Understanding the impact of diabetes stigma

Wednesday, 26 Apr 2017

Can you describe the aim of your research in 10 words?

To understand the nature, extent and impact of diabetes stigma.

What do you know/have discovered about this topic so far?

Not all people with diabetes experience stigmatisation as a result of their condition, but many do. People with both type 1 and type 2 diabetes report perceiving and experiencing stigma in the form of negative stereotyping, judgement, blame, exclusion and discrimination.

People with type 2 diabetes also experience shame and self-stigma, whereas people with type 1 diabetes tend to worry about identity concerns, such as being mistaken for an illicit drug user when injecting, or even being concerned about others assuming they have type 2.

Regardless of diabetes type, diabetes stigma is encountered in healthcare settings, in the media, in the workplace, and within families and friendship groups. Diabetes stigma is associated with sub-optimal self-care, lower healthcare engagement, lower empowerment, higher diabetes distress, more depression and anxiety symptoms, and lower quality of life. This highlights the urgent need to determine how best to mitigate and minimise diabetes stigma in our community.

What aspect of this research excites you the most?

Making new contributions to knowledge that can inform how we structure our healthcare settings and consultations, how we frame our health promotion messages, and how we offer support to people with diabetes.

 What’s your Holy Grail – the one thing you’d like to achieve in your research?

People with diabetes report that one of the key sources of diabetes stigma is the media – particularly diabetes prevention campaigns! Many find this surprising.

But take a moment to think about the various health promotion campaigns you have seen over the years that focus on type 2 diabetes prevention messages, and no doubt you’ll soon realise that they draw heavily on negative stereotypes, and messaging that over-emphasises the role of individual behaviour, resulting in blame and shame of people who already have the condition.

I’d love to see us get to a point where my research is guiding evidence-based effective type 2 diabetes prevention campaigns, that do not have the unintended negative consequence of driving or reinforcing diabetes stigma.

What has been/will be your biggest hurdle?

Attracting funding! In the psychology world, qualitative research and population-based surveys are the equivalent of our basic science. They drive discovery and inform the direction of more applied research that can shape policy and practice.

But it has been a challenging sell to funding bodies, especially because diabetes stigma has only been acknowledged as a ‘real’ issue in very recent years.

We have been fortunate enough to attract some competitive funding to advance particular aspects of this research in a stepwise manner over the past five years, and we are actively seeking additional funding to take this work forward into the future.

How long before your work impacts patient care?

Diabetes stigma research is in its infancy, and we do not yet have widespread acknowledgement or awareness of the issue. In working with health professionals to help them uncover and address any unconscious bias they may bring into consultations, we hope that this can improve the experience for people with diabetes quite quickly.

Changing the way society talks about type 2 diabetes, how it is represented in the media, and how workplaces support people with type 2 diabetes will take longer and requires a stronger evidence base to instigate change.

Who has inspired you and why?

The Foundation Director of the ACBRD, Prof Jane Speight, has been an inspirational mentor to me, providing ample encouragement and opportunity for me to follow my passions in this area of research. I’m also inspired by researchers working in other health stigma spaces, such as Dr Rebecca Puhl from the Rudd Center for Food Policy and Obesity (University of Connecticut) and Prof Bruce Link (University of California).

If you could only keep three possessions, what would they be?

My iPad, my credit card (the one that earns frequent flyer points…) and a MAC lipstick!  


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