An inter-generational approach to understanding the experiences of Diabetes amongst UK Pakistanis : individual, family and health provider perspectives

Type Two Diabetes is six times higher amongst UK Pakistanis than the remainder of the British population. This thesis examines the impact of cultural influences on diabetic health within three different generation groups of UK Pakistanis, through three qualitative studies on: I) Intergenerational aspects of food and health behaviours, 2) Attitudes toward diabetes symptoms and the seeking of medical help, and 3) The perceptions of health professionals regarding the treatment of diabetes within the UK Pakistani community. A Grounded theory approach of three studies were carried out; the first two utilised semi-structured interviews with 60 participants across three generations. The third was a focus group study with 12 health professionals. Thematic analysis of data in the first study revealed that UK Pakistanis across all three generation groups differed in their perceptions and behaviours toward 'traditional' food values and what is regarded as 'healthy'. For first and second generations, traditional values corresponded to the cultural belief that their diets were healthy, that diabetes was hereditary, and that the family was central to eating practices. This stood in contrast to the majority of the young generation, who displayed higher levels of knowledge of food, diet and diabetic health, but were also compliant to family eating practices and culture. The second study found there were differences in help-seeking behaviour for diabetes, with the majority of the first and second generation groups recognising the symptoms of diabetes as worthy of concern, and were generally willing to discuss these symptoms with others and with their GPs. However, the majority of the young generation group exhibited the tendency (often identified with 'western' ideals) to keep diabetes symptoms private, and thus to maintain a high tolerance for such symptoms. The third study found that health professionals generally held overly simplistic and ethnocentric attitudes toward the interaction of culture and diabetes within the UK Pakistani population. It also ascertained that they tended to identify foreign language, lack of education, cultural barriers to altering food choice, and culturally influenced approaches to presenting symptoms as the primary obstacles to reducing diabetes within the community. Findings were discussed in terms of an eco-cultural model, calling attention to the ways in which the concepts of ethnicity and family shape UK Pakistanis' attitudes toward food, diabetes, and the seeking of help. Inter-generational differences, society, and community all act together in the production of culture, values and practices shared in UK Pakistani families. The research extends understanding about how diabetes is defined and managed, how it is taken for granted, and how it is resisted within a small section of the UK Pakistani population.EThOS - Electronic Theses Online ServiceGBUnited Kingdo