Coventry should be global model for diabetes care for ethnic minorities

Study finds city exhibits more signs of diversity than others worldwide

• Diversity in Coventry makes it an ideal model for other developed countries planning diabetes care

• Study reveals that one in 10 Coventry residents is from an ethnic minority, but one in three residents with diabetes is an ethnic minority

• Study also highlights food and language as the most common barriers to providing diabetes care for ethnic minorities

Cities across the developed world should look to Coventry when they plan diabetes services for ethnic minorities.

That’s the conclusion of a study led by an academic from the University of Warwick. The review suggests Coventry is the most ethnically diverse city, of its size, in the developed world. As a result the researchers believe that Coventry should be the exemplar for other similar cities when commissioning diabetes care for ethnic minorities in the future.

The research was led by Dr Peter Zeh Clinical Research Fellow, Warwick Medical School and consisted of a survey of all GP surgeries across the city. An analysis of the data revealed that seven of the eight previously identified cultural barriers to effective diabetes care and management found in the developed world were present in Coventry. The researchers compared Coventry to London, Ontario in Canada, Tampa, Florida in the US and Bologna, Italy. However they found that a similar study to theirs of Coventry has yet to be conducted in any other city.

The study Exploring culturally competent primary care diabetes services: a single-city survey which is published in the journal Diabetic Medicine revealed that one in 10 Coventry residents are from an ethnic minority, but for every three residents with diabetes living in Coventry, one is from an ethnic minority group.

Dr Zeh said: “For the first time we have pinpointed the number of BME patients who have diabetes and it is disproportionate with the population of the city. Only one in 10 of the city is of an ethnic minority but of the diabetic population it is one in three. Diabetes can be debilitating and even fatal and this study can be used to tackle this problem amongst the city’s BME population.”

These cultural barriers identified included differences in ethnicity between patient and health care provider, language barriers, and low levels of health literacy which led to lack of knowledge of diabetes.

Dr Zeh added: “Coventry is a medium-sized industrial and ethnically-diverse UK city which has areas of affluence alongside pockets of severe deprivation and health inequalities.

“One in 10 of its population is from an ethnic minority, many of which live in socially deprived areas with high illiteracy levels – and poor health literacy can impede access to diabetes care and poor self-management.”

Dr Dinesh Reddy a GP at Stoney Stanton Medical Centre took part in the study. He said: "There can be language barriers in treating some BME diabetes patients however I use link workers and interpreters to overcome barriers and understand issues such as reasons given for resistance to taking medications.”

Food was also highlighted as a cultural barrier with some patients, especially those from south Asia having a cultural tradition of eating high fat, low fibre food.

However despite evidence of these ‘barriers’ more than half (56%) of GPs surveyed were found to be ‘highly culturally capable’ at providing diabetes services for patients from black or ethnic minority (BME) backgrounds.

Existing evidence shows that BME people are more likely to develop diabetes, especially Type 2, than the rest of the population. Nationally and in Coventry BME people from an afro-Caribbean and south Asian background are three and six times more likely to develop Type 2 diabetes compared to white British peoples, and at an earlier age.

Following the research results the academics suggested that cultural barriers could be overcome and/or minimised by training of NHS staff.