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The Globalization of the Diabetes Epidemic

BONNEAU, Claire
2021

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As globalization continues to bring everyone and everything closer together, not all of the trade-offs are necessarily positive. As we export our unique cultures and experiences around the globe, we also increase the spread of chronic health problems.

For much of the 20th century, a person’s likelihood of developing a chronic health disease like type II diabetes depended on the wealth of the country they lived in equally as much as their own biology and genetic factors. In wealthy, developed countries, people are much more likely to survive to old age and eventually pass away from diseases of affluence — chronic diseases like cancer, heart disease, and diabetes that primarily impact the ageing population. In contrast, people living in developing nations are much more likely to experience malnourishment, violence, and communicable diseases that have a major impact on their overall health and quality of life.

This distinction has proven to be true across many developed countries, including globalization giants like the United States. Even in the more economically disadvantaged areas of America, hardly anyone dies as a result of communicable diseases like tuberculosis, a disease that is still a serious problem in lesser developed nations. Alternatively, in low to middle-income countries, these types of health concerns are still a going concern. Alongside the increased risk of encountering a communicable disease, people living in these areas are also at a higher risk for developing diseases of affluence such as type II diabetes. In this way, people living in developing nations are more likely to experience cancer while also battling cholera infections, and someone living with diabetes is also more likely to be struggling with chronic malnourishment. This lack of distinction between diseases of affluence and communicable diseases puts people living in developing nations at a disadvantage.

In this new global landscape of health and disease, the impact of diabetes is truly overwhelming. Since 1980, the number of people living with diabetes has almost doubled from 152 million to between 285-347 million (1). As a result of this dramatic increase, health spending and global costs have also had to increase to meet the growing demand for care. In 2019, it is estimated that diabetes caused over 760 billion USD in health expenditures, making up about 10% of all global spending on adults (2).

As the prevalence of diabetes continues to grow around the world, we need to shift our attention to finding global solutions to this invisible epidemic. Understanding the connection between obesity, globalization, and diabetes is a great starting point in order to tackle this ever-growing global health problem.

Labour Market Assessment: Kenya 2021 refresh

INCLUSIVE FUTURES
BROWN, SIMON
OBOSI, Shikuku
August 2021

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This Labour Market Assessment for Kenya is a refresh of the initial assessments done in 2019 for the Inclusion Works programme. The assessment adopts a Markets for Poor (M4P) approach to mapping demand for and supply of labour, supporting functions and regulatory frameworks; recognising that labour markets conditions will have evolved since 2019, especially in light of COVID-19. The perspectives of jobseekers, employers, and organisations of persons with disabilities (OPDs) are also included in this analysis. The report provides insights into market changes and recommendations to enable Inclusion Works programming to adapt and be more effective in their interventions.

Labour Market Assessment: Bangladesh 2021 refresh

INCLUSIVE FUTURES
BROWN, SIMON
August 2021

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This Labour Market Assessment for Bangladesh is a refresh of the initial assessments done in 2019 for the Inclusion Works programme. The assessment adopts a Markets for Poor (M4P) approach to mapping demand for and supply of labour, supporting functions and regulatory frameworks; recognising that labour markets conditions will have evolved since 2019, especially in light of COVID-19. The perspectives of jobseekers, employers, and organisations of persons with disabilities (OPDs) are also included in this analysis. The report provides insights into market changes and recommendations to enable Inclusion Works programming to adapt and be more effective in their interventions.

A Global Agenda for Inclusive Recovery: Ensuring People with Intellectual Disabilities and Families are Included in a Post-COVID World

Inclusion International
June 2021

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This report documents the experience of exclusion of people with intellectual disabilities and their families during the COVID-19 pandemic. These experiences reveal pre-existing structural inequalities that affected the lives of people with intellectual disabilities and their families before COVID-19, during the pandemic, and beyond, and this report raises up the voices of those most excluded in a time of global crisis and demands an inclusive COVID-19 recovery.

 

This report includes the experiences of people with intellectual disabilities and families across eight different issue areas. Across these themes, we examined how and why people with intellectual disabilities were left out and excluded in pandemic responses, what pre-existing conditions and inequalities contributed to their vulnerability and exclusion, and how future policy structures could begin to address both this immediate and systemic exclusion.

 

Together, these experiences and policy solutions form our global agenda for inclusive COVID-19 recovery, an action plan to ensure that government efforts to ‘build back better’ are inclusive of people with intellectual disabilities and their families.

Disability and Indigeneity: intersectionality of identity from the experience of Indigenous people at a global level

GILROY, John
UTTJEK, Margaretha
LOVERN, Lavonna
WARD, John
2021

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The authors of this paper have protested, fought, written extensively and represent the broader theoretical foundations of Indigenous and disability research by focusing on their standpoint perspectives informed by their ancestral spirits and knowledge. Based on our knowledge, cultures, and advocacy skills, this paper collectively explores and compares the intersections of Indigeneity and disability as an embodied identity in four countries: USA, Canada, Sweden, and Australia. This is accomplished by beginning with a brief synopsis of colonization to provide context and then examine the consequences of Western assimilation practices, including academic support of the Western status quo. The paper will then turn to the impact of both colonization and academic constructs on Indigenous epistemologies and ideas of self in disability dialogues. Finally, the paper will focus on Indigenous concepts of difference to not only advance Western disability discussions, but also as a way for Western dialogue to overcome its predilection to hierarchical binaries.

Bungoma county disability-inclusive budget tracking

DEVELOPMENT INITIATIVES
June 2021

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This briefing presents research that was undertaken as part of Development Initiatives’ work on data to support disability inclusion. It is part of a series of publications that track disability inclusion in county budgets in Kenya. This briefing looks at the inclusivity of Bungoma county budgets towards persons with disabilities between the financial years (FY) 2016–17 and 2020–21. It begins with an overview of the disability prevalence rate in the county, then looks at county investments towards disability inclusion. It concludes by outlining the critical financial gaps in the disability sector and provides actionable recommendations for both the county government and disabled persons organisations (DPOs).

Busia county disability-inclusive budget tracking

DEVELOPMENT INITIATIVES
June 2021

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This briefing tracks the inclusivity of Busia county budgets from financial years (FY) 2016–17 to 2020–21 towards persons with disabilities. It begins with an overview of disability prevalence in the county, and then looks at county investments in disability inclusion. It concludes by looking at the critical financial gaps in the disability sector and providing actionable recommendations to be taken up by both the county government and disabled persons organisations (DPOs).

Kakamega county disability-inclusive budget tracking

DEVELOPMENT INITIATIVES
June 2021

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This briefing tracks the inclusivity of Kakamega county budgets towards persons with disabilities from financial year (FY) 2016–17 to 2020–21. It begins with an overview of disability prevalence in the county, and then looks at county investments on disability inclusion. It concludes by looking at the critical financial gaps in the disability sector and providing actionable recommendations to be taken up by both the county government and persons with disabilities.

Trans Nzoia county disability-inclusive budget tracking

DEVELOPMENT INITIATIVES
June 2021

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This is part of a series of briefings that track the disability inclusivity of county budgets. In this briefing, we present the inclusivity of Trans Nzoia County budgets towards persons with disabilities between financial years (FY) 2016–17 and 2020–21. It should be noted that this briefing has utilised data from only three FYs, as opposed to five as planned, due to the unavailability of budget data. The three FYs with available budget data are FY2017–18, FY2018–19 and FY2020–21. For the two FYs without budget data, we have used projections from the previous years.

Vihiga county disability-inclusive budget tracking

DEVELOPMENT INITIATIVES
June 2021

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This briefing tracks the inclusivity of Vihiga county budgets from financial years (FY) 2016–17 to 2020–21 towards persons with disabilities. It begins with an overview of disability prevalence in the county, then looks at county investments in disability inclusion. It concludes by looking at the critical financial gaps in the disability sector and providing actionable recommendations to be taken up by both the county government and disabled persons organisations (DPOs).

Social protection measures for persons with disabilities and their families in response to the COVID-19 crisis: An updated overview of trends June 2021

UNPRPD
INTERNATIONAL LABOUR ORGANISATION (ILO)
June 2021

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An overview of social protection measures announced in response to COVID-19 that have made specific reference to persons with disabilities. Rather than seeking to provide an exhaustive survey of measures, it identifies the main characteristics and trends for social protection responses that specifically sought to support persons with disabilities during the crisis. This brief focuses on specific crisis response measures adopted during the COVID-19 pandemic, acknowledging that persons with disabilities also benefited from access to health care and income support provided through pre-existing social protection schemes and programmes. The document provides an update to an initial analysis in May 2020 (UNPRPD, 2020).

 

This overview draws on a database of social protection measures specifically relating to disability, which is provided as an Annex to this paper. 

What progress has been made to operationalise the United Nations’ Convention on the Rights of People with Disabilities (UNCRPD) framework to promote inclusive employment? - Evidence Brief

LAMBERT, Felix
May 2021

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Employment contributes to well-being and dignity. Additionally, it can break the vicious cycle of poverty and the resulting negative mental health. However, nearly two-thirds of persons with disabilities aged 15 years and over are unemployed in low- and middle-income countries (LMICs). The ratio of persons with disabilities in employment compared to the general population in employment is almost half. Furthermore, among people with disabilities who are employed, two-thirds continue to experience workplace barriers. Inequality and discrimination in employment deprive persons with disabilities of their rights. Goal 8 in the 2030 Agenda for Sustainable Development explicitly calls for “promoting sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all.” The United Nations’ ‘Disability and Development’ report highlights the international frameworks relevant to optimize opportunities for persons with disabilities to participate in employment, to achieve Goal 8.  This brief will provide an overview of the available literature on LMICs’ efforts to promote inclusive employment underpinned by the UN Convention on the Rights of People with Disabilities (UNCRPD) framework.

How to design disability-inclusive social protection

UN Economic and Social Commission for Asia and the Pacific (ESCAP), SOCIAL DEVELOPMENT DIVISION
April 2021

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This is the fifth in a series of policy guides developed to support policymakers and practitioners in Asia and the Pacific in their efforts to strengthen social protection.

This policy guide explains why social protection is important for persons with disabilities 
and introduces key concepts and schemes that are necessary for disability-inclusive social protection.

A National Survey of the Social and Emotional Differences Reported by Adults with Disability in Ireland Compared to the General Population

McCONKEY, Roy
2021

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The disadvantages experienced by adult persons with disabilities are well documented. However, limited evidence is available on the extent of differences in comparison with the non- disabled population. In this study, selected indicators of social status and mental wellbeing derived from past research, were used with national samples of adult persons in Ireland with a disability (n = 440) and without a disability (n = 880) recruited through household quota sampling. In addition, comparisons were drawn with equivalent data derived from a contemporaneous national census. Although many of the differences were statistically significant, the effect sizes were mostly medium to low. Moreover, when the inter-relationships among the various indicators was taken into account using Discriminant Analysis, persons with disabilities were less likely to be employed; they reported lower levels of social engagement and had poorer emotional wellbeing. They were also older, more likely to be single and have no children. The study illustrates the potential of using comparative data to monitor the impact of national actions taken to reduce the inequalities experienced by persons with disability as well as highlighting the arenas into which professional supports need to be focused.

Combatting the costs of exclusion for children with disabilities and their families

MONT, Daniel
UNICEF
March 2021

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Compared with other children, children with disabilities are less likely to receive an education, less likely to be employed as adults, more likely to be victims of violence, less likely to start their own families and participate in community events, and more likely to live in poverty. 

The exclusion of children with disabilities affects not only them, but imposes costs on the whole community. If these children lack the opportunity to be productive, society loses out on what they could have produced.  The barriers faced by people with disabilities can also create more responsibilities for their family members, which can limit their opportunities to work or get an education.

Moreover, the impact of exclusion extends beyond the economic cost. If people with disabilities are absent from public discourse, the community cannot benefit from their ideas. If they are excluded from political participation, the government cannot truly represent the interests of all citizens. 

A growing body of research suggests that the costs of exclusion are high. Fortunately, evidence also demonstrates that there are effective ways to ameliorate these costs. A strong case can be made for the social and economic benefits of inclusion. This paper is an effort to begin making that case.

 

Disability inclusive Universal Healthcare

CENTRE FOR INCLUSIVE POLICY
March 2021

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The inclusion of direct medical costs, indirect medical costs and indirect costs incurred by people with disabilities into Universal Healthcare is discussed. The importance of including assistive devices, rehabilitation and extra transportation costs in the system is highlighted. Social protection measures are also highlighted.

Inclusive information systems for social protection: Intentionally integrating gender and disability

BARCA, Valentina
HEBBAR, Madhumitha
COTE, Alexandre
SCHOEMAKER, Emrys
ENFIELD, Susan
HOLMES, Rebecca
WYLDE, Emily
March 2021

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Digital information systems serving the social protection sector, and especially social assistance, are increasingly prominent and will continue to be, as is the case within all other sectors. “Why? Because the ability of a country to care for its people and respond to their lifecycle needs depends on its ability to identify those who are in need, enroll them, provide tailored benefits and services, and follow up to cater to evolving circumstances”. Governments also need to be able to monitor programme implementation and impact, feeding into longer-term decisions on design and resource allocation. “All of these actions require accessible, dynamic and real-time data and information exchange if the goal of universal coverage is to be achieved” (Chirchir and Barca, 2019).

The coverage (% of the population included in the information system), relevance (amount/type of data they store), and accessibility (e.g. level of interoperability/data sharing across the government data ecosystem) of these administrative data systems has also been increasing in many countries – posing important opportunities and challenges to policy-makers. The question is how to develop these systems in a way that is inclusive and right-based, leveraging technology “to ensure a higher standard of living for the vulnerable and disadvantaged” (Alston, 2019) rather than becoming a further barrier to inclusion. To illustrate the point this paper specifically focuses on gender and disability inclusion, while acknowledging similar considerations apply to all other forms of (intersectional) exclusion.

How targeting mechanisms can identify people with disabilities for inclusion in social protection programmes

SAMMON, Elayn
CARRARO, Ludovico
COTE, Alexandre
ZEVENBERGEN, Stacey
HOLMES, Rebecca
March 2021

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Developed by Social Protection Approaches to COVID-19: Expert Advice (SPACE) in collaboration with the UNPRPD joint program on inclusive Social Protection, the UNPRPD global initiative on COVID 19 inclusive response and recovery, and Humanity & Inclusion.

The COVID-19 pandemic has demonstrated that countries which have disability identification mechanisms and registries already in place have been in a better position to provide fast relief and expand shock responsive support to persons with disabilities and their families. 

This guidance note includes:

  • Brief introduction to the definitions and terminology surrounding disability and the concept of inclusive social protection
  • Summary of the rationale for the inclusion of persons with disability in social protection programming
  • Examples for overcoming the challenges for outreach, identification, and registration, and needs assessment
  • Some country examples
  • Overall implications for future programming.

Background: Sexual and reproductive health (SRH) of young people including those with disabilities is a major public health concern globally. However, available evidence on their use of sexual and reproductive health services (SRHS) is inconsistent.Object

KUMI-KYEREME, Akwasi
2021

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Background:Sexual and reproductive health (SRH) of young people including those with disabilities is a major public health concern globally. However, available evidence on their use of sexual and reproductive health services (SRHS) is inconsistent.


Objective:This study investigated utilisation of SRHS amongst the in-school young people with disabilities (YPWDs) in Ghana using the healthcare utilisation model.


Methods: Guided by the cross-sectional study design, a questionnaire was used to obtain data from 2114 blind and deaf pupils or students in the age group 10-24 years, sampled from 15 purposively selected special schools for the deaf and the blind in Ghana.


Results: About seven out of every 10 respondents had ever utilised SRHS. The proportion was higher amongst the males (67.8%) compared with the females (62.8%). Young persons with disabilities in the coastal (OR = 0.03, 95% CI = 0.01–0.22) and middle (OR = 0.06, 95% CI = 0.01–0.44) zones were less likely to have ever utilised SRHS compared with those in the northern ecological zone. The blind pupils or students were more likely to have ever utilised SRHS than the deaf (OR = 1.45, 95% CI = 1.26–3.11).


Conclusions: Generally, SRHS utilisation amongst the in-school YPWDs in Ghana is high but significantly associated with some predisposing, need and enabling or disabling factors. This underscores the need for policymakers to consider in-school YPWDs as a heterogeneous group in the design and implementation of SRHS programmes. The Ghana Education Service in collaboration with the Ghana Health Service should adopt appropriate pragmatic measures and targeted interventions in the special schools to address the SRH needs of the pupils or students.

Sommet Mondial sur le Handicap +2 Ans: Les Progrès dans la Mise en Oeuvre des Engagements [World Summit on Disability +2 Years: Progress in the Implementation of the Commitments]

GLOBAL DISABILITY SUMMIT
March 2021

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The 2018 World Disability Summit, held in London, was intended to spark a new wave in the disability rights movement.

The 2-year GDS + report presents critical information on the progress made by national governments, multilateral agencies, donors, foundations, and private sector and civil society organizations on the nearly 1,000 commitments adopted in 2018.
 

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