Marisa Vitorino Figueiredo

Two thirds of the world’s 400 million diabetes-sufferers live in cities. By tackling factors such as time shortage, economic vulnerability and the way residents get around, cities can take on an important role in the fight against the disease. A new study launched this month provides new clues on the social and cultural aspects of Diabetes.

How do you get to work every day? By car, right up to the door of your workplace? Choices such as these add to the sedentary lifestyle of city dwellers. On the other hand, the high-speed pace of city life - and the constant rushing between work and home - pushes people into unhealthy eating habits. These are all factors which increase the risk of urban diabetes.

This connection between type 2 diabetes and factors such as a sedentary lifestyle or eating habits, when paired with a genetic tendency, is well known. What’s new in this study by University College London (UCL) is its focus on cities and contextual factors. Five cities were looked at - Copenhagen (Denmark), Houston (USA), Mexico City, Shanghai and Tianjin - which are home to 60 million people in total. The conclusion was that “cities should reconsider their public health and urban planning strategies to deal with this increase” in urban diabetes.

This study is part of the Cities Changing Diabetes (CCD) programme, which hopes to give the urban factor in diabetes a greater visibility, through partnerships in various fields. The first step was the analysis of the pilot-cities, but there is a lot more to come. After the data is compiled, the initiative’s goal is to share it with other cities and raise awareness on this issue. The final step will be to take action, by coming up with solutions for the issue, since its estimated that by 2035 there will be 500 million sufferers - half of them living in cities - if the number of cases of diabetes continues to increase at the current rate.

“Social and cultural factors in cities play a much greater role in expanding the epidemic than was previously believed”, stated the UCL. For this reason, Novo Nordisk, a pharmaceutical lab heavily focused on treatments for the disease - and the founder of  the CCD programme - has promised to invest an additional 20 million dollars in the initiative by 2020.

From Houston to Shanghai

In each of the cities looked at by the study, different factors influence the perception of the disease, and consequently impact it’s expansion. In Copenhagen, for instance, financial problems and loneliness are the key factors. In Tianjin, diabetics who took part in the study pointed to several factors, from an unhealthy diet to an excessive workload, as well as mental health issues.

In Houston, the study concluded the risk of diabetes is the same across all social backgrounds, while in Mexico City, gender inequality causes women to neglect their health - and therefore be more vulnerable to the disease. Finally, in Shanghai, the cultural tradition of not publicly acknowledging any kind of suffering or difficulty means many diabetics don’t seek out help from doctors or relatives.