In the realm of chronic diseases, type 2 diabetes stands as a persistent public health challenge, profoundly affecting millions worldwide. Yet the lived experiences of those managing this condition often remain entangled in layers of social and cultural complexity, particularly when viewed through the lens of gender. A groundbreaking ethnographic study recently published in the International Journal for Equity in Health sheds vital new light on how gender profoundly influences the management, perception, and socio-cultural navigation of type 2 diabetes among individuals residing in both rural and urban areas of Mexico. This research unpacks the intricate ways in which gendered roles and expectations intersect with healthcare access and personal disease management in diverse Mexican communities.
The study was conducted by Heredia-Pi et al., who embarked on in-depth fieldwork to explore the nuances of diabetes care experiences from a gender perspective. Ethnography, a qualitative research approach rooted in immersive observation and narrative analysis, enabled the researchers to capture the subjective realities of individuals living with type 2 diabetes. By staying embedded within these communities across rural and urban settings, they sought to unravel how gendered experiences shape health behaviors, coping mechanisms, and the social stigmas associated with chronic illness in markedly different environments.
Mexico, with its striking socio-economic gradients and rapid urbanization trends, presents an ideal setting to investigate how place and gender converge in chronic illness experiences. Rural zones often bear the hallmarks of limited healthcare infrastructure, poverty, and stronger adherence to traditional gender roles, whereas urban areas exhibit more complex health systems and evolving social norms. This dichotomy provided a fertile ground for the researchers to examine disparities in disease management and highlight systemic inequities that may exacerbate complications for either men or women with type 2 diabetes.
One of the pivotal findings from the study reveals that women living with type 2 diabetes in rural communities frequently encounter a unique set of challenges shaped by entrenched gender roles. These women often shoulder the bulk of domestic responsibilities, including caregiving, cooking, and household labor, which complicates their ability to prioritize their own health. The expectation to maintain family welfare sometimes leads to neglecting their dietary and medication regimens, thereby worsening clinical outcomes. Furthermore, access to education about diabetes self-management is often limited, entrenching knowledge gaps that deepen health disparities.
Conversely, men in rural settings face a different set of difficulties rooted in societal expectations about masculinity. The cultural imperative to appear strong and capable often deters men from openly acknowledging their illness or seeking timely medical intervention. Fear of stigma and appearing vulnerable can contribute to poorer disease control and higher rates of diabetes-related complications. These insights underscore how gender norms function as invisible barriers to effective health management, perpetuating cycles of neglect and adverse outcomes.
In contrast, the urban landscape paints a somewhat different picture, albeit with persistent gendered disparities. Urban women with type 2 diabetes generally have somewhat improved access to healthcare resources, nutrition information, and diabetes education programs. However, they continue to confront challenges balancing work, family, and self-care, as modern professional roles add new layers of responsibility and stress. The commercialized food environment in cities also introduces additional hurdles, with calorie-dense, nutrient-poor options widely available and aggressively marketed, complicating adherence to diabetes-appropriate diets.
Urban men, meanwhile, may benefit from more progressive attitudes toward health but still wrestle with entrenched ideas of masculinity that discourage vulnerability. Workplace cultures and social networks often reinforce notions of invulnerability, leading to underutilization of health services even when facilities are accessible. This phenomenon emphasizes that expanding healthcare availability alone is insufficient without addressing deep-seated gender ideologies influencing health behaviors.
Integral to the study’s methodology was the nuanced analysis of how participants negotiate their diabetes within the cultural fabric of familial relationships. Women, often regarded as the emotional and nutritional anchors of families, experience not only physical but psychosocial stress by balancing diabetes management against expectations to provide care for others. Men’s experiences are marked by social isolation around their illness, as openly discussing health concerns clashes with prevailing norms of stoicism. These dynamics demonstrate how gender deeply molds not only bodily experiences of diabetes but also the social texture within which those experiences unfold.
Of particular note is how the intersection of gender with socioeconomic status compounds these disparities. Rural women with lower income levels face compounded vulnerabilities due to limited healthcare access, low literacy, and economic dependence, restricting disease management options and amplifying risk. In urban settings, economic inequality intersects with gender to influence food security and healthcare affordability, reinforcing patterns of health inequity. These intersections highlight the critical need for intersectional frameworks in diabetes care policies that recognize how multiple axes of identity impact disease experience and outcomes.
The study also draws attention to systemic deficiencies in Mexico’s health infrastructure concerning gender-sensitive care. Current diabetes interventions frequently employ generic, one-size-fits-all strategies, overlooking the socio-cultural realities shaping men’s and women’s lives differently. The authors argue for tailored health education programs and support systems that explicitly incorporate gender considerations—addressing, for instance, the caregiving burdens faced by women or the stigmatization fears of men—to enhance adherence and wellbeing.
An innovative dimension of this research is its use of ethnography to amplify voices often marginalized in public health narratives. By focusing on the lived, everyday realities of individuals, the study transcends statistical analyses to reveal the human stories behind diabetes statistics. This approach brings critical empathy to the discourse, emphasizing that effective interventions require understanding patients within their unique gendered contexts rather than abstract clinical categories.
The findings bear profound implications for global diabetes strategies, especially in middle-income countries experiencing rapid social transformation. Mexico’s example illustrates the urgent need to integrate gender as a central axis in chronic disease management frameworks. Policies that ignore gendered experiences risk overlooking crucial determinants of health behaviors and outcomes, thus perpetuating avoidable disparities and inefficiencies.
Moreover, the research resonates with broader theoretical discourses on health equity, suggesting that gender operates as both a social determinant and a mediator of healthcare access and quality. This dual role mandates interdisciplinary collaborations involving healthcare providers, social scientists, and community leaders to design and implement culturally attuned, gender-aware diabetes programs.
Given the global surge of type 2 diabetes cases and the rising burden on health systems, translating such nuanced ethnographic insights into practice is not merely advisable but imperative. Innovations such as community-based peer support groups differentiated by gender, targeted health literacy campaigns, and flexible care models that accommodate caregiving demands promise to bridge the gap between policy and patients’ lived realities.
In summary, Heredia-Pi and colleagues’ ethnographic exploration offers a compelling, richly textured portrait of how gender shapes the daily reality of living with type 2 diabetes in Mexico’s contrasting rural and urban environments. The study’s robust findings invite policymakers, clinicians, and researchers to rethink standard approaches, foreground gender as a core variable, and champion equity-informed innovations in chronic disease management that honor diversity and complexity.
As healthcare continues to evolve in the 21st century, such gender-sensitive insights advance the promise of truly personalized medicine—not just at the molecular or genetic level but at the intersection of culture, identity, and lived experience. Addressing the gendered dimensions of diabetes holds promise not only for enhancing patient outcomes but also for fostering inclusive health systems that reflect the multifaceted realities of all individuals living with chronic illness.
Subject of Research: Gendered experience of people living with type 2 diabetes in rural and urban Mexico
Article Title: Gendered experience of people living with type 2 diabetes in rural and urban Mexico: an ethnographic study
Article References:
Heredia-Pi, I.B., Orozco-Núñez, E., Guerrero-López, C.M. et al. Gendered experience of people living with type 2 diabetes in rural and urban Mexico: an ethnographic study. Int J Equity Health 24, 157 (2025). https://doi.org/10.1186/s12939-025-02523-1
Image Credits: AI Generated
