DIABETES | How Inequality Is Fuelling South Africa’s Diabetes Crisis

South Africa is experiencing a growing diabetes crisis, with diabetes now the leading natural cause of death for the past three years. The country has an estimated 4.2 million people living with diabetes, half of whom are undiagnosed. While diabetes is often viewed as a lifestyle-related disease, evidence points to socioeconomic conditions as the primary drivers of the rising number of cases. Health-e News has extensively covered the social determinants of health, which are the key factors influencing health outcomes.

The increase in diabetes cases can be attributed to urbanization following the end of apartheid, leading to a shift from rural to urban areas. However, this narrative is evolving. The Eastern Cape, one of South Africa's poorest provinces, has seen a consistent rise in diabetes cases, particularly in rural districts. This trend is primarily driven by persistent health inequality, both historical and present, shaped by social and commercial determinants of health.

The social determinants of health play a significant role in the development of diabetes. Lower education, lower income, physical environment, and food insecurity are all risk factors for the disease. South Africa's policy plan to address this crisis is currently focused on stemming the tide of new cases, but the focus is often on treatment, medicine stockouts, and complications, rather than addressing the underlying causes.