Review Timeline | CrossMark Policy | ClinMed Features
logo
International Archives of
Public Health and Community Medicine ISSN: 2643-4512

Citation

Linder SH, Anna-Maria V, Wisniewski T, Hesseldal L, Napier AD (2018) Understanding Social and Cultural Factors Associated with Composite Vulnerability to Better Inform Community Intervention Strategies: Cities Changing Diabetes in Houston. Int Arch Public Health Community Med 2:016 doi.org/10.23937/iaphcm-2017/1710016

Copyright

© 2018 Linder SH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

RESEARCH ARTICLE | OPEN ACCESS DOI: 10.23937/iaphcm-2017/1710016

Understanding Social and Cultural Factors Associated with Composite Vulnerability to Better Inform Community Intervention Strategies: Cities Changing Diabetes in Houston

Stephen H Linder1*, Anna-Maria Volkmann2, Tami Wisniewski3, Louise Hesseldal4 and A David Napier5

1Institute for Health Policy, The University of Texas Health Science Center, Houston School of Public Health, USA

2Clinical, Educational and Health Psychology, University College London, London, UK

3Formerly with Novo Nordisk, Inc., Princeton, NJ, USA

4Research and Evidence, Cities Changing Diabetes, Novo Nordisk A/S, Bagsværd, Denmark

5Science, Medicine, and Society Network, University College London, London, UK

Abstract

We describe a novel procedure for estimating population-level vulnerability to type 2 diabetes and then demonstrate how differences in social and cultural factors among vulnerable sub-groups translate into design considerations for prevention-oriented community interventions. Our study adopted a mixed method approach combining a quantitative evaluation of population data with a qualitative vulnerability assessment that centered around in-depth interviews. Harris County, Texas serves as the setting. Four distinct sub-groups were identified within neighborhoods considered vulnerable to diabetes, based on clinical predictors of diabetes and on economic disadvantage. Differences among these groups were then characterized by their prominent social and cultural factors. Understanding these differences offers a critical refinement important for designing effective local policies and targeted community interventions to prevent type 2 diabetes. This paper emphasizes the qualitative analysis and its implications.