“put people with diabetes in harm’s way by interfering with evidence-based diabetes care, ultimately increasing the risk of rapid onset of complications…The determinants of poor diabetic management uncovered in this research are inseparable from the structural violence exhibited in colonial history resulting in persistent disempowerment, poverty, stress and marginalization of First Nations communities and their health.” (p. 13)
Using a structural violence framework to understand health disparities in Albuquerque, New Mexico, we explore how structural forces and institutionalized inequality similarly create the social, emotional, and physical condition that invite and sustain diabetes in a Hispanic immigrant community. METHODS Research for this article was conducted by investigators from the University of New Mexico (UNM) in collaboration with community partners at East Central Ministries (ECM), a faith-based and social justice-oriented nonprofit organization in Albuquerque that primarily serves Hispanic immigrants. The issue of diabetes was identified as a health priority by members of the community who requested assistance in understanding and addressing diabetes as a threat to the health of their families, and study design reflected a community-engaged approach. The analysis presented here uses data gathered through key community member interviews and focus groups, contextualized by geocoding and data mapping of secondary data sets. The larger study, discussed elsewhere (Mishra et al, 2012; Page-Reeves et al, n.d.) also included a survey and blood analysis based assessment of diabetic status with 100 people. Study Setting and Population The site for this research was the International District (ID) in southeast Albuquerque, home to a significant Hispanic immigrant population. Located a few miles from the University of New Mexico, the ID is the one of the most diverse neighborhoods in the state, has a large Hispanic population (Childress, 2009), and is the most densely populated sector of the city (U.S. Census Bureau, 2010). Although the cultural diversity of the neighborhood has recently been recognized by some as an asset, the ID is also an area of the city with a reputation for its high levels of poverty (U.S. Census Bureau, 2010), transience (U.S. Census Bureau, 2010), and low educational attainment (U.S. Census Bureau, 2010). In addition, residence in the ID is associated with high levels of diabetes-related hospitalizations and mortality, and childhood obesity. Our preliminary research with ECM in the neighborhood (Mishra et al, 2012) found that
