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Case Study Analysis: Using a Health Promotion Framework for Multilevel Analysis


There have been many impacts associated with diabetes among the Canadian population. More than a third of the population lives with pre-diabetes, while more than 10% have been diagnosed with diabetes (Tremblay & Hamet, 2019). However, the cases will rise if the individuals diagnosed with type-two diabetes are included. The problem has been associated with many premature deaths in the country. At the same time, the impacts associated with the disease can reduce lifespan from five to fifteen years. The mortality rate is twice higher among individuals living with the disease compared to those not diagnosed with diabetes. Additionally, the patients with the problem are likely hospitalized for other chronic diseases, such as cardiovascular problems (Tremblay & Hamet, 2019). Moreover, they are more than ten times more likely to be hospitalized with the end-stage renal disorder than other community members.

The country has a major challenge in preventing the problem and meeting the needs of the victims. The problem is prevalent due to the older population who are more when compared to the younger children. However, there is a need to understand that the government is spending a lot of resources and energy to combat the effects. The situation made the government use more than $35 million the previous year in diabetes research and developing a comprehensive framework (Tremblay & Hamet, 2019). The budget also intends to develop life-sustaining therapy using working hours as the eligibility criteria. The country had also initially announced the healthy eating habits program to increase the food environment’s safety and reduce the risks associated with chronic problems. At the same time, the problem is prevalent in Canada due to the presence of self-identities such as Africans, Arabs, and the Hispanic population who have increased risks of being diagnosed with diabetes. There are close to two million indigenous people in the country having higher rates of diabetes and other health problems when compared to other members of the population. Therefore, the high prevalence rate calls for intervention to control the effects among the population.

Healthy eating and moving more is the best way to prevent diabetes, so there is a need to conduct promotions. People need to be taught about the best food choices because the diet is a crucial part of lifestyle (Shulman et al., 2018). Healthy eating habits can be modified to allow the population to take the first step in reducing the risks associated with the problem. At the same time, advising individuals to move more will be important in the promotions because just an extra activity a day will go a long way in the prevention of the problem; therefore, there is a need to develop programs that will allow individuals to have at least 3 hours a week to participate in aerobics because this smaller amount of activities can have a lot of benefits. Healthy eating and more exercise will help individuals to lose weight and reduce the chances of being diagnosed with the problem (Tremblay & Hamet, 2019). However, getting motivation cannot be easy, and developing an action plan will play a major role in the process.



Controlling weight and having the best eating habits will go along with having the best lifestyle to prevent individuals from being diagnosed with diabetes. There is a need to understand that much weight is the fundamental cause of the problem. Individuals with overweight have higher chances of developing type-two diabetes. At the same time, being obese makes individuals more than 20 times more likely to develop the problem when compared to individuals having a healthy weight (Kolardooz et al., 2019). Losing weight help individuals cut the chances of developing the problem by half, and individuals in the healthy weight range are less likely to develop the problem. At the same time, inactivity promotes the problem’s prevalence, and individuals need to work their muscles to allow the insulin to absorb glucose and reduce the stress in the insulin-making cells. Additionally, it is proper to have outlets that may include the care workers and other healthy lifestyle activists who can change individual perspectives on the importance of healthy eating and participating in exercises.

Walking reduces the risk of developing diabetes, and exercise should last less than an hour a day. Studies indicate that long hours of sweaty exercises are unnecessary, but walking will help reduce the problem. The amount of exercise associated with brisk walking has many benefits because it can reduce the chances of getting cardiovascular diseases. At the same time, research indicates that watching television has been the major cause of inactivity. Every two hours spent watching increases the chances of being diagnosed with diabetes by 20% (Shulman et al., 2018). Therefore, individuals are supposed to understand their diets, reduce alcohol consumption and control their weight through exercise.


Care providers play an important role in community control of obesity and reducing the burden associated with the problem. Caregivers need to develop guidelines focusing on nurses’ role in controlling obesity. A population health approach is essential to address the complex challenges associated with obesity (Kolardooz et al., 2019). At the same time, healthcare providers must go beyond medical treatment and incorporate obesity prevention to deal with diabetes. The prevention of the problem through screening and referrals currently is not fruitful in the country, and there is a need to put more emphasis on preventing the risks associated with diabetes. At the same time, further research indicates the important role of healthcare in preventing the problem and the need to use the systems approach to examine the structures in the health sector. At the same time, there is a need to understand the interrelationships between good policies and best practices in healthcare that are important in preventing diabetes. Therefore, the best way is to deal with service delivery boundaries and perspectives that will impact the changing care models.

Additionally, there is a need to develop a committee in the country to provide information about the prevalence of diabetes. The committee should be tasked with the provision of information, recommendation, and the best way of training the problem in the community. At the same time, the community members will be concerned about community wellness among the indigenous minorities in Canada (Shulman et al., 2018). The members will also be able to develop sports programs that will improve the healthy lifestyle among the population. At the same time, the sorts program will create a positive environment that will focus on training and making lifestyle healthier and more effortless. The programs will also deal with other chronic diseases developed due to the obesity prevalence in the community. Programs such as Obesity Canada are crucial in research, creating education programs, and advocacy when dealing with the problems of diabetes (Kolardooz et al., 2019). The program is a leading charity group associated with healthcare professionals, policymakers, scientists, and other people who have much interest in dealing with obesity that causes diabetes. Diabetes is chronic and progressive and therefore impairs health and mental well-being among the victims.

Many people in Canada are diagnosed with diabetes because of the marginalization of minority groups. People of African and Asian heritage are the most affected individuals in the country because of their eating habits and access to healthcare (Kolardooz et al., 2019). At the same time, individuals with low income and lower education levels are at risk of being diagnosed with diabetes. Therefore, chronic disease surveillance is essential to understand the changes associated with the pattern of prevalence in diabetes. At the same time, surveillance will inform the program and development of policies that will improve the lives of individuals with chronic conditions. Canada has the most effective surveillance system and should use it to improve the healthcare system and prevention of diabetes. Therefore, the Canadian Chronic Disease Surveillance System (CCDSS) should be part of the programs to prevent obesity prevalence.


The built environment determines the prevalence of diabetes in the community because it is associated with the transportation system and the land development pattern. Therefore, its prevalence in the country is associated with policies and programs for urban design, transport, and land use planning (Amuda & Berkowitz, 2019). Most of the policies act as facilitators of the problem. They can inhibit the level of physical activities, overweight and obesity, and healthy eating among the community members. However, the problems, despite being the major risk factors, can be adjustable to prevent the development of the problem and other related complications. Personal experience makes me believe urban containment policies promote density and do not facilitate active transport. The infrastructure in the country does not support proper and active transport, such as bike lanes and well-maintained sidewalks (Amuda & Berkowitz, 2019). At the same time, there is no affordable, efficient and reliable system of transport in the public sector. Finally, the policies in the country do not ensure mixed land use and support walking and biking, which can be an alternative mode of transport. The country also does not have a better population-health approach that deals with the importance of environmental changes that will improve the population’s health (Amuda & Berkowitz, 2019). Therefore, there is a need to recognize the important role played by the built environment because it creates population-health level differences and is the best intervention to reduce the spread of diabetes in the country. There is a lot of importance associated with the built environment because it affects active transport and the determinants of health status in the community.

Summary and Recommendations

The increased diabetes prevalence in Canada is associated with obesity as the main contributor. However, other factors, including physical inactivity, ethnicity, and lifestyle, can be potentially identified as important factors (Dawson, 2021). However, there are no studies that provide a comprehensive list of factors of the contributors to the problem. The comprehensive list always creates a foundation that will aid in the population health planning and development of successful strategies in dealing with the effects of diabetes. Therefore, understanding the problem through surveillance can allow policymakers in the decision-making process to develop programs that will create a built environment supporting a healthy lifestyle. Each actor’s relative contribution is unknown in the country because there are no direct measurements at the individual level that will be used to understand the evolution of diabetes. The increasing number of diabetes patients in the country is not impressive because it has many effects on the population (Dawson, 2021). Therefore, there is a need to understand the factors responsible for the problem and develop policies and programs to reduce the effects. Most city activities in the country are not associated with the mixed use of land to support walking and biking to reduce obesity.

Developing urban containment policies will have a bigger role in reducing the effects of diabetes. The policies manage urban sprawl and call for more opportunities to increase active transport. At the same time, the government should increase infrastructure to support active transport by introducing sidewalks that will be used for biking and walking. Additionally, the policy-making process should ensure equitable access to recreational facilities, especially for the members of the indigenous population (Dawson, 2021). People also need to prioritize physical activities as a means of reducing body weight and allowing them to be physically healthy. Conclusively, choosing healthy food is important, and limiting television time will be essential in reducing the diabetes level in the country. However, a lot of research is required to understand the factors that contribute to the problem and evaluate their effects in the early evolutionary stages of the disease.


Amuda, A. T., & Berkowitz, S. A. (2019). Diabetes and the built environment: evidence and policies. Current diabetes reports19(7), 1-8.

Dawson, L. (2021). The Hidden Embodied Stories behind Diabetes as Racialized Health Disparities. Body Studies in Canada: Critical Approaches to Embodied Experiences, 1.

Kolahdooz, F., Nader, F., Daemi, M., Jang, S. L., Johnston, N., & Sharma, S. (2019). Prevalence of known risk factors for type 2 diabetes mellitus in multiethnic urban youth in Edmonton: findings from the WHY ACT NOW project. Canadian journal of diabetes43(3), 207-214.

Shulman, R., Shah, B. R., Fu, L., Chafe, R., & Guttmann, A. (2018). Diabetes transition care and adverse events: a population‐based cohort study in Ontario, Canada. Diabetic Medicine35(11), 1515-1522.

Tremblay, J., & Hamet, P. (2019). Environmental and genetic contributions to diabetes. Metabolism100, 153952.


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