One and Done:Why Inclusion Isn't A Cycle
This article reviews the initial step in the cycle of inclusion and provides two clear ways we can increase access to diabetes care.
Understanding the basic needs of inclusion begins with the felt sense of belonging. What can you do to help clients feel like they belong? When I asked this question, I looked around my office to see what messages were being communicated. There are a lot of diplomas, some handouts, and a few food-related pictures.
As a weight-inclusive professional, there aren’t any fatphobic signs or images, such as BMI charts, weight loss flyers, or before and after images. There also wasn’t any art or images that represented higher-weight bodies, bodies of color, or anyone who is queer or gender non-binary.
While my office isn’t offending, it didn’t evoke a feeling of inclusion.
What helps a client feel that they belong? The most obvious answer is to ensure that there are chairs and equipment that fit them. Information, resources, and handouts include options that would meet their needs, ranging from modified activity to lower-cost options, larger print handouts, and audio recordings. However, inclusion is more than being prepared. It is our desire to meet the many needs of our clients.
After seeing my office with fresh eyes, I made some changes, including hanging a colorful quilt made from West African fabrics, a small picture with a quote painted by a Black artist, and small symbols of inclusion, including a nameplate with my personal pronouns listed. These steps shifted the space's vibe, creating a welcoming sense, but it wasn’t enough for me to be called ‘inclusive.’
The next level of inclusion is trying to imagine what my clients face after leaving the office. For example, am I referring to other weight-inclusive or at least weight-neutral professionals? If that can’t happen (because weight-inclusive professionals like yourself aren’t the norm), can I take a few minutes to explain that I don’t know if the professional practices inclusive care? This space of empathy for myself is a game-changer. Like you, I am busy at work, and while I ‘want’ to help everyone, I realized it just wasn’t possible. This caused me to ponder what I could actually do.
My deep dive into inclusion is summarized as a five-step process. I would like to share how the first two steps are connected and can be seen as a cycle. The initial step is belonging, quickly followed by the need for ease. Understanding that these two experiences are connected because not having ease is a weathering experience connected to poor health because it accelerates aging due to chronic psychological stress.1
Without a sense of belonging, clients are reluctant to ask for help and thus address problems, concerns, and challenges alone, reinforcing the sense that they don’t belong. Having a decreased sense of ease reduces a person’s mental bandwidth to manage the daily choices of life. We are all making tons of decisions, and one estimate is we are engaging in 35,000 decisions each day. Someone with diabetes has an additional 180-300 choices. While that might not seem like a massive increase, by comparison, this equals 7-12 decisions per hour, or every 2-7 minutes, a choice is made to manage a PWD overall diabetes care.
The IDC has created the basic needs of inclusion pyramid to visualize the concept of inclusion. Yet, this model isn’t accurate because it is depicted as a hierarchy. Inclusion is a cycle where meeting one need allows you to meet another. To visualize this, the pyramid has been changed into a cycle.
At Inclusive Diabetes Care, we want to come together and understand ways to provide inclusive diabetes care. We are a membership program that offers professional training and dialog to address the social determinants of health and improve access to diabetes services. Learn more by visiting InclusiveDiabetesCare.com.
Galkin F, Kochetov K, Koldasbayeva D, Faria M, Fung HH, Chen AX, Zhavoronkov A. Psychological factors substantially contribute to biological aging: evidence from the aging rate in Chinese older adults. Aging (Albany NY). 2022 Sep 27; 14:7206-7222 . https://doi.org/10.18632/aging.204264