Senedd Cymru	Welsh Parliament
Pwyllgor yr Economi, Masnach a Materion Gwledig	Economy, Trade, and Rural Affairs Committee
Costau byw	Cost of living
COL–17
Ymateb gan: Diabetes UK Cymru	Evidence from: Diabetes UK Cymru

Diabetes UK Cymru Response

Written by: Mathew Norman, Policy and Public Affairs Manager (Wales)

Submitted as: Submission as an organisation.

Authorisation to publish the submission:  Happy for submission to be published as Diabetes UK Cymru.

About us

Diabetes UK’s vision is a world where diabetes can do no harm. We lead the fight against Wales’ largest growing health crisis, which involves us all sharing knowledge and taking on diabetes together.

Over 209,015 people live with diabetes in Wales, equivalent to one in 13 people, the highest level of prevalence of any of the UK Nations. The last twenty years have seen a rapid increase in the diagnosis of diabetes; this is due in part to a growing rate of type 2 diabetes diagnoses, with an estimated 65,000 people in Wales living with undiagnosed type 2 diabetes. 

The continued prevalence of obesity suggests that an estimated 580,000 people in Wales could be at risk of developing type 2 diabetes, the most common form of diabetes, accounting for 90% of all cases. By 2030 the number of adults with diabetes in Wales is likely to grow from 8% to 11%.

Further information on diabetes can be found on our website.[i]

Response

We thank the Committee for the opportunity to respond to the consultation on the economic and rural impact of the cost-of-living pressures. Diabetes UK Cymru equally shares the concerns of the Committee, particularly as wages in real terms have decreased, energy prices continue to increase, and pressures on household incomes continue to feel the squeeze from projected double-digit inflation.

Food Poverty

As people and families make decisions regarding their budgets, our biggest concern is the impact this will have on our poorest and most deprived. The poorest in our society are 2.5 times more likely to have diabetes than the average person at any age. Once they have the condition, those in the most deprived homes are twice as likely to develop complications than those in the least deprived.[ii]  Wales was found to have the second-worst levels of deprivation in the UK, with 22% of the population living in the poorest fifth of the UK.[iii]

Already the Institute for Fiscal Studies has found that 9% of the poorest households face the highest inflation rates in the nation, facing double-digit inflation on essential day to day items accounting for a significant proportion of their monthly budgets.[iv]

With increasing pressures on the cost of living, living healthily in the UK is not attainable for our most deprived. The Food Foundation states that the poorest fifth of homes with children would need to spend 42% of their disposable income to meet the Public Health ‘Eatwell Guide’.[v] As well as the potential impact on the development of type 2 diabetes, such pressures may negatively impact type 1 diabetes health, with research from the University of Edinburgh unveiling that poorer living circumstances increase blood sugar levels. Increasing the stresses and burdens of a family in a deprived area to support their children with type 1 diabetes to live well.[vi]

Such impact is further compounded in communities of Black African, African Caribbean and South Asian (Indian, Pakistani, Bangladeshi) backgrounds. They are at a higher risk of developing type 2 diabetes from a younger age (your risk increases from 25 years old). These rates are much younger than the white population, and their risk increases from 40 years and older. The research is uncertain about the cause; however, further health support for ethnic groups should be encouraged, primarily as higher numbers who live in deprivation are also found in these communities.[vii]

Diabetes UK Cymru welcomes measures that the Welsh Government has introduced, such as healthy and balanced Free School Meals, to help reduce the financial burdens of Welsh families and ensure that all children receive a healthy balanced diet.  Nonetheless, we are concerned that nutritional information needed for the good management of diabetes will not be readily available and call for further support for all children with conditions such as diabetes that require nutritional information to manage their condition well. This will help reduce pressure on families with children who have diabetes and avoid families having to consider sending their children with a packed lunch to avoid any complications.

We further welcome the proposed measures outlined in Healthy Weight Healthy Wales 2022-24, which aims to improve the food environment that will see the end of price promotions, aiming to make the healthy choice the easy choice.[viii] However, recent changes in policy in the UK have raised several concerns for the Charity, delaying key pledges from their Obesity Strategy, already approved by the UK Parliament, by a year. The policies to be delayed are restrictions on advertising unhealthy food online and on television before 9 pm and multibuy offers in supermarkets. Diabetes UK supports calls to stop delays to these policies and ensure that they are followed through.

In Wales, we have concerns that such pressures may influence strategy as outlined in Healthy Weight Healthy Wales. As a charity, we cannot stress enough the importance of a positive food environment and the need to introduce measures and legislation to reduce the sale of junk food and marketing promotions of unhealthy food, the consumption of which can lead to lifelong complications, eating disorders, obesity and diabetes diagnosis later in life.

Contrary to the reasons proposed by the UK Government, multi-buy promotions are not an effective means for households to save money; instead, these promotions encourage further spending.[ix] The promotions are designed to encourage impulsive purchases and normalise frequent buying. Promotions have been found to increase the total amount of household food and drink purchased by around 1/5 (22%), and a minute of junk food advertisement is enough to encourage children to eat additional calories.[x]

Diabetes UK Cymru, a member of Obesity Alliance Cymru, stresses that progressive policies to promote a positive food environment must continue and should not be delayed by arguments proposed by industry member-led representative organisations that do not support such changes.

Fuel Poverty

The committee is aware of the effects of Fuel Poverty on a significant proportion of Wales’ population, especially in rural regions, before the current crisis. Ofgem’s updated April energy tariff cap increased the average households’ bills on gas and electricity by 54% from the previous month, which translated to a 70% year on year increase.[xi] Diabetes UK Cymru is concerned about the impact this will have on our most vulnerable populations managing their Diabetes.

With many already struggling during the warmer months, our concerns are heating costs. Colder temperatures may impact the management of diabetes, especially when managing blood glucose levels. Diabetes UK Cymru welcomes the Welsh Government’s Cost-of-living package of support for the most deprived and vulnerable communities; however, further support will be needed in the winter months to support our most vulnerable to heat their homes and help reduce complications from diabetes.[xii]

Conclusion

As a Charity, we are already receiving calls from people managing their Diabetes and struggling to manage the increased cost of living.  We have set up a monthly data dashboard to track contact with beneficiaries with Diabetes UK and its impact on people affected by diabetes.

We will continue to raise concerns from our beneficiaries; however, the cost of living may impact future diabetes prevention work, diabetes care and support for people living with diabetes. As a Charity, we welcome opportunities to raise our concerns, and if you wish for further information, please do not hesitate to contact us.

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[i] Diabetes in Wales, accessed April 2022, https://www.diabetes.org.uk/in_your_area/wales/diabetes-in-wales.

[ii] Diabetes UK Cymru, 2009, https://www.diabetes.org.uk/about_us/news_landing_page/uks-poorest-twice-as-likely-to-have-diabetes-and-its-complications

[iii] Abel GA, Barclay ME, Payne RA Adjusted indices of multiple deprivation to enable comparisons within and between constituent countries of the UK including an illustration using mortality rates BMJ Open 2016;6:e012750. doi: 10.1136/bmjopen-2016-012750.

[iv] Institute for Fiscal Studies, May 2022, ‘Inflation hits 9% with poorest households facing even higher rates’, Heidi Karjalainen and Peter Levell, https://ifs.org.uk/publications/16058. 

[v] BBC, 2018, Families ‘can’t afford to follow healthy diet guidance’, https://www.bbc.co.uk/news/education-45420295.

[vi] Diabetes Times, 2019, Deprivation ‘negatively impacts’ type 1 diabetes health, https://diabetestimes.co.uk/deprivation-negatively-impacts-type-1-diabetes-health/

[vii] Diabetes UK, 2022, Ethnicity and Type 2 Diabetes, https://www.diabetes.org.uk/preventing-type-2-diabetes/diabetes-ethnicity

[viii] Healthy Weight Healthy Wales Delivery Plan – 2022 – 2024 Delivery Plan - https://gov.wales/healthy-weight-healthy-wales-2022-2024-delivery-plan

[ix] UK Government, Department of Health and Social Care, Press Release, ‘Government delays restrictions on multibuy deals and advertising on TV and online’, May 2022, https://www.gov.uk/government/news/government-delays-restrictions-on-multibuy-deals-and-advertising-on-tv-and-online.

[x] UK Government, Department of Health & Social Care, Consultation Outcome: Restricting promotions of products high in fat, sugar and salt by location and by price: Government response to public consultation, July 2021, https://www.gov.uk/government/consultations/restricting-promotions-of-food-and-drink-that-is-high-in-fat-sugar-and-salt/outcome/restricting-promotions-of-products-high-in-fat-sugar-and-salt-by-location-and-by-price-government-response-to-public-consultation.

[xi] Institute for Fiscal Studies, May 2022, ‘Inflation hits 9% with poorest households facing even higher rates’, Heidi Karjalainen and Peter Levell, https://ifs.org.uk/publications/16058. 

[xii] Welsh Government, Cabinet statement, Cost-of-living support package, Feb 2022, https://gov.wales/written-statement-cost-living-support-package.