Translating Sweetness: Type 2 Diabetes, Race, Research, and Outreach

Through the lens of Type 2 diabetes this dissertation considers race and problems of difference and risk with developments in treatment, genomic science, and the conduct of research and research priorities. Based primarily on fieldwork in New York and California, I interrogate public health notions of outreach with biotechnology and clinical research concepts of biomedical translation as synonymous practices. Institutional relationships and marketing drivers, I argue, reflect relatedness back onto the Type 2 diabetes patient through causal narratives of risk and inevitability. In effect, kinship—genetic, familial, racial, ethnic, and environmental—becomes the driver of both risk and emergent forms of bioliterary discipline. I present a narrative of how diabetic risk became racialized over time and how African Americans became seen as a desirable research population. Arguing against biological race, I present an ethnographic example of how one such African American population, or community, emerged from particular social and political histories. Fieldwork uncovered lingering memories of the Tuskegee Experiment combined with cultural incompetency in both public health and biotechnology sectors. Further, I consider the bioethical challenges of African (American) participation in new genomic research aimed toward reducing health disparities. However, as a racial category, genetics researchers debate the precise genetic location and definition of "Africa" in the human genome. I suggest that the search for a pathological Africa in the human genome may deepen racial stigmatization as well as author new narratives of difference. I submit that social disparity, not biological disparity, presents the ultimate challenge to successful effective clinical translation and public health outreach.