Managing the unmanageable: elderly Russian Jewish émigrés and the biomedical culture of diabetes care.

In this article, we examine the apparent resistance of elderly Russian Jewish émigrés to the dominant U.S. biomedical model of diabetes treatment. Cultural competence on the part of medical professionals who make assumptions about Russian culture tends to be based on particularly American values of self-control and individual agency. The American consumer model of health care incorporating risk, individual responsibility, autonomy, and choice, when applied to elderly Russian Jewish émigrés, results in a reading of different values and choices as failed self-management or noncompliance. This article argues for a more reflexive understanding of U.S. biomedical culture as a replacement for the current "sound bite" model of cultural diversity.