Cultural negotiations in health and illness: The experience of adult onset diabetes among Gujarati South Asians in England.

Diabetes has become a global health problem, with both physical and psycho-social impacts on people's lives. The South Asian communities in the UK have been identified as 'high risk' groups with high rates of type 2 (non-insulin dependent) diabetes. This thesis explores the experiences of type 2 diabetes among a group of Hindu Gujaratis in several locations in England. Purposive and snowball sampling was used to recruit participants and a grounded theory framework was utilised to generate and analyse data. It is possible to suggest that health science discourse in a variety of forms has constructed a type of 'South Asian diabetic risk', alluding to a particular relationship between health and ethnicity. Through the use of qualitative methods participants in this research demonstrate active resistances to these constructions, through their accounts of diabetes management. By exploring the biographical, historical and socially embedded contexts that surround diabetes, participants constituted culture and ethnicity as dynamic entities, contingent on social, political and personal contexts. Within the context of qualitative methods, the role of the researcher and the various ways in which identities connect and need to be explicitly explored also forms a central idea within this work. This thesis highlights these active and dynamic constructions of cultural and ethnic identity. Health research needs to acknowledge the many varied ways in which people are able to manage their conditions as part of their overall social and cultural context. Situating health and illness experiences within a wider experiential field allows the possibility of fluid notions of identity to be implemented, and the relationship between health and ethnicity to be theoretically informed. These considerations may contribute to an understanding of how people manage their diabetes and where help and support might best be channelled