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Hemoglobin a1c as a diagnostic tool: Public health implications from an actor-network perspective

Journal Article


Abstract


  • Public health arguments for collecting hemoglobin A1c (HbA1c) data, particularly in clinical settings, should be reframed to place more emphasis on nonmedical determinants of population health. We compare individual- with population-level interpretations of HbA1c titers. This comparison reveals that public health researchers need to pay close attention to diagnostic tests and their uses, including rhetorical uses. We also synthesize historical and current evidence to map out 2 possible scenarios for the future. In the first scenario, prevention efforts emphasize primary care and focus almost entirely downstream. The second scenario anticipates downstream interventions but also upstream interventions targeting environments. Our analysis adapts actor- network theory to strategic planning and forecasting in public health.

Publication Date


  • 2012

Citation


  • Degeling, C. & Rock, M. (2012). Hemoglobin a1c as a diagnostic tool: Public health implications from an actor-network perspective. American Journal of Public Health, 102 (1), 99-106.

Scopus Eid


  • 2-s2.0-84857278622

Number Of Pages


  • 7

Start Page


  • 99

End Page


  • 106

Volume


  • 102

Issue


  • 1

Place Of Publication


  • United States

Abstract


  • Public health arguments for collecting hemoglobin A1c (HbA1c) data, particularly in clinical settings, should be reframed to place more emphasis on nonmedical determinants of population health. We compare individual- with population-level interpretations of HbA1c titers. This comparison reveals that public health researchers need to pay close attention to diagnostic tests and their uses, including rhetorical uses. We also synthesize historical and current evidence to map out 2 possible scenarios for the future. In the first scenario, prevention efforts emphasize primary care and focus almost entirely downstream. The second scenario anticipates downstream interventions but also upstream interventions targeting environments. Our analysis adapts actor- network theory to strategic planning and forecasting in public health.

Publication Date


  • 2012

Citation


  • Degeling, C. & Rock, M. (2012). Hemoglobin a1c as a diagnostic tool: Public health implications from an actor-network perspective. American Journal of Public Health, 102 (1), 99-106.

Scopus Eid


  • 2-s2.0-84857278622

Number Of Pages


  • 7

Start Page


  • 99

End Page


  • 106

Volume


  • 102

Issue


  • 1

Place Of Publication


  • United States