Troubled Interventions: Public Policy, Vectors of Disease, and the Rhetoric of Diabetes Management Jeffrey A. Bennett Published online: 22 November 2012 # Springer Science+Business Media New York 2012 Abstract This essay examines the debate surrounding New York City’ s controversial diabetes registry program. Exploring the tensions between public health officials and privacy advocates, the article explores how diabetes is imagined in the public sphere. Although rhetorics underscoring privacy may seem the more progressive discourse, I argue New York City’ s Department of Health and Mental Hygiene has the more forward-looking plan, attempting to reconstitute diabetes not as a chronic condition necessitating individual management but as a disease that requires systemic intervention. Keywords Rhetoric . Diabetes . Epidemic . Privacy . Registry program In December 2005 the New York City Department of Health and Mental Hygiene (DOHMH) implemented one of the most far-reaching chronic disease intervention programs in the municipality’ s history. In an effort to combat alarming surges of diabetes diagnoses and related complications among New Yorkers, the agency established a patient registry to help people monitor blood sugar and motivate at-risk residents to visit doctors when glucose levels are precariously elevated. As most people with diabetes are reminded, persistently high blood sugar can lead to complications such as kidney failure, blindness, foot amputation, and other life- altering conditions. To prevent such ailments from materializing, DOHMH required all labo- ratories serving New York City residents to report individual A1C scores (blood glucose averages for approximately three months) directly to the department. The plan was ground- breaking because for the first time the government would begin tracking individual data about a condition that is neither infectious nor caused by an environmental toxin. While public health agencies have a long history of intervening in outbreaks like tuberculosis, polio, and yellow fever, this particular intervention was controversial because diabetes is not contagious. 1 J Med Humanit (2013) 34:15–32 DOI 10.1007/s10912-012-9198-0 1 Mitchell and McTigue (2007, 401-402) rightfully point out that the CDC has monitored noninfectious agents, but these outbreaks (gastrointestinal symptoms, melanoma, and mesothelimoa) involved environmental causal agents (such as methyomyl, ultraviolet light, and asbestos). The author would like to thank Isaac West, Suzanne Enck, and the anonymous reviewer for their feedback on previous drafts of this essay. J. A. Bennett (*) Department of Communication Studies, University of Iowa, 105 Becker Communication Studies Building, Iowa City, IA 52242, USA e-mail: jeff-bennett@uiowa.edu