James Doucet-Battle, Ph.D.
Sweetness in the Blood: Race, Risk and Type 2 Diabetes challenges the increased focus on racial biomarkers in targeting Black people in diabetes education, as well as research participants. James Doucet-Battle looks at how the “diabetes industrial complex” tends to oversimplify the complex and layered intersections of race, culture, socioeconomic backgrounds, history and access to power in determining community groups for recruitment, outreach and education strategies.
It’s an important lens for public health leaders, community health educators, researchers and healthcare workers to view the problem of hyper-focus on race as the primary determinant of diabetes risk. Doucet-Battle investigates the evolution of the disease -- and its management -- from biomedical, social scientific and medical humanities fields, including the history of the African diaspora and globalization of sugar production. The growing diversity of the Black community -- which includes the U.S.-born, immigrant and refugee population -- pose a complex view of race and genetics. He presents research that points to how genes that govern metabolism are matrilineal, suggesting that gender -- not race -- may be a more effective predictor of risk for developing the disease.
The researcher describes his fieldwork among diabetes educators, community health workers and leaders of a Black church. He notes the lack of cultural competence among diabetes educators, who may have knowledge about local treatments and remedies that are widely used by diverse Black communities. He advocates for the recruitment and training of healthcare workers who understand how to navigate cultural particularities in diverse Black diasporic communities. In sharing his analysis of the role of the Black church as a recruitment venue for diabetes research participants, the author names the problematic unequal power dynamics that may be present in these activities. He lays bare the apprehension among youth and young adults in the Black church about participating in biomedical research, noting the social dynamics of developing and maintaining trust.
There are practice and policy implications for addressing health disparities in diabetes risk management. The focus on race commingles with capitalistic forces that require the biogenetic industry to develop a consistent stream of consumers and patients. It’s a potent observation, especially amid increased awareness about the business of healthcare. After all, who benefits the most from more pre-diabetics and diabetics, consumers of products to monitor their blood sugar and to manage chronic illness?
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