Everyday translation: health practitioners’ perspectives on obesity and metabolic disorders in Samoa

Research in Samoa and the diaspora has documented the nutrition transition and related rising metabolic disorders. Research suggests cultural influences, including large body size preference, sedentarism, and dietary patterns, as well as political and economic influences, including changed labor patterns and food dependence, contribute to rising metabolic disorders. This article documents how Samoan health practitioners understand barriers to lifestyle change as primarily cultural rather than structural. They highlight differences between health, framed as individually oriented, and well-being, framed as socially oriented. Drawing from participant observation and semi-structured interviews, this article shows how health practitioners engage in ‘everyday translation’ by aiming to change the meaning of food, body, and wealth. Attention to everyday translation provides insights into the ambivalent ways interviewees identify culture as a barrier to health care. They avoid blaming patients, which has the paradoxical effect of suspending blame on individuals for not changing health behavior until cultural change occurs. This requires local leadership to effect community-wide change. When culture is recognized as the primary barrier to lifestyle change, health practitioners inadvertently reproduce structural inequalities in their daily interactions with patients. This has the effect of obscuring structural influences and promoting the idea that metabolic disorders are under individual control.