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87 CHAPTER FOUR Latina/o Local Knowledge about Diabetes: EmotionalTriggers, PlantTreatments, and Food Symbolism —Michael Owen Jones Sitting on a well-worn sofa in the living room of her small apartment in Venice , California, the walls adorned with family photos and religious images, Silvia Herrera lists her relatives with diabetes.1 They include her mother, an aunt,a nephew,and one brother—all of whom died of complications from the disease—along with another brother, two sisters, a grandson, and a six-yearold niece who are still living. Mrs. Herrera, an émigré from Guadalajara, has diabetes as well. The disorder has also beset Jorge Alvarez and his wife Rosa Alvarez,both from Jalisco,Mexico,who have had diabetes for thirty years and twenty years, respectively. Mr. Alvarez’s father and grandfather suffered from diabetes, as did Mrs. Alvarez’s father, two of her father’s brothers, and two of her older sisters as well as her younger sister (who died at age sixty-five from the disease). None of Mr. and Mrs.Alvarez’s three daughters has diabetes, but two of their four sons were diagnosed with the disease ten and eight years previously at ages thirty-nine and forty-two. A similar situation obtains for many other immigrants and Mexican Americans I have interviewed; they or a spouse or other family members have diabetes. Several have died from it. Statistics released by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for 2005, when I began my interviews, indicate that 23.9 percent of Latina/os aged forty-five to seventy-four are afflicted with diabetes compared to 12 percent of non-Hispanic whites. According to the NIDDK, 20.8 million people in the United States, or 7 percent of the population aged twenty or older, have this metabolic disorder, which is twice the proportion in 1993. Millions more have pre-diabetes consisting of impaired Michael Owen Jones 88 fasting glucose and impaired glucose tolerance. Diabetes is now the seventh leading cause of death inAmerica.2 The prevalence rate of adult-onset diabetes among African Americans, Latina/os, American Indians, and Native Hawaiians is two to three times that of non-Hispanic whites. These ethnic populations experience much higher rates of complications too, such as blindness, amputations, strokes, and heart disease, and twice as many as whites die from diabetes. Latina/os have a sixfold greater incidence of end-stage renal disease than do non-Hispanic whites, and they are much more likely to require insulin treatments, which many of them fear. In this chapter, I discuss several areas of Latina/o local knowledge about diabetes.3 First, I consider explanatory models regarding causes and the course of illness or disease, especially the role of emotional precipitants and aggravators of their condition. Second, I discuss the use of plants from cactus salad to horsetail tea and others in between in order to lower blood glucose levels, which seems to be effective. The third is awareness of non-nutritional meanings and uses of food—rituals, symbols, and sources of identity—that dieticians seem to seldom take into account but which render modifications in diet difficult. The fourth is self-reported“barriers”to maintaining a recommended dietary regimen, which go beyond several mentioned in the literature that tend to blame and stigmatize the patient. The fifth is perceptions of the social and psychological dimensions of illness that all too rarely are considered by medical personnel when treating diabetes among Latina/os. My point is that systems of local knowledge regarding illness and healing , revealed through folkloristic ethnography, may be a source of insight for health education initiatives, the training of healthcare professionals, and developing and assessing intervention programs. In regard to the concept “local knowledge,” I am following Vandebroek et al. (2011:1), who write that “Local Knowledge Systems (LKS) consist of the knowledge,beliefs,traditions, practices, institutions, and worldviews developed and sustained by indigenous and local communities, and [that] are believed to represent an adaptive strategy to the environment in which the communities live.” Employing ethnography that involves in-depth interviews, observation, and other techniques to obtain qualitative data is particularly useful for discovering local knowledge and people’s experiences such as reported here. 1. Causation and Exacerbation:The Role of Emotions and Stress With no prompting other than my statement that I wanted to talk about diabetes , most of the twenty-eight individuals I interviewed in the Los Angeles Latina/o Local...


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