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Guest Article by Maxence Prizzi – Junior Policy and Advocacy Advisor & Sabine Dupont – Director, Strategy and Policy, International Diabetes Federation Europe (IDF Europe) 

Health is determined by a wide range of factors including, for example, social and economic circumstances (“the conditions in which people are born, grow, work, live and age, and the system put in place to deal with illness” [1]) and a person’s individual characteristics and behaviours. Social and economic determinants can significantly contribute to health disparities and inequities. Several studies have shown that, combined with environmental factors, social determinants “account for 50% to 60% of health outcomes” [2].  

While diabetes can affect anyone, social and economic determinants are intrinsically linked to the prevalence of diabetes and play a pivotal role in shaping health outcomes for people living with diabetes (PwD). For example, there is a strong correlation between the education level and the development of type 2 diabetes (T2D) and diabetes-related complications [3],  which increases as the level of education decreases, placing people with a lower level of education at a 2.4 times higher risk of developing the condition [4]. PwD with lower socio-economic status are exposed to difficulties such as low income, insecure employment, food insecurity and poor housing which may affect the self-management of their condition leading to poor glycemic control, debilitating complications, and increasing the mental health burden [5]. 

Understanding the profound impact of social determinants of the health of people living with chronic conditions such as diabetes and fostering the development of health-enabling environments are key to mitigating the impact of the social determinants of health. IDF Europe is calling for the implementation of a range of policy actions that can help overcome the barriers to equitable access to care, namely: 

• Tackling stigma and discrimination; 
• Promoting digital and health literacy;  
• Implementing an EU-wide common and harmonised digitalisation/data framework. In this context, IDF Europe welcomes the new inter-institutional agreement on the European Health Data Space which has the potential to significantly improve the prevention, management, and care of diabetes and other NCDs, and reduce health inequities; and 
• Increasing transparency in medicines procurement, including fair pricing models, review of incentives and improvements in logistics. 

Health equity is a right that our systems must be able to guarantee for all citizens, regardless of their age, sex, location, and socio-economic determinants. It is crucial that stakeholders align their efforts to promote health equity across and within EU countries. In this context, health equity is a core and continuous component of IDF Europe’s advocacy work, which is highlighted in the following publications and initiatives. 

• IDF Europe’s MMD Group Blueprint for Action on Diabetes in the EU by 2030 
• IDF Europe’s campaign (article and highlights of main articles) surrounding the European Parliament Resolution on Diabetes in November 2022.  
• IDF Europe/WHO Europe Joint Declaration on Accelerating Action on Commitments to improve Diabetes Detection and Quality of Care. The online endorsement of the Joint Declaration is open to individuals and organisations. 
• Other IDF Europe’s campaigns such as the Health for All campaign (article and poster) on World Health Day and the poster on the occasion of the Global Week for Action on NCDs.