Social Constructions of Stigmatizing Discourse Around Type 2 Diabetes Diagnoses in Appalachian Kentucky

Type 2 diabetes is a growing problem among Appalachian Kentucky residents. Several issues contribute to diabetes disparities in the region, including lack of access to health care and geographic isolation. Previous studies also indicate that social stigma may be associated with type 2 diabetes. We used 28 semistructured interviews to explore how stigma is socially constructed across health status (diagnosed/undiagnosed). Perceived severity of the disease is high, yet the etiology of diabetes is not well understood. Thus, onset is perceived to occur "out of the blue," and a positive diagnosis is perceived as having life-threatening consequences. Diagnosed participants, who had learned more about the disease's etiology, prevention, and management, expressed intrapersonal stigma. In interpersonal situations, the visible indicators of a diabetes diagnosis (i.e., physical weight, insulin injection), rather than diagnosis status, tended to evoke stigmatizing interactions. These findings form the foundation for our recommendations for prevention messages in the region.