254782 “You must not confuse poverty with laziness”: A case study on the power of discourse to reproduce diabetes inequalities

Tuesday, October 30, 2012 : 10:30 AM - 10:50 AM

Claudia Chaufan, MD, PhD , Institute for Health & Aging / Social & Behavioral Sciences, University of California, San Francisco, San Francisco, CA
Sophia Constantino , None currently, San Francisco, CA
Meagan Davis, BA , None currently, San Francisco, CA
The disproportionate impact of type 2 diabetes (T2DM) on poor persons and the social and biological processes linking poverty and T2DM inequalities are well documented. Moreover, millions of dollars are invested annually in programs aimed at reducing T2DM inequalities, yet these remain stubbornly high. Our paper explores how public discourses reproduce T2DM and related health inequalities in a low-income neighborhood in Northern California, through a thematic analysis of interviews and focus groups of staff and clients at a non-governmental organization. We probe participants' beliefs vis-à-vis the causes of, and solutions to, T2DM inequalities and explore whether and how the discourses normalizing them are challenged. We find that staff identify the ultimate source of T2DM inequalities within health sufferers, i.e., in their lifestyle choices, psychological makeup, or cultural preferences, even as they acknowledge the widespread poverty and multiple other social determinants that present serious barriers to their health. Notably, we find this normalizing discourse among clients themselves. While our study is empirical, its goal is primarily conceptual: to add to the evolving understanding of discourse as a social practice that may contribute both to status quo reproduction and to social change and resistance.

Learning Areas:
Public health or related public policy

Learning Objectives:
1. Explain how the social determinants of health shape patterns of distribution of type 2 diabetes in the US population 2. Identify how explanations for, and solutions to, high risk for diabetes individualize disease 3. Compare critical functionalist and behavioral theories of diabetes inequalities 4. Discuss how health practitioners can contribute to the visibility of the social determinants of health.

Keywords: Health Disparities, Minority Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the PI in this project. I have no conflicts of interest to disclose.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.