"I Am the Last Priority": Factors Influencing Diabetes Management Among South Asian Caregivers in Peel Region, Ontario

Nuzha Hafleen; Chelsea D'Silva; Elizabeth Mansfield; Dianne Fierheller; Ferzana Chaze; Amish Parikh; Sara Martel; Gurpreet Malhotra; Baldev Mutta; Zofishan Hasan; Ian Zenlea

doi:10.1016/j.jcjd.2024.03.006

"I Am the Last Priority": Factors Influencing Diabetes Management Among South Asian Caregivers in Peel Region, Ontario

Can J Diabetes. 2024 Jul;48(5):312-321. doi: 10.1016/j.jcjd.2024.03.006. Epub 2024 Apr 5.

Authors

Affiliations

¹ Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada.
² Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Department of Occupational Health, University of Toronto, Toronto, Ontario, Canada.
³ Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; School of Social Work, McMaster University, Hamilton, Ontario, Canada.
⁴ Faculty of Applied Health and Community Studies, Sheridan College, Brampton, Ontario, Canada.
⁵ Department of Medicine, Trillium Health Partners, Mississauga, Ontario, Canada.
⁶ Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Institute of Communication, Culture, Information, and Technology, University of Toronto Mississauga, Mississauga, Ontario, Canada.
⁷ Indus Community Services, Mississauga, Ontario, Canada.
⁸ Punjabi Community Health Services, Mississauga, Ontario, Canada.
⁹ Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: [email protected].

PMID: 38583768
DOI: 10.1016/j.jcjd.2024.03.006

Abstract

Objective: In this study, we aimed to identify sociocultural and systemic factors influencing diabetes management among South Asian (SA) caregivers in Peel Region, Ontario.

Methods: Twenty-one semistructured interviews were conducted with SA caregivers using a qualitative descriptive design. Data were analyzed using thematic analysis and intersectionality analysis.

Results: Themes identified included 1) prioritizing family caregiving over diabetes self-management; 2) labour market impacts on diabetes self-management; and 3) challenges navigating Canadian health and social service systems. SA caregivers described social, economic, and systemic challenges impacting type 2 diabetes management. Systemic factors influencing diabetes management included discrimination and inequities in labour policies and lack of social and health resources funding. Recommendations by caregivers included whole-family, community-based, culturally tailored approaches to diabetes prevention and management strategies.

Conclusions: Providing support with system navigation, encouraging family-based approaches, and addressing the social determinants of health could be beneficial for supporting SA families with diabetes management and prevention.

Keywords: South Asian; barrières systémiques; community health; diabète de type 2; déterminants sociaux de la santé; population sud-asiatique; santé communautaire; social determinants of health; systemic barriers; type 2 diabetes.

MeSH terms

Adult
Aged
Asian People / statistics & numerical data
Caregivers* / psychology
Diabetes Mellitus, Type 2* / therapy
Female
Humans
Male
Middle Aged
Ontario / epidemiology
Qualitative Research
Self-Management