A toxic combination of poor social policies and programmes, unfair economic arrangements and bad politics: the experiences of poor Canadians with Type 2 diabetes

Raphael, Dennis; Daiski, Isolde; Pilkington, Beryl; Bryant, Toba; Dinca-Panaitescu, Miha; Dinca-Panaitescu, Serban

doi:10.1080/09581596.2011.607797

Cited by 25 publications

(33 citation statements)

References 28 publications

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“…In this age of rapidly rising chronic disease burden, primary prevention strategies must go beyond the status quo promotion of healthy lifestyles that target individuals. In light of these findings, prevention strategies must include actions to mitigate the adverse impacts of socio-contextual factors that contribute to diabetes risk, which includes the consideration of health in all policies, the modification of social and economic structures that create inequality, and the empowerment of those in positions of disadvantage [43]. Under the status quo, diabetes has risen dramatically; a paradigm shift in the diabetes prevention and management community is warranted.…”

Section: Discussionmentioning

confidence: 99%

The influence of socioeconomic status on future risk for developing Type 2 diabetes in the Canadian population between 2011 and 2022: differential associations by sex

Rivera

Lebenbaum

Rosella

2015

Int J Equity Health

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Section: Discussionmentioning

confidence: 99%

The influence of socioeconomic status on future risk for developing Type 2 diabetes in the Canadian population between 2011 and 2022: differential associations by sex

Rivera

Lebenbaum

Rosella

2015

Int J Equity Health

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“…However, social inequalities, material deprivation and social class impact on the capacity and capabilities of people to manage a long‐term condition (Raphael et al . ). At a micro level educational interventions cultivate the ability of some people to make positive comparisons with others who are worse off in health as a means for effectively motivating the uptake of self‐care practices.…”

Section: Introductionmentioning

confidence: 97%

“…Self-management support interventions adopted by health systems tend to emphasise individual goal setting, motivation, lifestyle modification and individualised problem-solving as the bases of improving personal CIM (Ong et al 2014). However, social inequalities, material deprivation and social class impact on the capacity and capabilities of people to manage a long-term condition (Raphael et al 2011). At a micro level educational interventions cultivate the ability of some people to make positive comparisons with others who are worse off in health as a means for effectively motivating the uptake of self-care practices.…”

Section: Introductionmentioning

confidence: 99%

The articulation of neoliberalism: narratives of experience of chronic illness management in Bulgaria and the UK

Vassilev

Rogers

Todorova

et al. 2016

Sociology Health & Illness

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The shift from social democratic to a neoliberal consensus in modern welfare capitalist states is characterised by an emphasis on individual responsibility, consumer choice, market rationality and growing social inequalities. There has been little exploration of how neoliberalism has shaped the environment within which chronic illness is experienced and managed. This article explores the different articulations of neoliberalism manifest in the arena of personal illness management in Bulgaria and the UK. People with type 2 diabetes discussed their experiences in terms of struggling with diet, diabetes as a personal failure, integrating illness management and valued activities, and the trustworthiness of the healthcare system. The UK narratives were framed within an individual responsibility discourse while in Bulgaria lack of resources dominated discussions, which were framed as structurally generated and unrelated to individual capabilities and choices. Respondents faced personal management challenges related to consumer and healthcare market failures in both countries. Differences in market regulation and emerging stakeholder and interest coalitions influenced users' expectations and their navigation and adaption to market failures in managing their everyday illnesses. The UK and Bulgarian articulations of neoliberalism can be described differently: the first as a logic of managed choice and the second as a logic of unmanaged consumerism.

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“…Empirical research taking the SDH as its lens has helped to discredit the characterisation of NCDs as diseases of affluence, yet its impact on policy is less definite. An analysis of the policy interventions taken by the Canadian government to improve health outcomes for the domestic type 2 diabetic population by Raphael et al [15] found that public policy approaches targeting the SDH have been largely ineffectual. Indeed, the challenges associated with translating the SDH into local and national policies were highlighted in a review by Krumeich and Meershoek [16] who cautioned against the implementation of policies which fail to adapt the SDH based on features of the local context.…”

Section: Introductionmentioning

confidence: 99%

Non-communicable diseases in Indian slums: re-framing the Social Determinants of Health

Lumagbas

Coleman

Bunders

et al. 2018

Global Health Action

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Background: The epidemic of non-communicable diseases (NCDs) in slums has pushed its residents to heightened vulnerability. The Social Determinants of Health (SDH) framework has been used to understand the social dynamics and impact of NCDs, especially in poorly resourced communities. Whilst the SDH has helped to discredit the characterisation of NCDs as diseases of affluence, its impact on policy has been less definite. Given the multitude of factors that interact in the presentation of NCDs, operationalising the SDH for policies and programmes that account for the contextual complexity of slums has stalled. Objective: To organise the complex networks of relations between SDH in slums so as to identify options for Indian municipal policy that are feasible to implement in the short term. Methods: The study reviews the literature describing SDH in Indian slums, specifically those that establish causal relations between SDH and NCDs. Root cause analysis was then used to organise the identified relations of SDH and NCDs. Results: Although poverty remains the largest structural determinant of health in slums, the multi-dimensional relations between SDH and NCDs are structured around four themes that describe the dynamics of slums, namely scarce clean water, low education, physical (in)activity and transportation. From the reviewed literature, four logic trees visualising the relations between SDH in slums and NCDs were constructed. The logic trees separate symptomatic problems from their more distal causes, and recommendations were formulated based on features of these relationships that are amenable to policy intervention. Conclusion: Root cause analysis provides a means to focus the lens of examination of SDH, as evidenced here for Indian slums. It provides a guide for the development of policies that are grounded in the actual health concerns of people in slums, and takes account of the complex pathways through which diseases are socially constituted.

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A toxic combination of poor social policies and programmes, unfair economic arrangements and bad politics: the experiences of poor Canadians with Type 2 diabetes

Cited by 25 publications

References 28 publications

The influence of socioeconomic status on future risk for developing Type 2 diabetes in the Canadian population between 2011 and 2022: differential associations by sex

The influence of socioeconomic status on future risk for developing Type 2 diabetes in the Canadian population between 2011 and 2022: differential associations by sex

The articulation of neoliberalism: narratives of experience of chronic illness management in Bulgaria and the UK

Non-communicable diseases in Indian slums: re-framing the Social Determinants of Health

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