Matthew Klingle has departed from his comfortable academic specialization of environmental history and the North American West to plunge into the unfamiliar world of public health and chronic disease.
Klingle, an associate professor of history and environmental studies, was supported in his new research venture by a unique fellowship from the Andrew W. Mellon Foundation. Called New Directions, the multi-year fellowship enables scholars in the humanities to train in a new discipline.
For the past past five years, Klingle has traveled across the U.S., scouring archives and conducting interviews to study the environmental and social history of diabetes, particularly Type II diabetes. He also took graduate-level classes at the Harvard T.H. Chan School of Public Health at Harvard University in epidemiology, social epidemiology, and nutrition. “The classes allowed me to pick up and read materials on scientific studies, and they also allowed me as a historian to place those studies in particular contexts in a way that scientists often don’t see their work,” Klingle said.
Klingle admitted that taking the Harvard courses reminded him, a 40-something professor who has achieved professional success, how humbling it can be to step into a classroom to learn something new. “I am hoping that the experience has in some way made me a better teacher by reminding me of the humility with which I need to approach my students who are coming into the classroom with a wide range of strengths and challenges,” he said.
Now that the years of funded research are over, Klingle is turning his focus to completing his book, tentatively titled Sweet Blood: Diabetes and the Nature of Health in America. This work will cover the history of diabetes from the late 19th century to the present, focusing on how changes in nutrition, the environment and society have contributed to the skyrocketing rise of diabetes in this country, particularly among the rural and urban poor, Native Americans and African Americans. “I hope to show that the history of diabetes is an environmental and cultural history of our modern nation,” Klingle said.
Among the central questions Klingle’s new book will address is, “How is it that [diabetes] is simultaneously a disease of affluence, a disease of over-consumption, but is also a disease that is closely tied to poverty, to socioeconomic status, to location?” One of the goals of Sweet Blood will be to challenge stereotypical conceptions of diabetes resulting from either people’s failure to manage their appetites or genetic bad luck, and instead present it as a disease shaped by our changing environments and socioeconomic landscapes over time.
New teaching directions
As a side effect of retooling his scholarship, Klingle created both a new class and a new unit for another class. He designed an upper-level environmental studies and history seminar, Nature and Health in America, to explore the relationship between environmental history and medical history in North America from 16th century to today. With John Lichter, professor of biology and environmental studies, he added a new unit on food, agriculture, nutrition and health to the college’s introductory environmental studies course the two professors teach together.
Klingle said that students are growing more interested in public health as a potential career. “We have a group of increasingly sophisticated students that are really thinking thoughtfully and carefully about the environment, and are amenable to thinking about how it is that when we talk about environmental issues, we’re not just talking about birds, trees and mountains, but also how those are linked to questions of human prosperity and human inequalities,” he said. “And health is at the very nexus of that.”
Diabetes, like cardiovascular disease and cancer, is sometimes referred to as a “disease of civilization.” Its growth tracks closely with the growth of our modern energy economy, Klingle points out. “We live in a world of hyper-abundant carbohydrates,” the product of our massive and efficient petroleum-driven agricultural sector. “You’re taking the energy from the earth and translating it into abundant carbohydrates, which are transforming the human body on the individual scale and on the scale of populations,” Klingle said.
While obesity is a known cause of Type II diabetes, there are other possible factors that might have historically interacted with genetics and diet to make people more susceptible to diabetes. “Current (if debated) theories for the uptick in diabetes rates today include exposure to persistent organic pollutants (like polychlorinated dibenzodioxins, common to many pesticides and herbicides), or reduced contact to allergens thanks to modern hygiene,” Klingle wrote in his original grant proposal. “As humans reshape the environment, it comes back to reshape us,” he added.
Klingle is also interested in looking at how persistent health problems can be transmitted across generations. “To what degree is diabetes the result of living in a world of hyper-abundant calories, of energy unleashed? And to what degree is it a result of persistent socioeconomic inequality?” he asked. He points to patterns across the country where certain populations have not had have easy access to fresh food or good healthcare, or have been exposed to endocrine disrupting chemicals. Stress, too, might play a role. “If you’re a single mom in East St. Louis who is working three jobs and you’re not getting enough sleep, and you’re constantly worried about your kids’ wellbeing, that stress day in and day out changes your body,” he said. “And it not only changes your body, but may be changing the body of your kids in utero with future consequences.”
Klingle said that he hopes his book will spur people interested in public health — clinicians, physicians, scientists and policy makers — to consider the complex history of diabetes as they think about treatment and prevention strategies. “I hope to discover how present-day solutions to poor health must face the history and ecology we have all inherited unequally in our landscapes and in our bodies,” he said.