Sweet blood and social suffering: Rethinking cause-effect relationships in diabetes, distress, and duress

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Abstract
I draw upon anthropological engagements with bioscience and embodiment in order to unpack current approaches to defining and preventing diabetes mellitus. The analysis stems from the conviction that carefully considering the symbolic frames through which we conceive of diseases, their origins, their distribution, and their consequences will assist us in planning and implementing interventions to improve population health. I argue that research and interventions focused on the sweetness of blood would benefit from rethinking intersections between diabetes, distress, and duress. In many instances, the lived experience of diabetes is consonant with an understanding of distress (i.e., "social suffering") that expands conventional understandings of population health problems. Diabetes incidence is rising worldwide, but it is rising especially rapidly in Aboriginal and other disadvantaged populations. Notably, diabetes is now three to five times more common in Canada's First Nations population than it is in its non-Aboriginal population. Yet as recently as 50 years ago, diabetes and associated health problems were rare in these groups. To come to grips with such transformations and disparities is to advance the population health research agenda.