Over the last two decades, scholars attentive to the social and cultural factors shaping the interpretations and experiences of illness have turned increasing attention to community experiences of diabetes, particularly among groups, including Indigenous populations, that are at particularly high risk for this condition. In her well-researched and richly contextualized book, Diabetes in Native Chicago: An Ethnography of Identity, Community, and Care, anthropologist Margaret Pollak makes an admirable contribution to this body of scholarship.
While most anthropological studies on diabetes in Native communities have focused on reservation settings, Pollak turns attention to an urban setting, documenting the experience, care, and understanding of diabetes within Chicago’s Native community. Drawing on twenty-five months of ethnographic research with Chicago’s Indigenous population between 2007 and 2017, Pollak considers the reciprocal relationship between culture and health. In her words,
“I show how colonialism affects bodies and communities through intergenerational trauma, displacement, chronic poverty, and altered foodways…I further demonstrate that this ongoing epidemic has influenced Native culture, showing that diabetes, as a disease that Natives are at risk of developing, has been adopted and incorporated into local discussions of Indigenous identity in the urban space” (xx). Throughout her exploration of this multidirectional flow of influence between culture and health, she integrates various voices from Chicago’s intertribal Native population, highlighting the complex dynamics of identity in that urban community while also offering insights into people’s experiences with and perspectives on key issues, such as urban migration, urban Native life, and practices of care.
Chapters 1 and 2 introduce the Chicago Native community that is the focus of the study, engaging first with the political, economic, and social factors influencing Native migration to cities in the twentieth century, and then shifting to the ways in which members of the Indigenous community in Chicago perform and negotiate their individual and collective Native identities. The remaining chapters turn attention to Native experiences with diabetes. Chapter 3 offers a brief history of diabetes both in human history generally and in Native American populations in particular, linking high rates of diabetes among the Indigenous populations in North America to structural violence brought on by European-American colonialism. Chapters 4 and 5 address local understandings of diabetes in Native Chicago: the ways in which they both are informed by and differ from biomedical understandings of the disease, as well as how local definitions and explanations of disease development “are situated within individual, social, and dialogical experiences with the disease” (108). It is at the end of chapter 5 that we begin to see a central argument of the book take shape. Pollak asserts that
the health of the social and the individual body correspond with group membership. In Native Chicago, a vulnerability to diabetes is a widely recognized characteristic of Indigenous populations of North America. To be an Indigenous American, one is also at risk for developing diabetes. This shared risk, in turn, strengthens the ties of Chicago’s intertribal community by binding together the citizens of many tribal nations as an ethnic enclave of Indigenous Americans. (127)
Pollak continues to build this argument in chapter 6, as she highlights how intertribal ties in the city space are strengthened by how Natives in Chicago engage in visible and hidden care work both “within individual households and across multiple spheres of community life” (159). The brief concluding chapter considers what work is needed moving forward to counter the rising health disparities faced by Indigenous urban communities; she echoes other scholars in her call for collaborative, community-engaged work through participatory research and the need to decolonize health-care practices.
A strength of this book is Pollak’s attention to the seemingly mundane practices of care she encountered during her fieldwork with the Chicago Native community, e.g., “conducting research, attending appointments, shopping, cooking, administering medications, doing exercise, eating diabetes diets when not diabetic, reminding patients about foods, watching for signs of hyperglycemia in others, providing education and advice, and considering diet needs for larger community events” (153), and her consistent foregrounding of the voices of the people with whom she worked. Her engagement with existing historical and anthropological scholarship also highlights how the perspectives and experiences of the community she worked with do not exist in isolation, converging in significant ways with Native communities elsewhere. Ultimately, Pollak offers a nuanced, deeply contextualized ethnographic study of diabetes in Native Chicago, one that would be of interest to any reader seeking to learn about the dynamic relationship between health, illness, and the social and cultural worlds we live in.
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[Review length: 747 words • Review posted on November 11, 2022]