Using Poetry to Fight Childhood Diabetes

The Bigger Picture inspires young people to change the conversation about type 2 diabetes by exposing the environmental and social conditions that lead to its spread.

How do you get teens to care about type 2 diabetes? Once known as “adult-onset diabetes,” the disease is now striking children and teens in epidemic proportions, particularly in low-income communities and among youths of color. “Shaming and blaming” won’t get kids off the couch or get them to stop drinking sugary sodas. 

But what about slam poetry? Rap music? Or short, provocative videos? Can these art forms tap into values young people hold dear and stimulate individual and communal action? 

As part of The Bigger Picture campaign, Bay Area teens use their creative juices and their own voices to change the conversation about type 2 diabetes. Dean Schillinger, MD (above), resident alumnus, chief of the UCSF Division of General Internal Medicine, and a founder of the UCSF Center for Vulnerable Populations (CVP) in 2006, initiated the innovative collaboration between arts organization Youth Speaks and the CVP to mobilize young people and foster policy change to end type 2 diabetes in this age group. The effort has won national awards, received more than 1.5 million video views on YouTube, and reached more than 10,000 students in Bay Area high schools to date. 

In 2018, the New York Times and the Journal of the American Medical Association featured the campaign’s pioneering efforts and debuted four original poetry music videos. These short but powerful youth-generated films confront the root causes of the epidemic.  

One shows how the targeted marketing of sugar-loaded energy drinks affects health. Another illustrates how migrant families can’t afford the fresh produce they’ve harvested. A third expresses how overexposure to sugar-sweetened beverages harms immigrant communities. The fourth shows the challenge of tackling physical inactivity when faced with obesity-related stigma.  

The national publicity provides an unprecedented opportunity to inspire more youth peers and spur collective action toward preventing type 2 diabetes, potentially transforming The Bigger Picture from a social media campaign into a social movement. 

“We know that many policies affect the environments where people live and work and play, and these ultimately affect health, especially in children,” says Kirsten Bibbins-Domingo, PhD ’94, MD ’99, MAS ’04, former director of the CVP and current vice dean of population health and health equity in the UCSF School of Medicine. A key campaign goal is to raise kids’ and their stakeholders’ awareness about the social and environmental pressures that contribute to those conditions in their neighborhoods. At its most basic, The Bigger Picture program enables young people to transform themselves from targets of diabetes risk to agents of change by fundamentally reframing the problem and demanding action to eliminate this risk. 

Now led by Margot Kushel, MD, the team at the CVP works closely with communities to help marginalized populations access services that are crucial for good health. They develop tools to help individuals with limited literacy skills navigate the complex health care system safely and effectively. They seek creative solutions for homeless people whose circumstances make it nearly impossible for them to manage their health needs. They develop innovative programs in partnership with others to make it easier for vulnerable individuals to get healthy food. 

“Ideally, we would like to prevent disease before it starts,” says Bibbins-Domingo, adding that she looks forward to the day when there are no new cases of type 2 diabetes in Bay Area young people. The films, music, and poetry created by kids for kids – art that also resonates with adults who shape our policies – may be powerful catalysts for that eventual day. 

Kirsten Bibbins-Domingo is the Lee Goldman, MD, Professor of Medicine. 

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