Beyond the Body: Using Photovoice to Explore Social Determinants of Diabetes With South Asian Adolescents in the Peel Region of Ontario, Canada.

OBJECTIVES: The higher prevalence of diabetes in the South Asian (SA) population living in Canada spans across generations and is often associated with individual risk factors while undermining the social determinants of health (SDOH). There is a scarcity of studies on the perspectives of SA adolescents with a family history of type 2 diabetes mellitus (T2DM). Learning directly from these adolescents can fill a major gap by providing insight on how the SDOH contribute to disproportionate rates of T2DM in SA immigrant communities. METHODS: In this study, we used Photovoice, which is a community-based participatory research (CBPR) method that involves the use of photography to visually capture the challenges of diabetes prevention from the perspective of those with lived experiences. A group of 15 SA youth were recruited from an adolescent diabetes education program in the Peel Region of Ontario. The youth discussed their images and accompanied written narratives during focus groups. RESULTS: Four themes emerged from the thematic analysis of the photographs and participant narratives that influence the manifestation of T2DM in SA communities: 1) immigration and resettlement stressors; 2) food insecurity; 3) unhealthy school environments; and 4) academic pressures. CONCLUSIONS: Findings suggest the need to address T2DM as a response to unjust conditions and environments rather than as an epidemic entrenched in genetic predisposition, culture, and poor lifestyle choices.

Measuring self-reported change in alcohol and cannabis consumption during the second wave of the COVID-19 pandemic in Canada. / Mesurer les changements autodéclarés relatifs à la consommation d'alcool et de cannabis au cours de la deuxième vague de la pandémie de COVID 19 au Canada.

This study presents nationally representative estimates of self-reported changes in alcohol and cannabis consumption since the onset of COVID-19 in Canada. We used data from the Survey on COVID-19 and Mental Health (collected from September to December 2020) to calculate the prevalence of self-reported change in alcohol and cannabis consumption. We found that 15.7% of respondents self-reported an increase in alcohol consumption and 5.4% in cannabis consumption since the start of the pandemic. Sociodemographic disparities were also observed, indicating that increased alcohol and cannabis consumption may be more prevalent among certain populations.

From 11 September to 4 December 2020, 15.7% and 5.4% of individuals self-reported an increase in alcohol and cannabis consumption, respectively, compared to before the pandemic. Individuals who reported that their mental health was worse now, compared to before the pandemic, had the highest prevalence of self-reported increase in alcohol and cannabis consumption. Understanding the social determinants of health is critical to the development of harm reduction and mitigation strategies.

Entre le 11 septembre et le 4 décembre 2020, 15,7 % des répondants ont déclaré avoir augmenté leur consommation d'alcool et 5,4 % leur consommation de cannabis par rapport à avant la pandémie. Les personnes ayant déclaré que leur santé mentale était pire au moment de l'Enquête qu'avant la pandémie offraient la prévalence la plus forte en matière d'augmentation de la consommation d'alcool et de cannabis. Il est primordial de comprendre les déterminants sociaux de la santé pour élaborer des stratégies de réduction des méfaits et d'atténuation.

Applying a gendered lens to understanding self-reported changes in alcohol and cannabis consumption during the second wave of the COVID-19 pandemic in Canada, September to December 2020. / Adopter une perspective axée sur le genre pour comprendre les changements autodéclarés dans la consommation d'alcool et de cannabis pendant la deuxième vague de la pandémie de COVID 19 au Canada, septembre à décembre 2020.

INTRODUCTION: Increased alcohol and cannabis consumption and related harms have been reported since the beginning of the COVID-19 pandemic. Existing evidence shows that substance use and related harms differ by gender. Yet, no Canadian study has applied a gendered lens to alcohol and cannabis consumption use during this time. Our objectives were to (1) provide gender-specific prevalence estimates of self-reported increased alcohol and cannabis use; and (2) examine gender-specific associations between sociodemographic and mental health variables and alcohol and cannabis use. METHODS: Using data from the Survey on COVID-19 and Mental Health, we calculated nationally representative, gender-specific prevalence estimates and disaggregated them by sociodemographic and mental health variables. Four logistic regression models were used to assess the likelihood of self-reported increased alcohol and cannabis use. RESULTS: The prevalence of self-reported increase in alcohol use (16.2% women; 15.2% men) and cannabis use (4.9% women; 5.8% men) did not differ by gender. For both genders, income, racialized group membership, working in the past week, being a parent/legal guardian of a child aged under 18 and screening positive for depression and anxiety were associated with increased alcohol use. Men and women who were between the ages of 18 to 44, screened positive for depression, or both, were more likely to report increased cannabis use. For women, education was significantly associated with increased alcohol use. For men, being a parent/legal guardian was significantly associated with lower odds of increased cannabis use. CONCLUSION: Sociodemographic factors, as well as depression and anxiety, were similarly associated with increased alcohol and cannabis use for both men and women in the second wave of the pandemic.