First Page

191

Abstract

INTRODUCTION: In East Harlem, it is possible to take any simple nexus of people -the line at an A.T.M., a portion of a postal route, the members of a church choir -and trace an invisible web of diabetes that stretches through the group and out into the neighborhood, touching nearly every life with its menace.Ten years ago, the New York Times published "Bad Blood," a series of articles examining the impact of diabetes on the residents of New York City. In the years that followed, New York pioneered a series of groundbreaking legal interventions, including implementing measures to track diabetes management at the population level, mandating calorie-count menu labeling at chain restaurants, and capping the container size for sugary drinks. These measures, and others enacted at the local, state, and federal level, indicate the beginnings of a subtle, yet crucial, shift of perspective on diabetes over the course of the last decade: from viewing diabetes primarily in individualistic terms as a self-managed disease to understanding it as a social phenomenon managed at the community level.

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