How Many Surveys Must They Take? Diabetes, Surveillance, and the Politics of Communicability

Abstract

The Behavioral Risk Factor Surveillance System (BRFSS) is the largest continuously conducted health survey in the world, providing key data on chronic health conditions and so-called ‘behavioral risks’ in the United States for more than four decades. Yet for the individuals and communities it surveys, this does not always translate into meaningful support or change. Drawing on qualitative analysis of BRFSS survey questionnaires, four interlocutor interviews, and theories of biopower, communicability, and knowledge production, I consider the limits of public health surveillance through BRFSS. At the heart of this story is a diabetes self-management educator in the Bronx who is herself living with type 2 diabetes. It is through her narrative that this thesis explores the ways in which institutionally circulated narratives of risk and responsibility, built on unstable scientific foundations, often leave much of the lived experience of diabetes management incommunicable. In turn, I consider how individuals and communities navigate this landscape on their own terms.