Gendered experience of people living with type 2 diabetes in rural and urban Mexico: an ethnographic study

Abstract

Objective: To analyse the gendered experience of women and men living with type 2 diabetes mellitus (T2D) related to diagnosis, treatment, and control in rural and urban contexts of Mexico.

Methodology: Qualitative ethnographic study. Thirty-six adults (21 women and 15 men) with a confirmed diagnosis of T2D for more than five years residing in urban and rural localities in Baja California and Morelos participated in this qualitative study between November 2022 and February 2023. A semi-structured interview guide was used to explore lifestyle changes, social and community networks, work and living conditions, experience with the disease, health services and associated economic burden. The analysis was guided by four conceptual domains of gender influence: identity, norms and roles, relationships and institutionalised gender.

Results: Women were more likely to report difficulty in accepting the diagnosis of T2D and stress in coping with the disease and related lifestyle changes. Men were more likely to report impact of T2D on their job and role as household providers, and their inability to contribute to the care of other family members. Women were more likely to report leaving their jobs, taking on caregiving responsibilities for family members, experiencing difficulty in accessing healthcare, and prioritizing their health in comparison to men. Men reported receiving more support from their partners, faced fewer financial barriers to care access, and had more freedom to pay for their medications and seek treatment in private care. However, they were also less adherent to treatment and disease care measures.

Conclusions: Gender appears to substantially influence experience of living with T2D. Women were more likely to provide family support and less likely to receive it and reported greater financial barriers to care access in comparison to men. Men were more likely to experience stress in relation to their employment as primary providers for their family, and less likely to adhere to prescribed medical management of their condition. These findings should be considered in more targeted health policy interventions to promote greater gender equity in the care of those with T2D in Mexico.

Keywords: Gender; Health inequalities; Mexico; Non-communicable diseases; Type 2 diabetes.

Fig. 1

Gender domains and related variables