It may not seem like spoken-word poetry and diabetes have a lot to do with one another, but public health educators in California are using the art form to engage young people about the disease.

"Between growing up in Colón, Panama and a tour in the U.S. army, Grandpa is a proud old soldier marching through a never-ending war," Gabriel Cortez, 24, wrote in his poem " Perfect Soldiers." "At 66, we are scared that another stroke could do what no war ever could and cut him to the ground."

Two of Cortez's grandparents have diabetes. "Half of our neighborhood [looks] like the emergency ward of a hospital," he wrote.

"If you look at our community, you see it, but to have it named, I think, is an important thing," he tells Shots. Writing poetry is "another way of opening up the conversation."

Cortez wrote his poem last year during a workshop run by The Bigger Picture, a project that brings together University of California, San Francisco's Center for Vulnerable Populations and the literary nonprofit Youth Speaks. The goal is to encourage them to talk about diabetes and the risks it poses to the health of young people.

About 95 percent of the 29 million Americans with diabetes have the Type 2 variety, and the number of young adults and children with it is rapidly increasing. The problem is acute in poor, urban neighborhoods and in communities of color. Half of African-American youths and a third of Latino youths born in 2000 are expected to develop Type 2 diabetes at some point in their lives.

Back in 2011, Dr. Dean Schillinger heard Erica Sheppard McMath's poem, " Death Recipe" at a Youth Speaks event. The poem recounts the struggle of McMath, now 22, to stay healthy while much of her family struggles with obesity and diabetes:

It's like knowing most of your family has diabetesbut your still smacking on sour patchesas you're walking your aunt to her dialysis appointmentIt's like Auntie Marlow being blind at 32It's like Grandma Susie dying from a heart attack at 51It's like cousin Kieara shooting insulin in her nine year old arm

"Young people can be such vocal and articulate revolutionaries in ways that old-fart doctors can't be," Schillinger says. He started the partnership between UCSF and Youth Speaks because he thought poetry could be a way to spark more conversations with young people about Type 2 diabetes.

The collaboration aims to shift the focus of the diabetes epidemic away from people's personal decisions. Schillinger says that Type 2 diabetes needs to be talked about in terms of a social disease.

The Bigger Picture holds workshops for teens and young adults to teach them about diabetes and to help them translate their reactions to the information into poetry.

Some of the best poems have been turned into short films that the organizers see as public service announcements. They've made about 20 so far, ranging from personal stories like McMath's to an over-the-top commercial satire called " Block O' Breakfast."

The Bigger Picture also takes its show on the road, conducting high school assemblies. So far, the team has worked with 40 poets and about 2,500 students in Northern California.

Twenty-nine-year-old José Vadi, who participated in the first Bigger Picture workshop and later facilitated them, now helps direct the project at Youth Speaks. He says that Type 2 diabetes is as much about class and access as it is health and diet.

"If you're traditionally disadvantaged economically, and you don't have the time to prepare a meal with fresh ingredients and whatnot, the idea of ... just putting something in your body to not be hungry, speaks to larger issues of inequality," Vadi says.

The Bigger Picture community also looks at the role food and beverage industries' marketing to minorities has played in the rise of diabetes. In the poem " A Taste of Home," 21-year-old Monica Mendoza says that "dinner has become an expedition where we lick our plates clean and swallow cups of nostalgia — nostalgia that isn't even from our own country. Our tongues have been colonized with the belief that this cup of Coke is home."

Cortez says he hopes the Bigger Picture poems will inspire youth anywhere in the country to write down their own experiences in a poem or a song, or to talk to their parents and friends "in a way they hadn't been able to before."

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