
The Global Diabetes Epidemic, Brought to You by Global Development
The link between economic growth and the worldwide diabetes epidemic, explained
Diners in Shanghai eat at a Kentucky Fried Chicken outlet. (Aly Song/Reuters)
As globalization exports our culture across the world, it also spreads our health problems. For much of the 20th century, a person's likelihood to develop type-2 diabetes depended as much on the wealth of their nation as their biology. Those living in the developed world survived to old age and eventually succumbed to "diseases of affluence": cancer, cardiovascular disease, and diabetes. In contrast, undernourishment, violence, and communicable diseases ravaged the health of residents of developing countries.
And this is the way things remain in the developed world: even in poor parts of the United States, almost no one dies of tuberculosis. But in low- and middle-income countries, the distinction fades. The "diseases of affluence" have embedded themselves in communities anything but affluent. Now, cholera strikes next door to cancer; the malnourished and diabetic share a roof.
In this new landscape of health in the developing world, the impact of diabetes is momentous. Since 1980, the number of diabetics worldwide has ballooned from 152 million to between 285 and 347 million today. Of these, three-quarters live in the developing world, where diabetes afflicts more than six times as many people as HIV. Why, if infectious diseases persist and life expectancies remain low, has diabetes taken such a toll on the health of the impoverished?
One explanation relies on a trio of social forces: aging population, urbanization, a
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