectively address the unique needs of diverse communities within Mauritius, there is a pressing demand for more targeted, evidence-based interventions (Shukla et al., 2021).
This project targets communities in Mauritius that are at a heightened risk for diabetes, particularly adults with a family history of diabetes, individuals who are overweight or obese, and those leading sedentary lifestyles. The primary focus will be on the prevention and management of diabetes through promoting lifestyle and behavioral changes (Mungloo-Dilmohamud et al., 2022). The objectives of the project are as follows:
The implementation of this project will involve educational resources and community-based interventions. Resources will be developed in collaboration with local health professionals and community leaders to ensure they are culturally relevant and appropriate (Mogre et al., 2019). The resources will include:
Community-based interventions will be tailored to engage the target population in their living, working, and social environments. These interventions will include:
The project will be conducted in select communities throughout Mauritius, chosen based on their high diabetes prevalence and other relevant social determinants of health, such as poverty, low education levels, and limited access to healthcare services. Collaboration with local partners, including health centers, community-based organizations, and local government authorities, will be essential to the project’s success (Morrell et al., 2019).
Several assumptions underpin the development of this educational resource or project proposal aimed at improving diabetes care in Mauritius:
The project will take place in community settings, including public venues, schools, and workplaces, with local pharmacies and health clinics also utilized for resource distribution. The target audience includes individuals with diabetes or those at risk, along with their families and caregivers. Key stakeholders will include representatives from the Ministry of Health, local healthcare providers, and community organizations (Mungloo-Dilmohamud et al., 2022).
The “Engaging Mauritian Communities to Prevent and Manage Diabetes” project represents a comprehensive, evidence-based strategy to tackle the diabetes epidemic in Mauritius. By addressing the social determinants of health and focusing on high-risk populations, the project seeks to reduce the prevalence and impact of diabetes within the country. Furthermore, this initiative can serve as a model for other nations facing similar public health challenges and can be adapted for various contexts. For the project’s success and sustainability, the support of key stakeholders, including the Mauritian government, local health authorities, and community leaders, will be crucial.
During my practicum experience, I had the opportunity to present a diabetes-related project proposal to a public health official. Although I initially felt nervous about the presentation, my thorough preparation bolstered my confidence in the subject matter. I successfully conveyed the importance of the project, which aimed to develop educational resources to help individuals effectively manage diabetes (Ahn & Choi, 2019).
The public health official was receptive to the proposal and provided valuable feedback for its enhancement. I appreciated the opportunity to share my insights and contribute to the public health domain. According to Ahn and Choi (2019), in future presentations, I plan to incorporate more visual aids to enhance engagement and clarity for the audience.
In conclusion, diabetes represents a significant challenge in today’s global health landscape. Addressing this issue necessitates a multifaceted approach that encompasses both prevention and management strategies. These include initiatives promoting healthy diets and lifestyles, awareness campaigns, diabetes screening and early detection, access to affordable healthcare, and effective diabetes management. A collaborative effort among government agencies, healthcare providers, civil society organizations, and individuals is essential to confront the diabetes epidemic in Mauritius. Through sustained efforts and a comprehensive approach, it is feasible to decrease the prevalence of diabetes and enhance the health and well-being of the population.
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