They say it runs in the family: Diabetes and inheritance in Oaxaca, Mexico

The globalization of genetic discourses, especially where ethnicity is treated as a "risk factor" for disease, deserves special attention and concern. In countries such as Mexico, with large indigenous populations, the consequences of the Thrifty Genotype hypothesis and/or the attribution of type 2 diabetes to "family history" may be especially detrimental to poor rural communities, playing as they do into existing racial hierarchies. Based on semi-structured interviews with doctors and patients in a public clinic in a community near Oaxaca, Mexico, the study examines etiologies for type 2 diabetes. While notions of genetic inheritance and family history figure prominently in government and public health discourse, the "explanatory model" of patients places most emphasis on strong emotions, traumatic events, and dietary factors. Clinic doctors emphasize diet and lifestyle factors. The diffusion of "genetic risk" has had little impact on doctor-patient interactions in this community, but can be clearly seen in academic research, government policy, and medical specialties in the region, raising concerns about whether or not interventions will be directed at the social determinants of this growing health concern.