Stephanie Stegman (Author)
Green, Monica H. (Advisor)
As early as 1940, physicians identified the American Southwest as an ideal place to study the natural history of diabetes. In the post World War II decades, the number of people diagnosed with diabetes began to escalate nationwide. Community-based studies conducted in the region generated new scientific data and posed new questions about the causes of the disease and how it is distributed among different populations. These epidemiological questions became the subject of biomedical inquiry and, in turn, the rationale for new public policies to control diabetes and its financial cost. As some of the first longitudinal studies of their kind, diabetes research in the region fundamentally altered the way scientists, clinicians, and policy makers conceived of the disease in the post-insulin era. These studies contributed to new standards of diagnosis, treatment, and education of diabetes both inside and outside the American Southwest. For more than fifty years, communities in the region have been active participants in the search for greater understanding and improved treatment of diabetes. The local community became not only the site for inquiry but also for intervention. Through the archival record, medical journals, and oral histories, I examine how scientists, policy makers, and community leaders gave meaning to the prevalence of diabetes in the region. While the knowledge amassed by researchers established a complex web of causation that entangled culture, environment, genetics, and race under a single umbrella of "risk," others sought ways to translate theory into practical application. Diabetes-related research and public policy in the region exposed historic disparities in health even as they contributed to new knowledge of the disease and of how best to control it.
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