“Because being fat means being sick”: children at risk of type 2 diabetes

This study addresses the social and cultural underpinnings that shape children’s risk of type 2 diabetes, as identified by a racially and economically diverse group of parents and their children living in Anaheim, California. Based on in-depth interviews with 28 adults and 17 children, we explored how they understood what constitutes “good health” in children and the aspects of their neighborhoods and communities that acted as resources or impediments to their children’s well-being. We found that parents and children employed a language of food that reflected a fear-based, medicalized orientation to food consumption. Although nearly all agreed that children should stay active, densely populated neighborhoods, apartment complexes with rigid outdoor rules, high crime rates, police surveillance, and diminished access to public parks and recreational facilities posed challenges. Similarly problematic were deficits in school lunch programs and the limited sometimes demeaning, conversations with healthcare professionals about diabetes risk and prevention. Together, these narratives identify key structural processes attendant to type 2 diabetes risk in children and call for a more politicized conversation regarding prevention strategies and public healthcare practices.