diabetes drugs in Kanada, social factors

Diabetes drugs in Canada, Social factor
Noora Sipilä

More than 9 million Canadians have diabetes or pre-diabetes, meaning that the market for diabetes drugs is massive and according to the studies the number is growing. There are three main types of diabetes. Type 1 diabetes, usually diagnosed in children and adolescents, is partly inherited, and then triggered by certain infections. The onset of type 1 diabetes is unrelated to lifestyle. Approximately 10 per cent of people with diabetes have type 1 diabetes. Type 2 diabetes is due primarily to lifestyle factors and genetics. Lifestyle factors are known to be important to the development of type 2 diabetes, including obesity, lack of physical activity, poor diet, stress, and urbanization. Dietary factors also influence the risk of developing type 2 diabetes as well as consumption of sugar-sweetened drinks. A third type of diabetes is gestational diabetes, which is a temporary condition that occurs during pregnancy. It affects approximately 2 to 4 per cent of all pregnancies so it has only a minor influence to the sales of diabetes drugs in Canada.

90 per cent of people with diabetes have type 2 diabetes, the type that has the biggest influence by social factor. These social factors (that are considered as modifiable risk) are overweight and obesity, physical inactivity, unhealthy eating and tobacco smoking. The more we have Canadian citizens in these social groups, the more we have people with type 2 diabetes, and thus more customers for the companies manufacturing drugs for type 2 diabetes. In other words this means that the more unhealthy Canadians are, the better it is for drug companies. The determinants of health according to World Health Organization are the following: "Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact.". As the determinants of health suggests, health and the ability to adopt healthy behaviors are influenced by many factors, for example the social, environmental, cultural, and economic conditions in which the individual lives. These include income, education and literacy, employment and working conditions, food security, environment and housing, early childhood development, social support and connectedness, and access to health care. As long as these factors are in a bad shape in Canadian society, the more Canadians will be having type 2 diabetes.
Also socio-demographic factors influence on the number of people having a type 2 diabetes, since low socio-economic status, rural residence and ethnicity have been found to be associated with diabetes, its complications, and its risk factors. Physical inactivity, inadequate consumption of vegetables and fruit, and daily smoking were more common among Canadians in the lowest income quintile than among those in the highest income quintile and the individuals with less education were also more likely to have risk factors for type 2 diabetes than those with higher education.
What comes to physical activity, it is affected by individual and interpersonal factors such as attitudes and motivation, but it is also affected by different aspects of the build environment, such as urban sprawl and access to walking paths, trails and sidewalks. Luckily for drug companies, more and more built environments are so called obesogenic environments that promote high-energy diets, and decreased access to healthy food stores, and sedentary lifestyles. Rural populations in Canada are higher in rates of obesity than urban populations. This may be because of the lack of convenient destinations within walking distance and the reliance on vehicles for transportation to destinations. This works also in contrast. Supportive built environments can encourage people to physical activity for example having a variety of destinations safely accessible by foot, but they also play a role in healthy eating, alongside health and social policies that influence food marketing. Levels of obesity have noticed to be lower when the access to local shops, health-related stores, and supermarkets, and the reverse association has been observed between access to fast food restaurants and obesity. For low-income communities and remote or northern communities the availability and accessibility of affordable nutritious food is a challenge, because of high transport costs and spoilage.
There is also two key non-modifiable risk factors for type 2 diabetes, ethnicity and immigration. Especially immigrants to Canada from non-European countries are known to have higher rates of diabetes. Immigration from these non-European countries (South Asia, Latin America the Caribbean) adds demand for diabetic drugs in Canada.

So the biggest threats for companies providing diabetic drugs to Canada are for example increasing time for physical activity in the school curriculum, providing access to community recreational facilities, forming and supporting networks of community-based organizations and services committed to improving nutrition or physical activity, instituting educational campaigns that enable people to read and understand food labels, and teaching young people to cook nutritious, low-fat foods. In other words the biggest competitor for drug companies is Canadian government.
For drug companies the situation in Canada is looking good. According to a new study made by the University of British Columbia, obesity rates across Canada are at historic high and continue to climb. Canadians are also showing a sweet tooth. The amount of sugar and syrup in Canadian diet has risen. On the other hand there is also increase in consumption of fresh fruits and vegetables, and decline in smoking rates.