Mallory Rogers

A Forced Issue: Diabetes in Native Americans

During an in-class discussion, it was brought to our attention that among Native Americans there is an unusually high number of reported diabetes cases—a notion I was unaware of until it was brought up. I wanted to learn more about this and have found a plethora of resources which reinforce the fact that diabetes and its complications are one of the leading causes of deaths among not only Native Americans, but also those from additional minority cultures as well.  According to the National Institute for Diabetes and Digestive and Kidney Diseases, the "thrifty gene" theory proposes that African-Americans, Hispanic-Americans, Asian Americans and Native Americans inherited a gene from their ancestors which enabled them to use food more efficiently during "feast and famine" cycles…and today there are fewer such cycles; causing these populations to be more susceptible to obesity and to developing type 2 diabetes.” Through my research, I would like to find more information on why this occurs and also if there are any proposed methods in place for alleviating this issue.

My first source is a report released in 2004 by The U.S. Commission on Civil Rights named Broken Promises: Evaluating the Native American Health System.  This government publication (found online at http://www.usccr.gov/pubs/nahealth/ nabroken.pdf) was initially created as a response to the multiple noted health problems that Native Americans are facing today. In it “intentional and unintentional racial discrimination” is uncovered through the identification of seven categories, including: limited access to healthcare services and facilities, poor access to health insurance; insufficient federal funding; quality of care; availability of culturally competent health services; disproportionate poverty and poor education; and behavior and lifestyle choices. In Chapter 2 specifically, Native Americans’ health behaviors and lifestyles are closely scrutinized. While it is noted and agreed upon that all individuals choose their own lifestyle behaviors and choices, for Native Americans their choices are more limited based on the effects of discrimination they have endured. Because the dominant culture pushed Native Americans into rural areas, they are forced to make do with what they were given—unfertile land and isolate locations.  The lack of economic prosperity in reservations has directly impacted Native Americans, earning them the highest level of poverty among American minorities and because of this the majority of Native Americans are forced to depend on welfare and government help just to put food on the table. While Native Americans began receiving assistance from the American government in the form of canned meat, fish, breads, beans, sugar, and coffee this has changed dramatically over time.  According to State of Science: a Cultural View of Native Americans and Diabetes Prevention there were calls to action to improve the quality of food assistance Native Americans were given. But because nutritious food is historically more expensive than food high in fat, many Native Americans are left with no options as the government has not changed its quality of food assistance. Thus, Native Americans are consuming entirely too much fat on a daily basis, which leads to multiple health problems--most commonly diabetes (more Native Americans have been diagnosed with diabetes than any other American minority group).  The lack of stores and fitness centers in rural areas where Native Americans historically reside only add to these problems, per the report. 

As the sixth leading cause of death among Native Americans, Diabetes has become an undisputed epidemic for this minority culture.  The first steps in truly addressing the problem have to come from the source realizing that there is an issue that needs to be dealt with. In Listening to Concerns about Type 2 Diabetes in a Native American Community, Diane Berry and her colleagues address Native Americans reactions to this undeniable growing plague of health issues, more specifically type 2 diabetes. Through the study, Native American elders and parents coherently agreed that this was an important issue that needs to be addressed; but, they also identified characteristics that hindered their culture’s ability to do anything about it. Barriers identified include the overall demands of everyday living, the inflated costs of consuming a well-balanced diet, a general lack of awareness/education about diabetes, and the desire to uphold customary family traditions. While the elders interviewed were hesitant to reveal any pertinent family history, they came up with a solution: their culture would support a system where family members could access their medical history, as long as it remained confidential to outsiders. Next, the group moved to expressing interest in an on-site health facility that had access to subsidized medications and employed quality doctors as many were concerned that the doctors they currently see aren’t interested in preventative measures, regardless of the history they do know.  Rounding out the discussion, the study says that Native American elders want to learn to eat healthier, but they need someone to tell them how. Their suggestion is a time-management program that can teach them how and what to cook that is both simple to make and easy on the wallet—characteristics that picking up fast food offers.

I am looking forward to finding out more about Native Americans and their association with heightened health issues. While I began my research hoping to learn more about the “thrifty gene” as it relates to multiple minority cultures, I have found myself shifting my focus to the direct impact diabetes has on specifically Native Americans.  In Black Elk Speaks, we are given an abundance of information regarding Native American’s diets and how they evolved to change from their natural means.  After the whites began to “kill and kill the bison just because they can do that” as Black Elk says, Native Americans diets and lifestyles were impacted tremendously.  When the whites forced the Native Americans into solitude and took away their weapons they left them with no options other than succumb to what they wanted—for Native Americans to rely on the dominant white culture.  Per correspondence with Dr. White, these ideas are further supported because he says, “when English diets, foodstuffs, and food preps started penetrating the Indian lifestyle, the Indians started feasting more often and their preferences ran to fried food, high carbohydrate foods, etc., leading to diabetes, which also resulted from less strenuous lifestyles as men changed from hunting to agriculture or various forms of welfare as their economic / ecological infrastructure was lost.”  In continuing my research, I hope to learn about the “thrifty gene” and other issues in Native American culture that are caused by health issues including what steps the Native Americans, and possibly even the American government, are taking to create lasting and worthwhile change.

Bibliography

Berry, Diane, et al. "Listening To Concerns About Type 2 Diabetes in a Native American Community." Journal of Cultural Diversity 16.2 (2009): 56-63. Academic Search Complete. 11 March 2010.

Edwards, Karethy (Kay), and Beverly Patchell. "State of the Science: A Cultural View of Native Americans and Diabetes Prevention." Journal of Cultural Diversity 16.1 (2009): 32-35. Academic Search Complete. 11 March 2010.

U.S. Commission on Civil Rights. (September 2004). Broken Promises: Evaluating the Native American Health System. Retrieved from http://www.usccr.gov/pubs/nahealth/nabroken.pdf.

White, Craig. (whitec@uhcl.edu).  "Midterm Response."  E-mail to Mallory Rogers (rogersm8975@uhcl.edu). 8 March 2010.