Opposing Discourses Surrounding Type 2 Diabetes in Eastern Appalachian Kentucky
Lindsay J Della1, Mary Z Ashlock, Kimberly R Hartson
1Department of Communication, University of Louisville, Louisville, Kentucky (Drs Della and Ashlock); School of Nursing, University of Louisville, Louisville, Kentucky (Dr Hartson); Department of Health and Sport Sciences and School of Medicine, Division of Pediatric Endocrinology, Wendy Novak Diabetes Center, University of Louisville, Louisville, Kentucky (Dr King); and College of Health and Human Services, Western Kentucky University, Bowling Green, Kentucky (Dr Basta).
Abstract:
Type 2 diabetes disproportionately affects individuals in Appalachia. This study investigated discourse among friends and family with different diabetes risk levels in Central Appalachia. Eighteen semistructured, in-depth interviews were conducted with Appalachian Kentuckians. Thematic analysis revealed 2 dialectic tensions centered on disease management (health as a personal problem vs diabetes management requiring social support) and disclosure (openness vs closedness). Health professionals should consider the powerful influence of speech with respect to family relations and support, along with the need to communicate early, clearly, and often in a manner that emphasizes family, friends, and connectedness.
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