Comparing Patient Perspectives on Diabetes Management to the Deficit-Based Literature in an Ethnic Minority Population: A Mixed-Methods Study

Marginalized racial/ethnic minorities have disproportionately high rates of type 2 diabetes prevalence, complications and mortality. Researchers and policymakers have typically addressed these disparities using a deficit-based discourse focused on individual/cultural deficiencies or failure. A mixed-methods study was used to compare the deficit discourse to the perspectives of adults with diabetes in the Arab minority in Israel, using data from 10 focus groups (5 men’s, 5 women’s) and 296 quantitative in-person surveys. Both qualitative and quantitative data were triangulated. In addition, multivariable regression models tested associations between diabetes management perspectives and participant characteristics. Contrary to the deficit-based characterizations of patients as fatalistic and unknowledgeable, participants viewed diabetes as a chronic disease with serious complications. They expressed more support for patient responsibility in diabetes management than for passive fatalism, and were less fatalistic as educational level and adequacy of diabetes self-care training increased. The impact of social/environmental barriers and changing cultural norms on lifestyle behaviors was highlighted. Over 95% used prescription medications for diabetes management, although 35% reported economic barriers. The deficit discourse is not well-aligned with Arab patients’ evolving perceptions and needs, and has deflected attention from the socioeconomic/structural determinants of health, and the healthcare system’s responsibility to provide effective, culturally-relevant diabetes services

Creative Responses to Separation: Israeli and Palestinian Joint Activism in Bil\u27in

This article examines creative ways in which Israeli and Palestinian activists engage with each other and the powers seeking to separate them in their nonviolent struggles for a just and lasting peace. Using the geopolitical theory of territoriality, the article briefly examines a number of administrative, physical, and psychological barriers facing joint activism and the strategies activists use to counteract them. Drawing on nonviolent theory and practice, the article analyzes how activists exert power through the creative use of symbols and practices that undermine the legitimacy of occupation policies. Based on fieldwork conducted in 2004-05 and July 2006, the article explores the implications of this activism on conceptions of identity, and strategies for restarting a moribund peace process. The relative \u27success\u27 of sustained joint action in Bil\u27in can provide scholars and policymakers with innovative approaches for addressing some of the outstanding issues needing to be addressed by official negotiators. Although government bodies are more constrained than activists, the imaginative means of engaging with the system- and the reframing of issues through the redeployment of \u27commonplaces\u27-can perhaps provide inspiration, if not leverage, for thinking outside of the box