Type 2 Diabetes in Vulnerable Populations: Community Healthcare Providers' Perspectives on Health Service Needs and Policy Implications

Abstract Objectives: To identify a) ways of enhancing health services for vulnerable populations with type 2 diabetes, taking into account the social determinants of health; and b) health and social policy approaches to reducing the incidence of type 2 diabetes and improving its management. Methods: Focus groups were held with 18 community healthcare providers at 3 community health centres in Toronto, Ontario. Results: Community healthcare providers' perspectives were organized under 3 themes: a) the compounding effects of social factors on the health of people with diabetes; b) the need for responsive support at multiple levels; and c) barriers to change. Participants showed a good understanding of the impact of social determinants of health on patients' lives, and they had many ideas about prevention/ health promotion and strategies to enhance health services. They seemed less aware of the important role that political advocacy can play. Conclusion: Assessment of the policy environment and political advocacy through coalition-building with communities and other health and social sector service providers should become part of healthcare professionals' education and responsibility. Adequate income and access to proper resources would help with the prevention and optimal management of diabetes.