Diabetes and income

A new study has found that people with lower incomes are more likely to die of diabetes complications compared to people with higher incomes. And this is in Canada, where we have "free" health care.

Part of the problem, I think, is that different provinces choose what drugs and supplies to cover on their prescription drug plans. Some provinces don't even cover insulin; others don't cover test strips. Some don't cover syringes and needles. When I was forced to go on welfare, I had one social worker tell me that "We're afraid you'll sell them to drug addicts, so we won't pay for your needles. You'll have to pay for them out of your own pocket." (I later found out that this was not the case, but at the time I figured that someone who worked for the government knew what she was talking about.) Diabetic people can drop off used needles at the needle exchange, but cannot pick up clean needles the way drug addicts can.

I thought that living in B.C. sucked, but I have to admit that Pharmacare does cover almost all diabetes supplies. They don't cover insulin pumps, and they don't cover Levemir insulin, but they do cover Lantus. They don't cover 100 percent of the cost of NovoRapid or Humalog, unfortunately, and I had a big problem when I was on disability and trying, out of my very limited income, to cover the portion of NovoRapid that the government doesn't pay for.

I think that another part of the problem is stigma. Diabetes has a very big stigma in our society. People with diabetes are considered to be fat and lazy. "Just lose weight, and your diabetes will go away." People don't want to admit to having diabetes, so they don't. They don't test their blood sugar, they don't take their medication, and they don't follow a proper diet. They probably don't talk to or listen to their doctors, either. Some people who are diagnosed later in life are just set in their ways and don't want to change.

I think this stigma is also part of the reason that governments don't want to pay for diabetes supplies. Who needs expensive insulin, test strips, oral medications or needles when all you have to do is exercise more, eat a healthier diet, and lose weight to get rid of your disease? Anytime I've heard provincial politicians talk about diabetes, they've all mentioned obesity, inactivity and unhealthy lifestyles. They refuse to acknowledge that not everyone who has diabetes, whether it's type 1 or type 2, has it because of weight or lifestyle. It's easier to blame everything on the diabetic person themselves.

It has also been noted that poor people usually live "unhealthy" lifestyles. When you're getting most or all of your food from a food bank, you aren't getting fresh fruits and vegetables. They're perishable. The food bank stocks non-perishable food. You're likely to be getting cereals, pasta, rice, Kraft Dinner and canned soups with a lot of chemical preservatives in them. The vegetables you get are probably canned and probably also contain lots of preservatives. So people who use food banks are getting a lot of starchy, high-carbohydrate food. But as the old saying goes, beggars can't be choosers.

People on income assistance in British Columbia can get an extra $15 a month for special dietary requirements if they have diabetes. This is just a drop in the proverbial bucket. It's not going to get you much, if any, extra food, especially if all of your money is going to keep the rent paid and the hydro turned on. Also, you have to re-establish your eligibility for this extra money every few months, in case you "get better" and your diabetes suddenly goes away. I told the case worker at the disability office that my diabetes is not going to suddenly go away after 35 years; she said, "But it could improve." Not that much, lady.

So what can be done about this problem? Well, the first thing, I think, is for governments to get their collective heads out of their collective asses and make sure that all people with diabetes have access to the prescription drugs and supplies that they need. All essential diabetes supplies need to be covered by provincial prescription drug plans.

Governments also need to stop blaming people for causing their own diabetes. The media could play a part in this too, by not conjoining "diabetes" and "obesity" (or even worse, using the word "diabesity") in every newspaper and magazine article and television news broadcast.

When a person is diagnosed with diabetes, he or she needs to be educated about how serious diabetes can be and why it is essential that it not be ignored. I don't advocate scare tactics, but people need to be aware of what the consequences of improper diabetes care can be. However, doctors need to stop making it sound like insulin is some sort of punishment for "bad" diabetics; I've heard from many people with Type 2 who think that having to go on insulin is some sort of failure, and they resist taking it.

I think that gyms and recreation centres should be more accessible to people with low incomes. It can be very difficult for people to exercise outdoors in winter in many parts of this country, unless they have the financial means to do things such as skiing. Being able to go to a rec centre and use a swimming pool or a skating rink or an exercise room would be beneficial not only for people with diabetes, but for lots of other low-income people as well. Regular exercise can help prevent Type 2 diabetes, and it has many other physical and mental health benefits as well.

To sum up, it is not surprising that people with low incomes are more likely to fall prey to diabetes complications. People need to rethink their views of diabetes to help combat this inequality.