The Swastika of Biomedical Imperialism: The Rich Man's Disease, the Poor People's Burden—Reductionism and the Politics of Diabetes Prevention.

This perspective examines the limitations of reductionist approaches to diabetes prevention and argues for integrating population-level social determinants of health (SDOH) into risk assessment, prevention strategies, and public health policy. It explores how socioeconomic deprivation, food insecurity, housing instability, environmental exposures, and unequal access to healthcare shape diabetes risk and outcomes. The paper critically considers the institutional, political, and economic barriers that impede the translation of SDOH evidence into effective interventions. It calls for a shift from individual-level risk attribution towards structural, equity-oriented approaches that address the upstream determinants of diabetes and support more effective, accountable, and socially responsive prevention strategies.