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Geographic inequity in healthy food environment and type 2 diabetes: can we please turn off the tap?

Geographic inequity in healthy food environment and type 2 diabetes: can we please turn off the tap? - Featured Image

We need fairer policies and investment in change that may only be realised in the long term

The human, financial and wider societal costs of type 2 diabetes mellitus (T2DM) in Australia are high,1 but not inevitable.2 Studies indicate that lifestyle interventions involving weight reduction can reduce T2DM risk.3 Prevention and better management of T2DM can also help to prevent cardiovascular complications.4 So, to paraphrase the title of a recent editorial in the Journal, if we know what to do, what is the problem?5

One problem is that the complexity of sustaining the prevention effort has not been captured well by randomised trials,6,7 which veer towards individual-level (sometimes referred to as “high-risk”) strategies rather than evaluations of structural interventions at the population level.8 General practitioners have a very valuable role to play, but placing the burden of prevention squarely on them will not work.9 The determinants of T2DM risk are intergenerational, relational, multifaceted and inequitably distributed.10 Legions of scientists have engaged with the idea…