Finding Meaning Through Illness Narratives: Latino Perceptions of Diabetes in a Post-Industrial American City
Glaser, Kathryn Marie
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Many chronic diseases, including diabetes, are more prevalent among the poor and disadvantaged. Racial and ethnic minorities are also disproportionately affected by diabetes and are at higher risk of developing complications compared to the general population. Given the high prevalence of diabetes among Latinos, it is important to understand the experience of these individuals living with this chronic illness to uncover barriers to managing self-care. This project explored common explanations (explanatory models) for diabetes and the socio-cultural factors and resources (social capital) associated with diabetes self-care to identify barriers and facilitators to management of chronic illness. Through illness narratives, questionnaires, and qualitative and quantitative methods of analysis, it was possible to understand the issues facing Latinos who live with diabetes. These issues include social, economic, cultural and political factors contributing to health. This research entailed an ethnographic study of Latinos living with diabetes receiving health care services in an urban community health center in Buffalo, New York. The study included qualitative interviews and demographic surveys of thirty individuals (18 years and older) of self-reported Latino/Hispanic origin. Interviews and surveys were conducted in English and Spanish, (depending on the preference of the participant) between June 2013 and January 2014 at the community health center. Participants were asked about their experiences with diabetes, cause/etiology, timing, symptoms, involvement with their health care provider, course, and treatments. Interviews were analyzed using qualitative methods to uncover explanatory models and themes related to the research questions. Analysis of the interviews revealed that those with more support from family, community, or friends had better health outcomes. In this study, differences in self-management were observed between those with ample resources compared to those with fewer resources. Variables such as age, gender, and marital/living status were also indicators of better self-management of diabetes. Some of the relationships that emerged from this study were expected while others raise many more questions. Recommendations that emerged from this research included education programs and early interventions, enhancement of social networks, and potential policy change around food programs. Additional recommendations included enhancement of community diabetes screening programs, early detection, and strategic interventions targeted at reducing the burden of diabetes and complications of uncontrolled diabetes.