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On the borderline of diabetes: understanding how individuals resist and reframe diabetes risk
Health, Risk & Society ( IF 1.8 ) Pub Date : 2021-03-25 , DOI: 10.1080/13698575.2021.1897532
Kelly Howells 1, 2 , Peter Bower 1 , Patrick Burch 1 , Sarah Cotterill 3 , Caroline Sanders 1, 2
Affiliation  

Medical sociologists highlight diagnosis as a critical moment in understanding the illness experience and have extended analysis to the growing focus on ‘predisease states’ in relation to policy and medical practice. The biomedicalisation of diabetes risk, labelled as ‘prediabetes’, is one predisease area Public Health England have prioritised via the roll-out of a national diabetes prevention programme (NDPP). The label and language of prediabetes frames this risk as a medical condition and this could have both social and practical consequences for how individuals manage this risk. Through data drawn from individual interviews and observations, we explore how individuals respond to the label of prediabetes and how they interpret and respond to their ‘at-risk’ status. The findings demonstrate that for some participants, the framing of risk seemed consistent with a biomedical paradigm as reflected within clinical discussions and the language used. For others, previous knowledge or experiences were drawn upon to resist, downplay and reframe their at-risk status. Our analysis reflects varying degrees of resistance where for some this seemed to mitigate against the threat of ‘biographical disruption’ associated with the risks of developing future diabetes. In such cases, respondents also resisted the notion that they were ‘candidates’. However, in some cases, there was little resistance to the label of prediabetes, yet the perceived risk was ‘low’ in the context of competing health priorities or in relation to their expectations of health status in older age. Across participants, these varied responses were reflected in corresponding resistance to key messages promoting health behaviour change.



中文翻译:

在糖尿病的边缘:了解个人如何抵抗和重组糖尿病风险

医学社会学家强调诊断是理解疾病经验的关键时刻,并已将分析扩展到与政策和医学实践有关的“疾病状态”日益受到关注。糖尿病风险的生物医学标记为“糖尿病前期”,是英国公共卫生部通过实施国家糖尿病预防计划(NDPP)优先考虑的疾病之一。糖尿病前期的标签和语言将这种风险定义为一种医疗状况,这对于个人如何管理这种风险可能会产生社会和实际后果。通过从个人访谈和观察中获得的数据,我们探索了个人如何应对糖尿病前期的标签,以及他们如何解释和回应其“处于危险中”的状况。调查结果表明,对于某些参与者,临床讨论和所用语言反映出风险的框架似乎与生物医学范式相一致。对于其他人,则利用先前的知识或经验来抵制,轻描淡写和重新构架其处于危险状态。我们的分析反映了不同程度的抗药性,其中某些抗药性似乎可以缓解与患上未来糖尿病风险相关的“传记中断”的威胁。在这种情况下,受访者也拒绝说自己是“候选人”。然而,在某些情况下,对前驱糖尿病标签的抵抗力很小,但是在健康优先事项相互竞争的背景下或与他们对老年健康状况的期望相比,感知到的风险是“低”的。在所有参与者中,

更新日期:2021-04-20
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