Ethnic inequalities in health : why is the prevalence of type 2 diabetes higher among South Asian immigrants?





Høgskolen i Oslo og Akershus. Fakultet for samfunnsfag



Master in International Social Welfare and Health Policy


Type 2 diabetes mellitus (T2DM) is a major public health problem with the burden of the disease distributed unevenly. The prevalence of the disease is higher among South Asian immigrants in comparison to the prevalence among the population of the host countries. Studies from Norway, UK and beyond indicate that there is ethnic inequality in the prevalence of T2DM. In order to find out the reason for this high prevalence of T2DM, this thesis, by reviewing relevant literature, looks into different factors which are said to affect the health inequality. Those different factors underlying the high prevalence of T2DM includes genetics, socioeconomic position (SEP), culture, migration, lifestyle, language barrier and access to health care services. The ethnic inequality in health happens due to a complex web of intermingled factors. Genetic factors, SEP, migration, dietary habit, pattern of physical activity, obesity, language barrier and access to health care all contribute to the higher prevalence of T2DM among South Asian immigrants. Although researches regarding the genetic and biological factors underlying diabetes are far from completed, there is an indication that South Asians are genetically prone to T2DM. In addition to that, a number of studies conducted to find out the correlation between T2DM and SEP indicated that low SEP was related to a higher prevalence of diabetes. Low educational level, low income and deprived areas are associated with higher prevalence of T2DM among South Asian immigrants. Moreover, the dietary habit of South Asian immigrants, their physical inactivity, obesity especially the high waist-to-hip ratio, language barrier and less access to health care contribute to the high prevalence of T2DM among the South Asian immigrants in UK and Norway. On top of that, migration of South Asians from the Indian Subcontinent to western countries by itself appears to be one of the contributing factors in health inequality. Numerous changes in the socio-cultural environment occurs with migration, which in turn leads to shifts in SEP, access to health care and life style, including diet and physical activity, and in due course the high prevalence of T2DM. Genetics and early life conditions affect health outcomes later in life and may interact with the changes taking place after migration.


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