Doing physical activity or not: an ethnographic study of the reasoning of healthcare workers and people with type 2 diabetes

According to biomedical notions, physical activity (PA) is an integral part of treatment for several non-communicable diseases, Type 2 diabetes (T2D) among them. Adapting one's life in accordance with such notions, however, involves considerations that reach beyond what can be confined to treatment decisions. Thus, we aim to explore the various reasons for doing PA or not among healthcare workers and people with T2D taking part in programs that promote PA. We do so based on ethnographic fieldwork that includes observations and focus group interviews in two programs in a Danish municipality, and with inspiration drawn from Habermas' theory of communicative action. Our results show that healthcare workers emphasize primarily health-related reasons for doing PA, including a moral imperative to be healthy, while people with T2D have a slew of other reasons for doing PA or not. These reasons together illustrate that for participants with T2D, long-term concerns for health and disease take a backseat to more immediate concerns for enjoyment, pain, and family, and that the participants generally reject the normative health imperative. We suggest that healthcare workers and participants with T2D engage in dialogue about their normative assumptions with the purpose of reaching a mutual understanding.