Amid national concern about rising rates of diabetes and obesity, which often coincides with Type 2 diabetes, one population stands out as facing an exceptional risk: Native Americans.
Native Americans face more than double the risk of receiving a diagnosis of Type 2 diabetes than Caucasians. Type 2 diabetes is a disease marked by high levels of blood sugar, created by the body’s difficulty processing the hormone insulin. Complications include nerve damage and pain known as neuropathy, as well as eye and skin problems.
The diabetes epidemic is especially challenging in Arizona, where Native Americans face the highest recorded rates of diabetes in the world, according to the Society for Public Health Education (SOPHE). Even outside of Arizona, rates remain high, and Native Americans have the highest rates of diabetes among all other ethnic groups in the U.S.
November is Native American Heritage Month, making it a good time to discuss the health risks faced by indigenous communities. Native American Heritage Month is an initiative designed to celebrate indigenous cultures, but also intended to raise awareness about pressing issues modern tribal citizens face. In a community that navigates innumerable challenges, the diabetes epidemic is one of the most serious.
Native Americans face some of the highest rates of diabetes in the world.
The risks of diabetes faced by Arizona’s Native Americans are 245% higher than average, reports SOPHE. Not only are these groups more likely to develop diabetes, but they’re also almost twice as likely to die from it than others in the general U.S. population.
Rates of diabetes among indigenous communities have risen over the past few decades. From 1994 to 2004, rates of diabetes among Native Americans youths, including native tribes from Alaska, has increased by 68%, according to the American Diabetes Association (ADA). That’s among teens aged from 15 to 19. Type 2 diabetes is most common to develop in tribal members; Type 1 is relatively rare.
In addition to these already startling numbers, about 30% of Native Americans have pre-diabetes, which means they have higher-than-average blood sugar levels that do not yet fall into the range for diabetes.
Native Americans face problems including high rates of poverty, obesity, and alcoholism that increase risk and complications of diabetes.
Diabetes is the fourth leading cause of death in Native communities, according to the Centers for Disease Control and Prevention (CDC). The rates of diabetes have skyrocketed as nutritional habits in the communities have changed in favor of processed foods and people get less physical activity, according to a report from the National Institute of Diabetes and Digestive and Kidney Diseases.
High rates of poverty also make it difficult for many people to pay for high-quality, nutritious food. The median household income for Native Americans is $37,353 compared to a $56,565 in Caucasian households, according to the Office of Minority Health.
One Native American charity reported visiting four Navajo elders to drop off fresh fruits and vegetables, whole grains, and white meats in hopes of convincing them to add some new, fresh foods into their diets. However, the elders were surviving on $400 to $650 each month, making it difficult to pay for healthy food. Their bodies were also weak from diabetes, making it difficult to start a new exercise program.
Public health initiatives reach out in an effort to improve the health of Native Americans.
Several Arizona initiatives have been developed to target high rates of diabetes, reports SOPHE. The Ajo Diabetes Outreach and Education Program, for instance, was organized to improve residents’ health in the form of outreach programs.
Some education initiatives were designed to teach patients how to better manage the condition, but others were targeted to reduce the risk among patients’ family members. Diabetes tends to be hereditary, but is often preventable through proper diet and exercise.
Another public health initiative took place on the Tohono O’odham tribe. The Food, Fitness and Wellness Initiative Project focused on disease prevention through increasing access to healthy food. As part of the program, students on the reservation were served meals cooked with the traditional food tepary beans. The efforts were successful and soon students were voting in favor of tepary beans over other foods, even pizza.
On a statewide level, the Arizona Diabetes Program works to implement prevention initiatives and treatment efforts to improve the lives of those already living with diabetes.
Nationally, the U.S. Department of Health and Human Services’ Indian Health Service has a special Division of Diabetes Treatment and Prevention (DDTP). The division works with local health service departments, providing information and training, and it administers a $150 million annual grant program known as the Special Diabetes Program (SDP). The grant money pays for various programs that are designed to make an impact on tribal citizens’ health.
The division also works with ADA to implement SDP initiatives. ADA works with tribal members, helping them to become politically active and ensure the funding remains in place. Native Americans are encouraged to tell their stories of how fear and suffering turned into hope and health as a result of outreach efforts and lifestyle changes.
ADA and DDTP also work together on a culturally sensitive program called Awakening the Spirit. Awakening the Spirit works with communities to encourage healthy food choices and more physical activity. The website says:
“Years ago, Native Americans did not have diabetes. Elders can recall times when people hunted and gathered food for simple meals. People walked a lot. Now, in some Native communities, one in two adults has diabetes.”
That stark reality inspires many who work to reduce the rates and help tribal citizens regain their health. An Awakening the Spirit subcommittee is made up of tribal members from across the nation. The group’s intention is to join forces and spread the message that taking care of the body is a spiritual imperative, and that those positive lifestyle choices reverberate throughout the community, improving lives for all.
Are you a Native American who has experienced the impact of diabetes? Tell your story.
Image by Adam Jones via Flickr
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