Cultural negotiations in health and illness: the experience of type 2 diabetes among Gujarati-speaking South Asians in England

Abstract

Diabetes has become a global health problem, with both physical and psychosocial effects on people’s lives. The South Asian communities in the UK have been identified as high-risk groups, with high rates of type 2, non-insulin-dependent diabetes (NIDDM). This paper reports on an exploration, based on qualitative methods, of South Asian Hindu Gujaratispeaking people’s experiences of type 2 diabetes. Participants were recruited through purposive and snowball sampling, and a grounded theory framework that while health science discourse in a variety of forms has constructed a type of South Asian diabetic risk, alluding to a particular relationship between health and ethnicity, the participants in the present study expressed active resistance to this construction, through their accounts of diabetes management. By exploring the biographical, historical and socially embedded contexts of diabetes, the participants constituted culture and ethnicity as dynamic entities, contingent on social and personal contexts.There were four major themes in the study, namely notions of familiarity with the illness through family and social connections, the management of physical exercise and activity, the personal and social moderation of food and nutrition, and the use of complementary remedies. This paper argues that it is these active and dynamic constructions of cultural and ethnic identity which health science discourse needs to acknowledge in order to understand how people manage their diabetes, and where help and support might best be channelled.