March 29, 2019 Diabetes Canada welcomes British Columbia’s Poverty Reduction Strategy

Diabetes Canada welcomes the announcement of TogetherBC: British Columbia’s Poverty Reduction Strategy, introduced by the Honourable Shane Simpson, minister of social development and poverty reduction.

Diabetes disproportionately affects individuals of low socioeconomic status, and we are pleased to see the introduction of initiatives to help alleviate the barriers to healthy living experienced by those with low-income experience.

There are more than 1.5 million British Columbians living with diabetes or prediabetes and prevalence is predicted to increase by 35 per cent in the next 10 years. In Indigenous populations, the rates of diabetes are three to five times higher than in the non-Indigenous population. Diabetes also costs the health-care system $509 million, rising to $685 million by 2029. Diabetes is a public health concern that deserves the support and attention of the government.

Living with low income puts one at risk of developing type 2 diabetes and creates barriers to managing it. Type 2 diabetes is brought on by a combination of genetic, environmental, and behavioural factors. Income affects both the environments to which people have access and their behaviour. Those under financial duress may struggle to achieve life circumstances that foster health.  They may be living in substandard housing in neighbourhoods that offer few low-cost opportunities for exercise, such as parks, trails, or bike lanes. Income also plays a key role in food security. Healthy food is more expensive and thus, low income individuals sometimes choose to consume highly processed, less nutritious food, to balance their budget. Lack of physical activity and nutritionally void diets are leading factors in the development of type 2 diabetes, and providing individuals with adequate income could help them mitigate some of these risk factors.

Once someone is diagnosed with diabetes, they require medications, devices, and supplies to properly manage their blood sugars and minimize the risk of developing complications. Provincial drug coverage covers the cost of some medications, but unfortunately, there are often co-payments or deductibles that can be prohibitive. Furthermore, if the medication prescribed by one’s physician is not listed on the formulary, individuals must either pay out-of-pocket or forego their optimal care plan. Some British Columbians pay up to $2,800 a year on costs related to diabetes care and management, and for individuals with low-income, such costs are unsustainable.

For these reasons, we are pleased to see that BC’s approach to poverty reduction recognizes and addresses the fact that poverty is about more than income – it is about access to healthy food, safe, affordable housing, education, employment opportunities, and health care and supports. The following initiatives included in this strategy are particularly beneficial for those living with diabetes:

• Increasing availability of affordable housing and supports for those experiencing homelessness
  • Support for renters such as restricting rent increases and improving rental assistance
  • Increasing supply of affordable homes by investing $1.9 billion over ten years in new units and retrofitting existing community housing.
• Expanded access to healthy food
  • Increasing funding to B.C. Farmer’s Market Nutrition Program to increase the value of coupons and number of coupons for food provided to participating households
• Increasing access to medications, devices and supplies
  • Introduction of Fair PharmaCare which will exempt families earning up to $30, 000 annually from deductibles for prescriptions and receive 70% drug coverage.
• Improving financial security and income supports
  • Increasing the minimum wage to $15.20/hr by 2021
  • Increasing income assistance rates and reducing access times
• Improving access to transportation
  • Providing a transportation supplement for people on disability assistance.
• Initiatives that reflect commitment to reconciliation with Indigenous peoples and the TRCs calls to action.
  • Investing $550 million to increase targeted housing stock by building 1, 750 new homes on- and off-reserve for Indigenous peoples       

Diabetes Canada also recommends the government of British Columbia list newer evidence-based diabetes drugs on its formulary; extend individual choice of the insulin pump best suited to unique needs of a person living with diabetes; and make devices available that help heal diabetic foot ulcers to prevent life-changing amputations.