Native Americans and Type 2 Diabetes: The Discourse of Predisposition and its Politics.

摘要

This research examines the discourse between geneticists, clinicians and their patients to elucidate the linkage of Type II diabetes in American Indian populations and larger social processes such as genetics, race, colonialism, and global capitalism. The goal of this work is to understand the mechanisms that perpetuate the hegemony of scientific knowledge as it constructs the diabetic body as belonging to a specific category of "otherness." As a result this work will contribute to a better understanding of how diabetes has become the newest epidemic in Native communities and constitutes contemporary racialized and politicized domains for the exercise of power. Using historical and ethnographic methods, this research examines the construction, distribution and use of knowledge about Type II diabetes. The main objective is to enhance understanding the influence of racial/ethnic discrimination in health care delivery and its association with disparities in disease incidence, treatment and outcomes among American Indians. This objective will be achieved by examining current understandings of predisposition for diabetes. When usual interpretations of causality fail to explain a disease, biomedicine often relies on such concepts of predisposition. Yet, such interpretations fail to give meaning of such an affliction to the sufferer (Finkler 1994:14). Type II diabetes needs to be situated within the historical context from which it arose and contextualized with current understandings of predisposition as they are used in the categorization and determination of diabetes treatment. This project follows the work of anthropologists who examine the political economy of health and argue that poverty and stress directly impact health, a factor that while acknowledged is often obscured in the biological emphasis in medical discourse.