Urban diabetes – understanding the challenges and opportunities

Purpose: Cities concentrate people, opportunities and services, including those for health. When cities are planned, managed and governed well, life flourishes and health outcomes can surpass those seen in rural areas. But... [ view full abstract ]

Purpose:
Cities concentrate people, opportunities and services, including those for health. When cities are planned, managed and governed well, life flourishes and health outcomes can surpass those seen in rural areas. But cities can also concentrate risks and hazards to health – this is evident in the case of type 2 diabetes. Two-thirds of the 415 million people with diabetes live in and around cities1. The number of people with diabetes is set to rise to more than 640 million by 2040 and with this the number of people with diabetes living in cities1.

The form and composition of cities – their size, density, diversity and complexity – provide tremendous opportunity for understanding the drivers behind type 2 diabetes, thus making cities a focal point for developing interventions that can break the rising curve of diabetes.

Methods:
The Cities Changing Diabetes Programme was initiated in 2014 by Novo Nordisk A/S, Denmark, in a global cross-disciplinary partnership with Steno Diabetes Center , Denmark, and University College London (UCL), United Kingdom, with the aim of understanding the urban diabetes challenge and placing it high on the global urbanisation agenda. In each of five cities (Mexico City, Copenhagen, Houston, Shanghai and Tianjin) – varying in terms of population, culture, setting and size - the research is performed by local academic partners in collaboration with UCL.

Conclusions:
In each of the cities, the extent of the urban diabetes challenge is mapped by applying quantitative research and an understanding of the drivers behind urban diabetes is generated through qualitative research. Together this will uncover new knowledge about the local diabetes burden, the social factors and cultural determinants behind urban diabetes. The work will act as a platform for the programme to grow globally and serve as a resource for many different stakeholders.