‘It’s like getting your car checked’: the social construction of diabetes risk among participants in a population study

In western industrialised societies, asymptomatic individuals are increasingly labelled as at-risk of future illness and targeted for public health interventions. These at-risk people are identified through health checks, population studies and national screening programs. The main purpose of communicating such risk to individuals is to motivate them to make lifestyle changes. Many of these risk-labels are controversial, both medically and ethically. Based on the relational theory of risk and a thematic analysis of qualitative interviews, we explore how individuals defined as at-risk perceive and conceptualise information about risk of developing diabetes. The interviews were conducted in 2019 with 26 participants from an ongoing population study in Norway. After participating within the screening, participants were informed that they had elevated or intermediate glycated haemoglobin values, and therefore at risk of developing type 2 diabetes. Our data reveal an ambiguous situation: while receiving information about being at-risk may function as a vulnerability-reminder that might motivate lifestyle changes, it can also create unnecessary fear over a disease that may never occur. Danger and uncertainty were interrelated aspects in the ways in which our participants conceptualised risk. Participants risk perceptions seemed to be regulated by fear, followed by a need for reassurance. Differences in risk perceptions and accounts of lifestyle changes depended on people’s trust in expert information versus their own experiences. Trust in medical expertise played a significant role in the ways in which participants constructed their risk, as well as their accounts of lifestyle changes.