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.