Intersection of Poverty and Gender in Coping with Diabetes: Insights from Rural Tamil Nadu

Based on in-depth narratives of rural women and men living in poverty, this chapter explores how poverty and gender interact in determining how people cope with diabetes in rural Tamil Nadu. The case studies of individuals living in poverty or near poverty in this chapter depict how none of the requirements for diabetes management are within their easy reach. Women in poor households were more often submerged in sickness-producing situations than men because of gender-based inequalities and gender roles and norms. Not only was food often inadequate, but the work burden and the stress of managing a household with little income led the women to neglect timely food intake. For women living in poverty, both access and affordability of healthcare were challenging. The day-to-day demands of work, family, and other responsibilities and their inability to meet even the meagre costs of transportation and food made regular visits to the health facility difficult. Women from better-off households faced gender-based barriers such as the need for their husband’s permission and financial support to visit health facilities, in addition to the work burden. NCD programs need to go beyond curative care and lifestyle modifications to address the systemic factors that contribute to the risk of diabetes and interfere with appropriate diabetes management. Improving the living conditions of the people by ensuring shelter, food security, employment, and living wages, as well as promoting gender equality, would pave the way to effective prevention and control of diabetes and its complications.