“…As Soon as She Stepped off the Plane”: Understanding and Managing Migration, Chronic Illness, and Poverty in Albuquerque, New Mexico

Abstract

This paper addresses immigration and diabetes treatment management through exploration of the experience of a Cuban immigrant household’s negotiations with providers and clinics around a grandmother’s type 2 diabetes treatment. (Mis)understandings and (mis)communications around blood draws, dietary modifications, and medicines illustrate the differences between provider and family perceptions of “compliance.” Specifically, this ethnographic study of family centered chronic disease management illustrates that, in the context of resettlement in an unwelcoming environment, language barriers, lack of clinical coordination, and differential meanings combine to decrease effective management and to increase stress levels within the family about management. In addition, this study illustrates the embedded nature of illness and its management in the broader circumstances of individual’s lives, with factors such as work schedules, children’s needs, responsibilities to family left in the home country, and neighborhood environment competing for the time and attention required by the treatment regimen. Competing priorities of the clinic, problems with communication across clinics and providers, and complicated home lives contribute to struggles to “control” sugar.

keywords:

• Diabetes
• Family
• Migration
• Poverty