South Asians have the highest rate of type 2 diabetes in the UK, due to a mix of racial and socioeconomic factors – now, researchers say that a more nuanced method of classifying race could improve their health outcomes
In the UK, racism is officially described as “haunting” people of colour in a Government-commissioned report on race. Inevitably, the connection between health and race can often be obscured in medical decision-making.
The public health crisis of COVID shed light on existing health issues in the UK, with a disproportionate amount of non-white patients dying from the virus. Discussions were evoked – about the quiet impact on lungs of air quality in built-up cities, about socioeconomic deprivation and intergenerational households, which were significantly more likely to pick-up the virus.
According to Diabetes UK, type 2 is up to four times as high in Asian and Black ethnic groups compared to the White ethnic group. Diabetes is currently still listed as a risk factor for severe COVID.
Now, researchers want to know more about how race functions in relation to socioeconomic deprivation, to create this high prevalence of type 2 diabetes in the first place.
First author, Shashwat Deepali Nagar at the Georgia Institute of Technology, led the study with Anna María Nápoles, National Institute on Minority Health and Health Disparities (NIMHD), I. King Jordan also at the Georgia Institute and Leonardo Mariño-Ramírez
also with NIMHD.
Race and deprivation are “important risk factors”
They found that genetic ancestry and socioeconomic deprivation are “important risk factors” for type 2 diabetes, which fits well with what is already understood about how this disease works. The team further suggest that when it comes to deprivation, more targeted interventions for ethnic groups in the UK are the way to improve health outcomes.
Right now, projections suggest that roughly 5.5 million people in the UK will have diabetes by 2030.
The researchers also suggest that socioeconomic deprivation is more of a risk factor for those with South Asian and African ancestry, as opposed to people with European ancestry.
In their paper, the team also note that they are not aware of any other studies focusing on how genetic ancestry impacts type 2 diabetes health disparities in the UK.
So how can changing race classification change health outcomes?
Currently, the UK classifies ethnic minorities into sub-groups – Asian, Black, Chinese, Mixed, White, or Other.
This study points out that ethnic groups are socially constructed, with a lot of different genetics and social factors impacting their health. For instance, not all Bangladeshi individuals have a similar biological potential for diabetes, as the country is vast and contains a variety of genetic sub-groups.
The authors further explained: “Since ethnic groups are socially defined based on shared heritage and culture, they are thought to be imprecise proxies for biological factors that impact health outcomes.”
The authors suggest that if the UK switched to using genetic ancestry instead of ethnicity, populations could be understood through evolutionary diversity.
If social and environmental factors are removed, all that remains is the genetic root of an issue. If researchers were able to do this accurately, it could mean health outcomes would change – because interventions would be far more accurate.
Those other factors would remain crucial to how treatments and interventions are created, but they would then take on their own weight – not simply connected to ambiguous racial genetics, as an inevitability.
