Reading the "Let's Beat Diabetes" Campaign Amidst Poverty in Singapore: A Culture-Centered Interrogation

Critical scholarship documents how health communication campaigns reinforce inequalities by promoting individualized behavior change while erasing structural contexts. Drawing on the culture-centered approach (CCA), this study inverts dominant campaign logic by examining how households negotiating poverty in Singapore interpret and respond to the state-led "Let's Beat Diabetes" campaign. Through in-depth interviews with 39 low-income residents, we document how marginalized voices render visible the gaps, erasures, and structural barriers embedded in technocratic campaign design. Findings reveal two key dynamics. First, structural conditions-illiteracy, food insecurity, healthcare costs, and digital divides-determine who can access and interpret campaign messaging, creating systematic exclusion despite campaign claims of universal reach. Participants identify contradictions between campaign advice (eat healthy food) and structural realities (food charity systems delivering predominantly unhealthy processed foods). Second, communicative infrastructure gaps manifest in lack of campaign awareness, perceived irrelevance of messages, inaccessibility of digital platforms, and absence of structural solutions in campaign content. The technocratic rationality celebrated as efficient systematically misses those most affected by diabetes risk. This study makes three contributions to CCA. Methodologically, it demonstrates how marginalized communities can interrogate hegemonic campaigns, inverting traditional formative/evaluative research. Substantively, it documents how communicative infrastructure itself becomes a structural barrier in technocratic governance. Theoretically, it extends CCA by foregrounding communicative inequality as a dimension of structural violence. Ultimately, voices from the margins teach that addressing diabetes among the poor requires confronting the structural conditions that produce health inequalities, not nudging individuals to make better choices.