'When checked sugar was there': Lay epidemiology and the prevention paradox in Kerala, south India
Cultural systems of accountability are often mobilised to explain general patterns of ill-health and the onset of sickness in individuals. Building on the concept of lay epidemiology, this presentation examines how the general public, health care professionals and people living with 'sugar' make sense of high levels of chronic morbidity in Kerala, south India. Once considered a mild disorder of the elderly, adult onset diabetes has become a leading cause of premature morbidity, disability, and mortality affecting many young and middle aged adults. In Kerala, glucose intolerance currently affects one in five adults, precipitating high awareness and concern about this potentially debilitating life-long condition. This paper examines the ways in which people assimilate and reflect upon the causes and social distribution of 'sugar', based on personal observations of illness cases, clinical encounters, the media and other sources of health related knowledge and experience. It compares public narratives of social and environmental transformation leading to perceptions of declining health status and high levels of chronic morbidity, and the ways in which individuals account for their own misfortune. In contrast to perspectives from public health which emphasise prevention, individual responsibility for health and control, people in Kerala manage uncertainty through diagnostic tests and initiate behavioural change in response to abnormal test results.
Speaker
Caroline Wilson, MRC-ESRC Post-Doctoral Fellow School of Social and Community Medicine University of Bristol
