CCD research identified a particularly vulnerable group of Copenhageners that did not manage their health actively and had little or no contact with local healthcare services. Through peer support programme, which connects two people both diagnosed with type 2 diabetes, individuals are able to build relationships – and share learnings that help them commit to the lifestyle changes necessary to improve their lives with a chronic disease.
Local Partners: Municipality of Copenhagen’s Center for Diabetes, Danish Diabetes Association and University of Copenhagen
Despite free universal healthcare, and a city designed for healthy living, Copenhageners today experience a quality of life that sits below the rest of Denmark’s population. Their life expectancy lags behind the national average by upwards of 2 years, and many residents live with one or more chronic illness1.
Whilst many city‑led initiatives help enable healthy living for the general population, evidence from CCD’s, Rule of Halves Analysis and the Vulnerability Assessment, compiled as a part of CCD’s ‘map‑share‑act framework’, demonstrated inequalities in health – especially amongst those with a low level of education, without employment or who live alone. Whilst Copenhagen’s prevalence of diabetes figure is a relatively low 5.1% across the general population, for citizens that are not employed it doubles to 10.2%2.
The research highlighted the complexities that make up diabetes vulnerability and concluded that there needed to be better and more equal access to health care services for people living in disadvantaged areas. Evolving out of the CCD analysis, it was noted that vulnerable populations faced two main challenges; firstly, despite Denmark’s free, universal healthcare there was a lack of knowledge and confidence in the ability to navigate the health and social services systems of the city, and secondly, for certain populations, alienation and a lack of community hindered their motivation to make long lasting lifestyle changes.
As a part of the City Action Plan, a volunteer peer mentoring group aimed at supporting socially vulnerable individuals with type-2 diabetes was created. Each peer supporter commits to a 6‑month programme, engaging one-to-one with peers in their local community. The initiative was rolled out in the two disadvantaged districts identified by the CCD analysis, Tingbjerg and Sydhavnen.
Since the programme’s launch, 25 volunteer peer supporters have been trained in how to be an effective diabetesbuddy to their peers. They have learnt skills like how to advise in the practicalities of manoeuvring through Denmark’s health and social services, as well as on workable solutions to living with diabetes on a day-to-day basis. Another positive outcome of the programme is that the participants, both peer supporters and their peer mentees, have built social bonds that can support them in their efforts to make long‑lasting lifestyle changes.
Research on the results and general findings of the programme is
still on-going. Yet, initial analyses suggest that both the peer
supporters and peers for most part have benefitted from the program
and experienced positive outcomes.
The peer supporters have helped with social and practical
activities. They have, for example, helped with grocery shopping,
cooking, cleaning and finances. Furthermore, they have facilitated in
bridging their peers to the municipal welfare service and linking them
to the national healthcare system. Several peer supporters have lent
their advice and given moral support by participating as observers in
meetings between the peer and the municipality, or at doctors’
After participating, both groups are expected to have strengthened
their health literacy, enhance their diabetes self‑management, learn
about effective glycaemic control and therefore contribute to a
greater quality of life and wellbeing for at‑risk populations. Long
term, these successes contribute to reducing the problem that
Copenhagen is facing with social inequality and type-2 diabetes,
therefore reducing overall inequalities in health in the city.
Copenhagen University will evaluate the activities until 2022 and produce a final report.
On the basis of a successful result, the project will be scaled up and integrated into Copenhagen’s standard health offerings in order to reach more people and create positive outcomes for those most at risk of diabetes in the city. Continued strong collaboration with and among local city stakeholders will ensure continued commitment to create change.
1. Statistiche demografiche Roma 2018. http://demo.istat.it/pop2016/ index1.html. Accessed March, 2019.
2. Vaccaro K, Crialesi R, Nicolucci A, Corsaro L. (2017). Roma Cities Changing Diabetes.