Assignment: EDMS/Scanning

Moreover, the findings of an Institute of Medicine report, (2002) identify the complicity of “policies and practices of health care systems…[with]…racial bias, discrimination, stereotyping and clinical uncertainty” (Smedley 2012, p. 993) as core factors in the creation and maintenance of disease and disparity. The etiology of diabetes, then, involves the complex intersection of multiple risk factors, some of which are not traditionally the focus of public health research. This reality has implications for prevention and treatment. Since the cause of diabetes is multidimensional, preventing it or treating it from a purely biomedical perspective is rarely effective; but without a comprehension of the relationship between health and broader social forces that produce disparity, efforts to improve health are not likely to result in meaningful change. Despite research regarding broader factors involved in disease and disparity, the public health model for diabetes prevention and treatment has tended to continue to focus on getting individuals to change their behavior in terms of diet and levels of physical activity (Diabetes Prevention Program Research Group 2002) or to be “compliant” with prescribed actions and medications for diabetes maintenance (Bahati, Guy, and Gwadry-Sridhar 2012). Expanding the focus to include more expansive factors like historical and structural racism, changing relationships in the international economy that affect employment, housing policy that defines