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Health capabilities and diabetes self-management: The impact of economic, social, and cultural resources

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  • Weaver, Robert R.
  • Lemonde, Manon
  • Payman, Naghmeh
  • Goodman, William M.

Abstract

While the “social determinants of health” view compels us to explore how social structures shape health outcomes, it often ignores the role individual agency plays. In contrast, approaches that focus on individual choice and personal responsibility for health often overlook the influence of social structures. Amartya Sen's “capabilities” framework and its derivative the “health capabilities” (HC) approach attempts to accommodate both points of view, acknowledging that individuals function under social conditions over which they have little control, while also acting as agents in their own health and well-being. This paper explores how economic, social, and cultural resources shape the health capability of people with diabetes, focusing specifically on dietary practices. Health capability and agency are central to dietary practices, while also being shaped by immediate and broader social conditions that can generate habits and a lifestyle that constrain dietary behaviors. From January 2011 to December 2012, we interviewed 45 people with diabetes from a primary care clinic in Ontario (Canada) to examine how their economic, social, and cultural resources combine to influence dietary practices relative to their condition. We classified respondents into low, medium, and high resource groups based on economic circumstances, and compared how economic resources, social relationships, health-related knowledge and values combine to enhance or weaken health capability and dietary management. Economic, social, and cultural resources conspired to undermine dietary management among most in the low resource group, whereas social influences significantly influenced diet among many in the medium group. High resource respondents appeared most motivated to maintain a healthy diet, and also had the social and cultural resources to enable them to do so. Understanding the influence of all three types of resources is critical for constructing ways to enhance health capability, chronic disease self-management, and health.

Suggested Citation

  • Weaver, Robert R. & Lemonde, Manon & Payman, Naghmeh & Goodman, William M., 2014. "Health capabilities and diabetes self-management: The impact of economic, social, and cultural resources," Social Science & Medicine, Elsevier, vol. 102(C), pages 58-68.
    • Handle: RePEc:eee:socmed:v:102:y:2014:i:c:p:58-68
    DOI: 10.1016/j.socscimed.2013.11.033
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    References listed on IDEAS

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    1. Keene, Danya E. & Guo, Monica & Murillo, Sascha, 2018. "“That wasn't really a place to worry about diabetes”: Housing access and diabetes self-management among low-income adults," Social Science & Medicine, Elsevier, vol. 197(C), pages 71-77.
    2. Jesús G. Arámburo-Gálvez & Noé Ontiveros & Marcela J. Vergara-Jiménez & Dalia Magaña-Ordorica & Martina H. Gracia-Valenzuela & Francisco Cabrera-Chávez, 2017. "Price and Availability of Sugar-Free, Sugar-Reduced and Low Glycemic Index Cereal Products in Northwestern México," IJERPH, MDPI, vol. 14(12), pages 1-5, December.
    3. Eric Yaw Naminse & Jincai Zhuang, 2018. "Does farmer entrepreneurship alleviate rural poverty in China? Evidence from Guangxi Province," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-18, March.
    4. Judith M. Ochieng & Janice D. Crist, 2021. "Social Determinants of Health and Health Care Delivery: African American Women’s T2DM Self-Management," Clinical Nursing Research, , vol. 30(3), pages 263-272, March.

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