Rethinking Diabetes

In Rethinking Diabetes, Emily Mendenhall investigates how global and local factors transform how diabetes is perceived, experienced, and embodied from place to place. Mendenhall argues that the link between sugar and diabetes overshadows the ways in which underlying biological processes linking hunger, oppression, trauma, unbridled stress, and chronic mental distress produce diabetes. The life history narratives in the book show how deeply embedded these factors are in the ways diabetes is experienced and (re)produced among poor communities around the world.

Rethinking Diabetes focuses on the stories of women living with diabetes near or below the poverty line in urban settings in the United States, India, South Africa, and Kenya. Mendenhall shows how women's experiences of living with diabetes cannot be dissociated from their social responsibilities of caregiving, demanding family roles, expectations, and gendered experiences of violence that often displace their ability to care for themselves first. These case studies reveal the ways in which a global story of diabetes overlooks the unique social, political, and cultural factors that produce syndemic diabetes differently across contexts.

From the case studies, Rethinking Diabetes clearly provides some important parallels for scholars to consider: significant social and economic inequalities, health systems that are a mix of public and private (with substandard provisions for low-income patients), and rising diabetes incidence and prevalence. At the same time, Mendenhall asks us to unpack how social, cultural, and epidemiological factors shape people's experiences and why we need to take these differences seriously when we think about what drives diabetes and how it affects the lives of the poor.

Emily Mendenhall is a Professor of Global Health at the Edmund A. Walsh School of Foreign Service at Georgetown University.

Rethinking Diabetes is an outstanding example of current medical anthropological theory, and one with important messages for other many fields—including global health and human biology. It is also highly readable, bringing the reader into the world it explores.

Rethinking Diabetes is an astonishing achievement for both its breadth and depth in mapping lived experiences around diabetes and other conditions. The breadth is provided by data collection over four locations, while teasing out the differences between those. The depths are in providing understanding of how diabetes is both a contributor to and effect of trauma, poverty, and other health conditions. The use of narratives within each chapter makes for compelling reading of a text that is accessible and relatable.

An erudite work of original and seminal scholarship, Rethinking Diabetes is an extraordinary study that is especially and unreservedly recommended.

Peter J. Brown, Emory University, and author of Foundations of Global Health:

Emily Mendenhall's insightful and innovative analysis of the growing global pandemic of diabetes using syndemic theory is an important contribution to medical anthropology and global health. The comparative cross-cultural case studies are persuasive and powerful.

Janet McGrath, Case Western Reserve University:

Emily Mendenhall critically explores how global health is confronting the rising prevalence of diabetes in the face of poverty, crippled health care systems, and HIV/AIDS. Her approach transcends epidemiological associations and paves the way for consideration of similar entanglements of disease, poverty, and local experience.

Lenore Manderson, The University of the Witwatersrand, and author of Surface Tensions:

Emily Mendenhall's rich case studies—introducing each chapter in Rethinking Diabetes—offer forceful illustrations of the interplay of social and biological worlds.