Type 2 diabetes: It’s time for a justice-based model of prevention: Insights from ethnography

Dr. Laura Montesi

Oaxaca: World Diabetes Day. Medical staff shows the quantity of sugar present in pre-packaged foods, popularly known as comida chatarra (junk food)

In May 2019, an interdisciplinary conference that explores the history, cultures and sociopolitical configurations of the Americas will take place in Perugia, Italy. Drawing on my ongoing ethnography of diabetes in Mexico, particularly among rural, indigenous communities, I will participate with a conference paper entitled “Type 2 diabetes: It’s time for a justice-based model of prevention: Insights from ethnography”.

Southern Oaxaca: Women rinsing corn kernels before going to the mill to prepare corn dough for tortillas

With almost 15% of adults with diabetes and being fifth in the world for number of people with diabetes (IDF 2017), Mexico has put in place several public health strategies to tackle this epidemic. However, the results of these initiatives have been far from satisfactory. An increasing number of people (at increasingly lower ages) are experiencing life with diabetes and its complications. Most of the clinical and public health actions focus on promoting “healthy” lifestyles, endorsing a behavioural model of disease. Even though individual and collective behaviours do play a role in diabetes causation and management, recent research is showing a more complex picture, where toxicity, chronic stress, and inadequate early life nutrition appear to play important roles.

My presentation interweaves ethnographic and scientific findings in an effort to show the realities of lived experience with diabetes as well as their wider environmental contexts. By reporting on how indigenous people in southern Mexico make sense of diabetes, I will offer vivid insights into the materiality and semantics of this illness while establishing a dialogue between lay and scientific understandings. Anthropological research into the everyday lives of people with diabetes and communities affected by the disease can shed light on the complex environmental synergies that contribute to sustained high blood glucose. Most importantly, it also reveals how social disparities affect minority and subaltern groups disproportionately. These findings call for a justice-based model of diabetes prevention.

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