Bryan May

BIOL 4500

Is our economy driving a rise in diabetes?

The main message of economics is how well off we are as a society in terms of comfort and health. Only since the 1700’s have things actually started to improve. Before that there were a few small spikes in well-being such as the Greeks and Romans, but even they didn’t have anything compared to what the world has today. Calculating the happiness of people is generally difficult to measure because of how subjective it is, but there are a few key indicators at which historical economists look. Some of these include the health of a population or individual’s teeth, size, age at death, cause of death, hair, and bone integrity. This is lucky because we can see how well they ate and what the people’s health looked like. For the most part, all were small because of malnutrition, and all died at what would be a very early age for people today; moving from late 40s in the fifteenth century to almost 80 in the United States today and according to the Social Security website, today’s 65-year-olds can expect to live to about 85 years of age (Griffin, 2008). This is all because of our incredible economy that has grown to be so strong in the last few hundred years. Instead of living day to day by performing hard labor out in the fields, we can instead perform less physically challenging services and get paid enough to put away savings for hard times. Our economy is growing, but with the growing economy comes other consequences such as a growing number of cases of diabetes. There are a number of factors to consider, such as type of work we perform, average age, type of diabetes, and cause of diabetes that come into play that we will need to consider as we go throughout this paper, but by the end I would like to show that our economy may be contributing to the increasing number of diagnosed diabetic patients in America.

Diabetes in essence is the body’s inability to control blood glucose due to improper amounts of insulin in the body. This can be caused in two different ways. Type 1 diabetes is an autoimmune disorder meaning one’s own insulin-producing pancreatic β cells are being attacked by the immune system. The cause of the rise in Type 1 diabetes is still relatively unknown so I will refrain from speculation. I will say that a lot of the hypotheses surrounding the cause are economically-driven including an increase in cleanliness, a decrease in outdoor activities, or consuming certain types of food (Egro, 2013). The cause of Type 2 diabetes is better understood and thus more practical to look into. Type 2 diabetes is essentially caused by the misregulation of glucose transporters in the body. When the body senses an increase of blood glucose, it signals the pancreas to release insulin. It will attach to insulin receptors that call for glucose transporters to uptake glucose into the cells. In people with diabetes, the signals aren’t received in the same way, particularly in cells containing the glucose transporter GLUT4 which is found in muscle and fat tissues. Type 2 diabetes is correlated strongly with lifestyle and for this reason we will explore the causes more fully as to the possible increase in the number of people with Type 2 diabetes.

One huge precursor to Type 2 diabetes is a sedentary lifestyle. In the past, people have had to work long days in the fields doing manual labor. Today most people in America are more oriented toward performing services. The majority of the population wants to have an easy desk job where they can work more with their minds than with their bodies. As technology advances, people can afford to move less and less by working online from home, going to school online, and even shop online and have the items brought to his/her front door. 15 years ago, this would have seemed impossible, but because of our technology-driven economy, we can live comfortably almost without leaving our bed. Even when we do leave home, we drive in comfortable air-conditioned vehicles instead of walking or riding horses. Entertainment is transitioning more and more from physical activities to indoor, technology based activities. It is now watching movies or television, playing video games or exploring social media. Our economy allows us more free time to do these things as well. Our time at work can buy us more than ever. If we look at it as a dollar amount it may not seem that way where in 1970 if we bought something for a dollar, it would cost over six dollars today, but today we make greater than six times more per hour than we did in 1970. Our purchasing power has grown and so with that, it gives us more food, more technology, and decreases the work needed for tour survival.

Another factor that leads to Type 2 diabetes is an unhealthy diet. In 1970, Americans spent around $6 Billion on fast food. That figure has grown to over $110 Billion in the year 2000 and $196.1 Billion in the year 2013. This is due to much more than simple inflation. While the dollar has decreased to about one sixth its value in 1970, the money put into fast food has increased to more than thirty-three times its original cost in 1970. Interestingly, the statistics for money put into diabetes has risen similarly with direct medical costs towards medical treatment being $176 billion in 2012 compared to $1 Billion in 1970 (2013). The trends follow each other very nicely. Whether this is a correlation or a causation is always an argument in science, but there are very strong similarities in these statistics. As the amount of fast food Americans consume goes up, so does the number of cases of diabetes. Because our time at work can buy more, we can afford to spend more on unhealthy eating and it is having a huge effect on our health.

One last thing that is generally overlooked in this is age. Sure the statistics point to there being more youth diagnosed with diabetes, but a lot of the increase in the numbers of diabetes cases comes from the aging generation. As age increases, so does our chance of developing diabetes. A person is more likely to develop diabetes after the age of 45 than before. Almost 16% of diabetics are diagnosed between the ages of 55-59 alone, according to the Center of Disease Control (2015). The baby boomers are currently right in that age where they are most susceptible to develop diabetes and have been for the last few years. Right as the increase of fast food consumption hit in about the 1970s, they were starting families and have been and are now getting ready to retire. Right now we are seeing the results of that huge generation’s choices. As they enter those prime years for developing diabetes, we can expect to see an increase even more in the number of diagnosed cases of diabetes. For some diseases such as cancer, the increased life expectancy is the main problem. An increase in life expectancy and population surely explains some of the increase of diabetes, but can’t fully explain the entire problem.

While the economy may be driving the increase in the number of diabetics by subjecting Americans to high risk factors such as a sedentary lifestyles and unhealthy eating habits, it doesn’t mean it's a bad thing. I won’t say that diabetes is a good thing, but it isn’t necessarily a drain on the economy. Pharmaceutical companies are finding new ways of solving the problem of lowering blood sugar with new drugs designed to get insulin into the body. Not only are they controlling it by changing insulin levels, but they are finding ways to change how long one’s digestive system takes to break down food, or even preventing the breakdown of some food. They are limiting the absorption of sugar in the intestines or limiting the breakdown of glycogen in the liver. These are just some of the solutions that pharmaceutical companies have found. These methods may come in handy in other areas in the future and many people have jobs because of this research. Diabetes has also forced health care providers to work more harmoniously with each other. Diabetes affects many different tissues, so optometrists, ophthalmologists, podiatrists, dieticians, and more all become involved in the health of one person. Healthcare technology and communication has increased, which also benefits everyone. Along with that, another possible cause for the rise in cases could include more physicians detecting possible silent cases that were always there but are now being diagnosed. Another benefit from this increase is that people are more conscientious of the causes and needs of diabetic patients. Some fast food restaurants offer healthier menu items, and money is going toward making people aware of diabetes and the risk factors of developing it. Hopefully because of this we can start to change the unhealthy culture to be something better.

In conclusion, I believe our strong economy is a leading factor in the growing number of people diagnosed with diabetes. The economy allows us to eat more than we need to for less work, but I also believe that we are better off now than any other country because of that. People continue to live longer and longer, and new treatments are being developed because of the money being put into the problem.

References

Economic costs of diabetes in the U.S. in 2012. (2013). Diabetes Care, 36(4), 1033-1046. doi:10.2337/dc12-2625

Egro, F. M. (2013, August 01). Why is type 1 diabetes increasing? Journal of Molecular Endocrinology, R1-R13. doi:10.1530/JME-13-0067

Distribution of Age at Diagnosis of Diabetes Among Adult Incident Cases Aged 18–79 Years, United States, 2011. (2015, November 3). Retrieved September 22, 2016, from http://www.cdc.gov/diabetes/statistics/age/fig1.htm

Griffin, J. (2008). Changing life expectancy throughout history. Journal of the Royal Society of Medicine, 101(12), 577. http://doi.org/10.1258/jrsm.2008.08k037