The Global Research Framework of Cities Changing Diabetes. Prof. David Napier Global Academic Lead Cities Changing Diabetes

Transcription

1 The Global Research Framework of Cities Changing Diabetes Prof. David Napier Global Academic Lead Cities Changing Diabetes

2 Today, two thirds of people with diabetes live in cities % OF PEOPLE WITH DIABETES LIVE IN URBAN AREAS % OF PEOPLE WITH DIABETES WILL LIVE IN URBAN AREAS 1 References 1. International Diabetes Federation. IDF Diabetes Atlas. 8th edn. Brussels, Belgium: International Diabetes Federation

3 image.guardian.co.uk/sysfiles/guardian/.../urban_world_2 Worldwide, 437 million people are currently living with diabetes. If diabetes were a country... By > 642 million China 1,367,485,388 India 1,251,695, ,000,000 U.S. 321,368,864

4 Understanding Rule of Halves

5 The Rule-of-Halves: Taking into Account Obesity and Overweight 2,000,000,000 1,800,000,000 1,600,000,000 1,400,000,000 1,200,000,000 2,0 Billion Overweight 650 Million Obese 1,000,000, ,000, ,000, ,000, ,000,000 0 Obese and Overweight Estimated Diabetes Population Diagnosed Diabetes Population In Treatment Achieve Treatment Target Achieve Desired Outcome

6 2014: The Cities Changing Diabetes programme A first-of-its-kind partnership platform Global Partners At the forefront of one of today s great health challenges: diabetes Novo Nordisk is committed to playing a part in the global fight against diabetes, and Cities Changing Diabetes is at the heart of this commitment. Academic excellence conduction research that addresses real world problems University College London (UCL) is the global academic lead in Cities Changing Diabetes. UCL works with local research partners in each city, investigating what drives diabetes in cities. A world-leading institution in diabetes care and prevention As a partner in Cities Changing Diabetes Steno Diabetes Center draws on their experience in creating innovative and sustainable approaches to tackling diabetes at the community level.

7 Cities Changing Diabetes: Cross-Sector Partnerships. Approach: engage different cross-sector partners to address the diabetes and obesity challenge Media Companies and other stakeholders Community representative s City governments Academia City planners/ urban designers Health communities (incl. patient voice)

8 Understanding the Diabetes Challenge in Each Partner City

9 Connecting Social Vulnerability and Rule of Halves Social and Cultural Domain Bio-social Domain Biomedical Domain

10 The Need for a New Evidence Base: Diabetes Research and Social and Cultural Factors Diabetes Publications past 10 years ISI Web of Science SCOPUS PubMed Science and Technology/ Life Sciences 767, , ,816 Social Sciences/ Humanities 62,667 (or: 8.16%) 9, 209 (or: 2.8%) - We spend much of our effort on only a small part of a very big problem.

11 The Need for a New Evidence Base: The Problem Social and cultural factors are Complex Locally diverse Difficult to identify and study Evidence Gap

12 Diabetes Vulnerability Assessments Vulnerability Domain external and internal stressors Formal Domain service utilization patterns and barriers Community Domain community structures, actions, and adaptations

13 WHO Health-in-all-Policies Framework 1) Housing 6) Occupational Factors 7) Physical Activity 2) Water and Sanitation 5) Health Communication 8) Food Production and Distribution 3) Transportation 4) Exposure to chemicals and their mixtures 9) Physical, Natural, and Social Environments

14 The Health-in-all-Policies Framework The Framework and Diabetes 1) Housing limited movement; dangerous 1) Housing 6) Occupational Factors 7) Physical Activity 2) Water and Sanitation drinking water; food safety 2) Water and Sanitation 5) Health Communication 8) Food Production and Distribution 3) Transportation 4) Exposure to chemicals and their mixtures 9) Physical, Natural, and Social Environments 3) Transportation long commuting for work; no exercise

15 Health-in-all-Policies Framework: QUALITY 1) Housing SAFETY LOCATION 1) Housing 2) Water and Sanitation 6) Occupational Factors 5) Health Communication 7) Physical Activity 8) Food Production and Distribution 2) Water and Sanitation LIVING CONDITIONS POTABLE WATER PUBLIC TRANSPORT 3) Transportation 4) Exposure to chemicals and their mixtures 9) Physical, Natural, and Social Environments 3) Transportation LONG COMMUTE UCL BIKE LANES ETC

16 Mapping complexity Case Definitions Biological Factors Social Factors Geographical Factors Cultural Factors Age Education level Character of neighbourhood Food culture Familial history Access to care Environmental givens Attitude to physical activity Ethnicity Access to resources Distance work-home Trust in government/ health care BMI Employment status Local Infrastructure Body image and stigma Blood glucose levels General health (comorbidities, chronic vs. acute, etc.) Health insurance Socio-economic status Living situation Level of social support Access to water, transportation, etc. Access to food/ economic status Attitude towards large body size Peer appearance

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18 Urban diabetes risk assessment framework

19 Cities Changing Diabetes research framework Exploring complexity and building a new evidence base

20 Why these tools? They allow us to understand vulnerability and barriers to behaviour change in real time. They allow complex case definitions of vulnerability to be scaled up to big data.

21 Goals of Research To bring lived experience to the level of evidence.

22 5 August 2014 Cities Changing Diabetes Shanghai Goals of programme Mapping Sharing Acting To discover actionable insights into health vulnerabilities among at-risk populations. To create opportunities for dissemination of findings through new knowledge networks. To work with local and global advocates to reverse the diabetes and obesity epidemics.

23 Rethinking the diabetes challenge in partnership VANCOUVER LEICESTER COPENHAGEN KORIYAMA BEIJING TIANJIN HOUSTON ROME SHANGHAI MEXICO CITY MÉRIDA BEIRUT HANGZHOU XIAMEN JOHANNESBURG BUENOS AIRES

24 Thank you.