South Africa: Diabetes | How Inequality Is Fuelling South Africa's Diabetes Crisis

South Africa grapples with a growing diabetes crisis, which has become the leading natural cause of death in the country over the past three years, surpassing even tuberculosis and HIV. Approximately 4.2 million individuals are living with diabetes, but half of them remain undiagnosed. While discussions often focus on numbers, treatment methods, and complications, a crucial aspect is often overlooked: what is causing the surge in diabetes cases and how it can be prevented.

Traditionally viewed as a lifestyle-related disease, new evidence indicates that diabetes is driven more by environmental factors than personal choices. Health-e News has extensively reported on the social determinants of health, emphasizing the significant role that socioeconomic conditions play in determining health outcomes. Diabetes exemplifies how upstream factors such as lower education, lower income, environmental conditions, and food insecurity contribute to its prevalence.

One contributing factor is the rapid urbanization following democracy, with many individuals moving to cities. This shift is often portrayed as an urban luxury, characterized by sedentary desk jobs, easy access to fast food, and individuals' perceived inability to adopt healthier lifestyle choices. However, this narrative is evolving, with the Eastern Cape province, one of South Africa's poorest regions, experiencing a steady increase in new diabetes cases, particularly in rural areas.

This rise is attributed to persistent health inequality, both historical and contemporary, which is shaped by social and commercial determinants of health. The question remains: what role do the social determinants of health play in the emergence of new diabetes cases? Additionally, what is South Africa's policy strategy to combat this growing epidemic?