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Hemoglobin a1c as a diagnostic tool: Public health implications from an actor-network perspective

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  • Degeling, C.
  • Rock, M.

Abstract

Public health arguments for collecting hemoglobin A1c (HbA1c) data, particularly in clinical settings, should be reframed to place more emphasis on nonmedical determinants of population health. We compare individual- with population-level interpretations of HbA1c titers. This comparison reveals that public health researchers need to pay close attention to diagnostic tests and their uses, including rhetorical uses. We also synthesize historical and current evidence to map out 2 possible scenarios for the future. In the first scenario, prevention efforts emphasize primary care and focus almost entirely downstream. The second scenario anticipates downstream interventions but also upstream interventions targeting environments. Our analysis adapts actor- network theory to strategic planning and forecasting in public health.

Suggested Citation

  • Degeling, C. & Rock, M., 2012. "Hemoglobin a1c as a diagnostic tool: Public health implications from an actor-network perspective," American Journal of Public Health, American Public Health Association, vol. 102(1), pages 99-106.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2011.300329_5
    DOI: 10.2105/AJPH.2011.300329
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    Cited by:

    1. Mendenhall, Emily & Omondi, Gregory Barnabas & Bosire, Edna & Isaiah, Gitonga & Musau, Abednego & Ndetei, David & Mutiso, Victoria, 2015. "Stress, diabetes, and infection: Syndemic suffering at an urban Kenyan hospital," Social Science & Medicine, Elsevier, vol. 146(C), pages 11-20.

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