Mihaela Dinca-Panaitescu

Diabetes prevalence and income: Results of the Canadian Community Health Survey

UNLABELLED This paper contributes to a growing body of literature indicating the importance of income as a key socioeconomic status marker in accounting for the increased prevalence of type 2 diabetes (T2DM). METHODS We analyzed data from the Canadian Community Health Survey cycle 3.1 conducted by Statistics Canada. Descriptive statistics on the prevalence of self-reported diabetes were computed. Multiple logistic regression was used to examine the association between income and prevalence of T2DM. RESULTS In 2005 an estimated 1.3 million Canadians (4.9%) reported having diabetes. The prevalence of T2DM in the lowest income group is 4.14 times higher than in the highest income group. Prevalence of diabetes decreases steadily as income goes up. The likelihood of diabetes was significantly higher for low-income groups even after adjusting for socio-demographic status, housing, BMI and physical activity. There is a graded association between income and diabetes with odds ratios almost double for men (OR 1.94, 95% CI 1.57-2.39) and almost triple for women (OR 2.75 95% CI 2.24-3.37) in the lowest income compared to those in highest income. CONCLUSION These findings suggest that strategies for diabetes prevention should combine person-centered approaches generally recommended in the diabetes literature research with public policy approaches that acknowledge the role of socioeconomic position in shaping T2DM prevalence/incidence.

The dynamics of the relationship between diabetes incidence and low income: Longitudinal results from Canada's National Population Health Survey

UNLABELLED This paper sheds light on the dynamic relationship between peoples experiences of low income and the development of type 2 diabetes (T2DM) by moving beyond the static perspective provided by cross-sectional studies to a long-term approach informed by longitudinal analyses. METHODS We analyzed data from the Canadian National Population Health Survey (NPHS) conducted by Statistics Canada from 1994 to 2007. The longitudinal sample is composed of 17,276 respondents (8046 males, 9230 females) 12 years of age or older. We further developed an algorithm to distinguish T2DM from other types of diabetes. Proportional hazard models with time-varying predictors were used to explore the dynamics of the relationship between low income and T2DM. RESULTS The results suggest that living in low income and experiencing persistent low income are significant precursors of developing T2DM. Being in low income in the previous cycle of T2DM onset was associated with 77% higher risk of T2DM (hazard ratio 1.77; 95% CI: 1.48-2.12). The association between low income and diabetes incidence remains significant after adjusting for age, sex, health behaviors, and psychological distress (hazard ratio 1.24; 95% CI: 1.02-1.52). CONCLUSION This study contributes to the under-developed research examining longitudinally the relationship between socioeconomic status and diabetes incidence. Employing this long-term approach, this study calls attention to the primary effect of socioeconomic position on diabetes incidence that cannot be explained entirely by behavioral factors. Findings draw attention to the need to address the role played in T2DM by the inequitable distribution of the social determinants of health.

Virtual Community Building and the Information Society: Current and Future Directions

This paper reports the results of an investigation into the life cycle model needed to develop information systems for groups of people with fluid requirements. For this purpose, we developed a modified spiral model and applied it to the analysis, design and implementation of a virtual community for a group of researchers and organizations that collaborated in a research project and had changing system requirements. The virtual knowledge community was dedicated to support mobilization and dissemination of evidence-based knowledge produced by the Disability Rights Promotion International Canada (DRPI-Canada) project.

Enabling Virtual Knowledge Networks for Human Rights Monitoring for People with Disabilities

Holistic disability rights monitoring is an imperative approach to permit translation of rights on paper into rights in reality for people with disabilities. However, evidence-based knowledge produced through such a holistic monitoring approach has to be accessible to a broad range of stakeholders, e.g., groups such as: researchers, representatives of disability community, people with disabilities, media, policy makers, and the general public. Besides, the collected evidence should contribute to building capacity within disability community around human rights questions. This article explains the design process of a Virtual Knowledge Network (VKN) as an operational tool to support mobilization and dissemination of evidence-based knowledge produced by the Disability Rights Promotion International Canada (DRPI-Canada) project. This VKN is embedded in the more general framework of DRPI, grounded in a human rights approach to disability that acknowledges the importance of creating knowledgeable communities in order to make the disability rights monitoring efforts sustainable.