This study was designed to 1) discover the strategies diabetes patients employ as they negotiate the economic and other structural factors influencing their everyday lives and 2) find out about participants’ ability to maintain good health in light of the interaction between participants’ personal health care strategies and the effects of each person’s strategy implementation on their overall effectiveness in chronic disease management. I collected quantitative descriptive data and qualitative interview data from 32 participants, visiting with participants for extended periods of time at Health for Friends clinic and in the homes of 15 of these participants. My study results yielded nine thematic areas of data about the complex structural and macro level impacts on individual diabetes management. The results of this study can be used to modify and formulate new local, state, and national public health programs that serve marginalized patient populations. The findings from this study will also contribute to theoretical understandings of the relationship between socioeconomic inequality and individual health behaviors and decision-making. Additionally, study results can be applied to research on other health disparities in other regions in the United States and across the world where certain groups of people are unequally suffering from a disease.