Ethnicity And Health: Impact On Diabetes In The UK - Essay.

Write a report related to ethnicity and health. Your report must focus on the United Kingdom. You must choose your own report title relevant to the content of your report.   You can either:

Choose one health issue and discuss the impact of ethnicity on that issue.  For example:

• Diabetes and ethnicity
• Mental health and ethnicity (or you can select just one mental illness in particular such as Depression OR Schizophrenia)
• Thalassaemia and/or Sickle Cell Disease and ethnicity
• Dementia and ethnicity
• And so on 

Literature Review

In the modern lifestyle people are getting more prone to the chronic diseases. Many researches have shown that ethnicity plays a very greater role in the development of these diseases (Khan, et al., 2011). People belonging to any particular ethnical group are more likely to have certain kind of chronic disease. This is due to various types of factors like their particular lifestyle, their eating habits, believes and approach towards facing any disease. In UK there are people that are coming from different regions of the world. Some of these ethnic groups are more likely to get different types of diabetes.  In the later section of this report proper details about those particular groups have been illustrated.

In the particular section of the people in particular regions it has been seen that they have developed a common type of disease. This is due to the fact that they have a particular type of genes in them. In the views of Zizi, et al., (2012) diabetes is most common in the UK in a particular ethnic group coming from south Asia and Caribbean origin. These groups of people are at more risk of developing diabetes as compared to the people from other origins. In the people of South Asian descent the chances of developing Type 2 diabetes is up to 6 times then the people having other origins. In African and Africa Caribbean people the risk of developing the Type 2 diabetes is three times more likely than that of people from other origins. 

On the contrary Chiu, et Al., (2011) has a view that in UK there are large number of people that have come from the India and China. These countries have been considered as the diabetes capitals of the world. The people that are having the black and Hispanic race are more likely to have diabetes as compared to that of non-Hispanic whites. Some of the minorities like American Indian and the natives of Alaska are more prone to develop diabetes. Apart from this the Asian American and Pacific Islanders have also been found to develop this disease. Development of this disease in the ethnic minorities has created problems for the health care organizations in UK. The treatment policies have to be designed as per their need. Developing culturally appropriate treatment programs can be helpful in this regards Mostafa, et al., (2012).

On the other hand Menke, et al., (2014) worldwide prevalence of diabetes for all age groups was calculated to be 2.8%. The total number of people that will be affected by this disease is expected to rise from 171 million in 2000 to 366 million in 2030. In the regions of Asia and Africa the rate of increase is expected to be two to three times. The major three countries that are affected by this disease is USA, China and India and in future some other capitals for diabetes is expected to come up like Brazil, Indonesia, Pakistan, Japan and Bangladesh. In most of the people are affected by the Type two diabetes. It is approximately 90% of the total cases. 

Factors Behind Diabetes Prevalence by Ethnicity

In the views of Carolan, et al., (2012) Type 1 diabetes is more likely to be found in the people belonging from temperate regions. It calculates to around 30-35 per 100000 children and reduces while reaching towards equator. On the other hand Type 2 diabetes is more likely to be found in the European and Asian communities. People who are living in the countries like UK and belonging from the Asian region are most likely to get affected by this disease. In the people who are from Indian sub continents and are above the age group of 40 years or so are more influenced by this disease. The obesity is considered as one of the prime regions for this rapid increase in the number of diabetic patients. American-Indian origins are the major example of this. In the White UK children, Maturity onset diabetes of the young (MODY) has also been found. This version of diabetes is same likely to be present in the white UK children as the Type 2 version. The prevalence of diabetes in the Chinese people is not different from the people in UK.  

On the contrary Mørkrid, et al., (2012) believes that obesity is the reason for having higher rate of Type 2 diabetes in South Asian community. The centralized fat distribution of the body act as the insulin barrier. This is less in the white people. Apart from this it has also been seen that the intake of folate and Vitamin B12 due to long cooking of the vegetables are also the major reason for this. Along with this, a lower level of physical activity is also a reason for it.  In the UK and Finland a hypothesis suggests that growth restriction in utero in the early life gives rise to metabolic programming which may result in the greater risk of developing diabetes. Mean insulin and Central adiposity concentration was higher in South Asian people but the glucose concentration were similar reflecting that there is higher chances of developing diabetes at even younger ages. In the study it was found that some of the children from Indian origin had phenotype with higher proportional central fat and higher cord blood insulin concentration than the white children in UK. Obesity has been found as the core reason for developing the Type 2 diabetes as these people has reduced insulin sensitivity.  In the UK schools the chances of black student developing diabetes is 15-20 % more than that of white students. This is due to the lifestyle that both the ethnic groups lead.

Implications for Healthcare Organizations

On the other hand Tahrani, et al., (2012) states that people suffering from Dyslipidaemia is more likely develop Type 2 diabetes due to poor glycemic control. The enhanced synthesis of plasma lipoprotein and overall cholesterol at the time of hyperglycaemia, adds to the acceleration of atherosclerosis found in Type 2 disease.

Hussen, Persson and Moradi, (2015) states that rising blood pressure due to the hypertension is one of the major reason why some of the ethnic people has any type of diabetes. These people have their poor vital functionality which leads to restriction in insulin secretion. In the case of Hyper tension obesity is always noticed which results in increase in the chances of diabetes. 

Glucose tolerance in both Pakistani and European people is less and hence a low insulin resistance is noticed. It is also due to the fact that there are many people that are coming to the Europe have more chances of gaining weights and hence their glucose tolerance is less. Their different metabolism is also a major factor why the person of some ethnic groups develops diabetes.

In the view of Robinson,  Agarwal and Nerenberg, (2011) people from India are having the eating habits that include more oil reach food. Such a heavy cooking always leads to decrease in the amount of insulin secreted from the pancreas which is a major reason for such predominanace of this disease in this area. The number of cases of diabetic patient in the south Asian region increased in last few decades (Everett, Frithsen and Player, (2011). This is due to the reason that there food habits have changes as well as the people are still preferring to eat highly oil reach food while the workouts have not been adequate. India has a large population of diabetic patients. One interesting fact about the spread of this disease in India is that most of the people who have this disease are rich or medium class families. This is due to the reason because they do not give proper care to the physical activity which leads to increase in the internal fat. In the countries like UK it can be seen that in the younger age the people are highly conscious about their health and hence are indulging in some of the physical activities. On the other hand in the countries like India the people are trained to become a professional from the early ages and hence they are unable to get participate in any of the physical activity (Sinha, et al., (2014). This starts at the school age where the students are not promoted towards the extra-curricular activity since their primary focus is on studies. This leads to increase in hyper tension which is another important factor of developing diabetes at early ages. In the early part of the 20^th century this problem started to worsen in many of the people from these regions.

Recommendations for Healthcare Professionals

Davis, Coleman and Holman, (2014) states that the spread of the diabetes was not been controlled at the earlier stages. In the early 20^th century a health program related to such chronic diseases was needed. This can also be seen in the African countries which also has a low quality health services. This has led to increase in the number of diabetic cases. According to the fourth national survey on health it was noticed that in UK the patients that are manual workers had less chances of developing diabetes while the people that are non-manual workers are more likely to develop this disease. In the countries like UK it was noticed that diabetes was more common in the no full time workers irrespective of their current socioeconomic position. 

On the contrary Khoo, et al., (2011) believes that people of these ethnic groups were highly uneducated about the initial symptoms of this disease. They also give no response to the intial sign of developing this disease. In the country like the population explosion has been fast and the health care needs of the country has not been properly addressed by the government which has made the situations worst. In some of the cases it was noticed that both the types of diabetes were genetic. This is due to the reason that after a certain age these people were unable to make so much of insulin as required (Oldroyd, et al., 2017). The change in the life style has made this situation worst. Many children from the South Asian origin develop this disease because their mother or father has this disease. In India the situation is illustrated by many examples. The Indian food habits like the intake of large amount of glucose in their food have worsened this problem (Diabetes, (2017).

Conclusion

From the above section of this literature review it can be seen that In UK there are many people present who are from different origins. The ethnic groups from south Asian and African region are more likely to develop this disease. This is due to various types of reason in which Lifestyle and food habits plays a more vital role. These people need a diet control that can help them in reducing the risk of the progression to diabetes. Apart from this a various surveys have shown that this disease was developed in the children at the early age and most of them were non-white. Their upbringing played a very crucial role in this regards. A proper health plan is needed for removing this disease especially in the mixed population like UK.

Challenges and Future Directions

A proper care is needed for the children whose family had a long history of diabetes patients. This is the only way that such a genetic failure can be controlled. A variety of drugs is available in the market for the recovery of such patients. It was also noticed that lifestyle intervention is more effective than that of drug intervention. The lifestyle change will helps more in removing this problem as compared to the drug the use. In the country like UK a special program for the removal of such disease in some ethnic group is needed. Some of the most common problem that arises in the removal of this disease is the life style and the age old thinking of these ethnic groups towards this disease. Once this barrier is removed it would be easy to provide better health care services to these ethnic communities in UK. It is also to be made sure that the people have a diet maintained at early ages so that such health concern does not occurs. Even though the removal of Type 1 disease is more difficult then also an approach towards this disease needs to change in the African and South Asian Region. 

References

Carolan, M., Davey, M.A., Biro, M.A. and Kealy, M., (2012) Maternal age, ethnicity and gestational diabetes mellitus. Midwifery, 28(6), pp.778-783.

Chiu, M., Austin, P.C., Manuel, D.G., Shah, B.R. and Tu, J.V., (2011) Deriving ethnic-specific BMI cutoff points for assessing diabetes risk. Diabetes care, 34(8), pp.1741-1748.

Davis, T.M.E., Coleman, R.L. and Holman, R.R., (2014) Ethnicity and long?term vascular outcomes in Type 2 diabetes: a prospective observational study (UKPDS 83). Diabetic Medicine, 31(2), pp.200-207.

Diabetes, (2017), diabetes and ethnicity, [Online]. Available at: https://www.diabetes.co.uk/diabetes-and-ethnicity.html. [Accessed on: 20^th  March 2018].

Everett, C.J., Frithsen, I. and Player, M., (2011) Relationship of polychlorinated biphenyls with type 2 diabetes and hypertension. Journal of Environmental Monitoring, 13(2), pp.241-251.

Hussen, H.I., Persson, M. and Moradi, T., (2015) Maternal overweight and obesity are associated with increased risk of type 1 diabetes in offspring of parents without diabetes regardless of ethnicity. Diabetologia, 58(7), pp.1464-1473.

Khan, N.A., Wang, H., Anand, S., Jin, Y., Campbell, N.R., Pilote, L. and Quan, H., (2011) Ethnicity and sex affect diabetes incidence and outcomes. Diabetes care, 34(1), pp.96-101.

Khoo, C.M., Sairazi, S., Taslim, S., Gardner, D., Wu, Y., Lee, J., van Dam, R.M. and Tai, E.S., (2011) Ethnicity modifies the relationships of insulin resistance, inflammation, and adiponectin with obesity in a multiethnic Asian population. Diabetes Care, 34(5), pp.1120-1126.

Menke, A., Rust, K.F., Fradkin, J., Cheng, Y.J. and Cowie, C.C., (2014) Associations between trends in race/ethnicity, aging, and body mass index with diabetes prevalence in the United States: a series of cross-sectional studies. Annals of internal medicine, 161(5), pp.328-335.

Mørkrid, K., Jenum, A.K., Sletner, L., Vårdal, M.H., Waage, C.W., Nakstad, B., Vangen, S. and Birkeland, K.I., (2012) Failure to increase insulin secretory capacity during pregnancy-induced insulin resistance is associated with ethnicity and gestational diabetes. European journal of endocrinology, 167(4), pp.579-588.

Mostafa, S.A., Davies, M.J., Webb, D.R., Srinivasan, B.T., Gray, L.J. and Khunti, K., (2012) Independent effect of ethnicity on glycemia in South Asians and white Europeans. Diabetes Care, 35(8), pp.1746-1748.

Oldroyd, J., Banerjee, M., Heald, A. and Cruickshank, K,  (2017), Diabetes and ethnic minorities, [Online]. Available at: https://pmj.bmj.com/content/81/958/486. [Accessed on: 20^th  March 2018].

Robinson, C.A., Agarwal, G. and Nerenberg, K., (2011) Validating the CANRISK prognostic model for assessing diabetes risk in Canada's multi-ethnic population. Chronic diseases and injuries in Canada, 32(1).

Sinha, S.K., Shaheen, M., Rajavashisth, T.B., Pan, D., Norris, K.C. and Nicholas, S.B., (2014) Association of race/ethnicity, inflammation, and albuminuria in patients with diabetes and early chronic kidney disease. Diabetes Care, 37(4), pp.1060-1068.

Tahrani, A.A., Ali, A., Raymond, N.T., Begum, S., Dubb, K., Mughal, S., Jose, B., Piya, M.K., Barnett, A.H. and Stevens, M.J., (2012) Obstructive sleep apnea and diabetic neuropathy: a novel association in patients with type 2 diabetes. American journal of respiratory and critical care medicine, 186(5), pp.434-441.

Zizi, F., Pandey, A., Murrray-Bachmann, R., Vincent, M., McFarlane, S., Ogedegbe, G. and Jean-Louis, G., (2012) Race/ethnicity, sleep duration, and diabetes mellitus: analysis of the National Health Interview Survey. The American journal of medicine, 125(2), pp.162-167