People of African, Caribbean and Asian descent are up to 6 times more likely to suffer from type 2 diabetes, heart disease and stroke, and they also develop these conditions at a younger age than the wider population, according to a report by NICE.
The paper highlights that a lower body mass index (BMI) of 23 kg/m2 should be used as a trigger to take action in helping people from these and other minority ethnicities to avoid ill health. This is a change from the usual threshold of 25 kg/m2 signalling increased risk of chronic conditions - however this figure is still valid for flagging risk in white European adults.
The new Local Government Briefing published by NICE sets out effective ways to help local authorities prevent and tackle these serious long term conditions in their diverse populations. With local authorities' wider remit for public health in communities, the new briefing highlights the importance of taking steps to address diabetes, cardiovascular disease and stroke to improve the health of local people, and also save money.
Professor Mike Kelly, Director of the Centre for Public Health at NICE said: "Type 2 diabetes, heart disease and stroke are potentially life-threating conditions, which people of African, Caribbean and Asian descent and other minority ethnicities are significantly more likely to develop than the wider population. So it's vital that local authorities are supported in taking action to prevent these illnesses in people who have a high risk of developing them.
“Not only are people from these ethnic backgrounds up to 6 times more likely to be diagnosed with type 2 diabetes, they are 50% more likely to die from cardiovascular disease, and they also suffer from these conditions at a younger age.
“This briefing recommends that a BMI of 23 kg/m2should be the threshold to trigger action to prevent these chronic conditions in people of African, Caribbean and Asian descent and other minority ethnicities, as these individuals are at an increased risk at what is normally considered a healthy weight. In our diverse population, it's essential that decision makers, practitioners and individuals are aware of this difference, as it's lower than the 25 kg/m2 BMI value routinely used to signal an increased risk of chronic illness.
"Local authorities and their partner organisations have an important role in helping ensure that services that they commission or provide include a focus on people from minority ethnicities, and particularly within the 25-39 age group. Lifestyle interventions targeting inactive lifestyles and diet have reduced the incidence of diabetes by about 50% among high-risk individuals, including people of South Asian, Chinese, African and Caribbean descent. As well as improving the health and wellbeing of individuals, taking effective action now also reduces future demand on health and social care services by enabling people to remain as independent as possible."
As well as improving health, there could be large potential savings from tackling these chronic conditions at an early stage. This is particularly true for local authority areas where people from minority ethnic backgrounds form a high proportion of the local population.
Professor Kelly continued: "Early intervention, using lower BMI thresholds could save over £6000 per person per year by reducing the number of people developing type 2 diabetes. The estimated savings from preventing type 2 diabetes are £8.8 billion each year in the UK including diagnosis, lifestyle interventions, ongoing treatment, management and complications.
“There is an additional estimated saving of £13 billion if mortality, sickness, and loss of productivity from those in work are included. These predicted future savings may not take account of the higher prevalence of obesity in children from minority ethnic backgrounds, so the projected estimated savings could be even higher. Following the briefing recommendations can help local authorities with diverse populations to tackle health inequalities and make the best and most efficient use of resources to improve the health of people in their area."