What drives distress? Rethinking the roles of emotion and diagnosis among people with diabetes in Nairobi, Kenya.

Journal: Anthropology & medicine

Volume: 27

Issue: 3

Year of Publication: 2021

Affiliated Institutions:  School of Foreign Service, Georgetown University, Washington, DC, USA. Africa Mental Health Foundation, Nairobi, Kenya. Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Abstract summary 

Type 2 diabetes mellitus is a condition that both results from and produces social and psychological suffering. As 'diabetes' increases among low income patients in poorer nations, new challenges arise that drive, co-occur, and result from the condition. In this article, we describe how social suffering produces diabetes by way of addressing the varied social, psychological, and biological factors that drive diabetes and are reflected in diabetes experiences among patients seeking care at a public hospital in Nairobi, Kenya. We recruited a non-probability sample to participate in a cross-sectional study of 100 patients (aged 35-65 years), where half of the participants sought care from a diabetes clinic and half sought care from the primary healthcare clinic. We obtained informed consent in writing, and collected life history narratives, surveys, anthropometrics, and biomarkers. This paper evaluates survey data using frequencies and regression tables. We found that social factors as opposed to disease factors were major drivers of psychological distress among those with and without diabetes. Psychological distress was associated with female gender and feelings of financial and personal insecurity. We also found insulin resistance was common among those undiagnosed with diabetes, suggesting that many seeking primary care for other health conditions did not receive a routine diabetes test (most likely because it is an out-of-pocket cost, or other competing social factors) and therefore delayed their diagnosis and care. Thus, social and economic factors may drive not only emotional distress among people with diabetes but also delayed care seeking, testing, and self-care as a result of cost and other social challenges.

Authors & Co-authors:  Mendenhall Musau Bosire Mutiso Ndetei Rock

Study Outcome 

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Statistics
Citations : 
Authors :  6
Identifiers
Doi : 10.1080/13648470.2019.1650243
SSN : 1469-2910
Study Population
Female
Mesh Terms
Adult
Other Terms
Kenya;Type 2 diabetes;hemoglobin A1c;mental illness;poverty;social distress
Study Design
Study Approach
Country of Study
Kenya
Publication Country
England