Forging Access to Improved Results of Diabetes Care for Minorities (FAIR)
Among those who face the lowest access to diabetes care are disadvantaged communities and vulnerable population groups such as low-income groups in emerging economies, migrants in developed countries, and children. While globalisation drives economic change and development, it also challenges the healthy development of the world. About 400 to 500 million people in the world today are migrants and they face significant barriers to accessing healthcare, according to Dr Manuel Carballo, Executive Director of the International Centre for Migration and Health (ICMH),. They are also at greater risk for chronic diseases due to transition to unfamiliar and often unhealthier lifestyles.
Addressing health and healthy development among disadvantaged communities and population groups in the world will impact positively on the global poverty gap. While globalisation has furthered world economic growth and decreased absolute poverty, the poverty gap is still widening and so is the access to health gap between people. With ill health and poverty reinforcing each other negatively, the global burden of disease today poses a threat to economic development and the attainment of the Millennium Development Goals.
The Novo Nordisk Forging Access to Improved Results of Diabetes Care for Minorities Programme (FAIR) works to address these gaps in diabetes care. The aim is to identify specific obstacles for access to diabetes care and how to overcome these obstacles in targeted subgroups of a given population. The subgroup can be of ethnic origin, belong to a different religion or culture, be in a low-income group, or belong to a certain age group.
Performance 2007
In 2007 Novo Nordisk together with the Lund University Centre for Health Economics initiated the first Grand Research and Implementation Symposium on globalisation and diabetes in Lund in March 2007. The Symposium was made possible by an unrestricted educational grant from Novo Nordisk.
The purpose of the Symposium was to create an initial list of the top five priorities in dealing with difference in access to diabetes care. A total of 35 researchers, practitioners and Novo Nordisk global health staff participated, resulting in the following priorities:
- Building the evidence: establishing the necessary evidence base for action
- Identification of target groups: diverse groups require diverse responses
- Alliance-building: many stakeholders need to be involved
- Tools for healthcare providers: dealing with differences in diabetes care requires a different set of tools
- Workplace involvement: it is important to engage companies with minorities employed, to serve as access points for healthcare information and involvement.
From theory to action
Many activities are underway. In Australia, epidemiological data is being gathered, focusing on ethnicity, medical and socioeconomic variables. An intervention study will be set up for a Greek community.
In Spain, the Spanish Diabetes Federation is conducting an epidemiological study to compare quality of access of care between the children of immigrants and non-immigrant children.
In Sweden, where there is a high prevalence of diabetes in Sweden among immigrants from non-European countries, there is a need to focus on access to care for this population. This includes collaboration with a data registry is underway to generate data on the incidence/ prevalence of diabetes in the immigrant groups in Malmö. Also in Sweden, three full-day training seminars training seminars on multicultural diabetes care were held for 81 healthcare professionals, including 25 doctors and 56 diabetes nurses, and will continue in 2008 for HCPs.
These focused on areas needed to be improved concerning both access to diabetes care for minority groups and possible areas of improving the diabetes care itself for minority groups, and particularly ethnicity, incidence and treatment of diabetes, cultural communication, and addressing lifestyle interventions.
An Advisory Board will be established in 2008 for sharing better practice and experiences and identifying further areas for improvement.
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