Since the arrival of Columbus in 1492, American Indians have been in a continuous struggle with diseases. It may not be small pox anymore, but illnesses are still haunting the native population. According to statistics, have much higher rates of disease than the overall population. This includes a higher death rate from alcoholism, tuberculosis, and diabetes than any other racial or ethnic group. Recent studies by Indian health experts show that diabetes among Indian youth ages 15-19 has increased 54% since 1996 and 40% of Indian children are overweight. Even though diabetes rates vary considerably among the Native American population, deaths caused from diabetes are 230 percent greater than the United States population as a whole.
Diabetes is an increasing crisis among the Native American population. Diabetes is a disease that affects the body’s ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: type 1, or juvenile diabetes, which usually occurs during childhood or adolescence, and type 2, or adult-onset diabetes, the most common form of the disease, usually occurring after age 40. Type 1 results from the body’s immune system attacking the insulin-producing cells in the pancreas. The onset of juvenile diabetes is much higher in the winter than in the summer. This association has been repeatedly confirmed in diabetes research.
Type 2 is characterized by “insulin resistance,” or an inability of the cells to use insulin, sometimes accompanied by a deficiency in insulin production. There is also sometimes a third type of diabetes considered. It is gestational diabetes, which occurs when the body is not able to properly use insulin during pregnancy. Type 2 diabetes encompasses nine out of 10 diabetic cases.
Diabetes is the fifth-deadliest disease in the United States, and it has no cure. The total annual economic cost of diabetes in 2002 was estimated to be $132 billion, or one out of every 10 health care dollars spent in the United States. Diabetes risk factors can fall into three major categories: family history, obesity, and impaired glucose tolerance. Minority groups and elderly are at the greatest risk of developing diabetes. Native Americans did not have a problem with this affliction until this past century. Diabetes is strongly affected by behavior.
Due to a sudden change in diet and lifestyle, Native Americans have experienced a sharp and sudden rise in diabetes. When the Native Americans were forced onto reservations they stopped hunting and preparing their own food. Instead the United States government gave them food that their bodies were not used to digesting. Indians were not used to eating flour, lard, canned meats and poultry that are swimming in fat, and canned fruits and vegetables packed in sugary syrup. Native Americans’ bodies could not handle the extra fat and sugar in their diet. This, coupled with a decrease in intense exercise, increased obesity and brought on the rise of diabetes.
The sudden lack of exercise resulted in a significant weight increase in the Native American community. Indians were used to roaming the countryside. They had to follow the buffalo or move to warmer weather. Now, they were put into permanent homes and bought their food. This created an overweight, obese group of people. Studies estimated that the overall occurrence of obesity among Native Americans was 13.
7 percent for men and 16. 5 percent for women. These are higher than the United States’ rates of 9. 1 percent and 8.
2 percent, respectively. It is reported that the United States spends $93 billion a year on preventable obesity- related illnesses and diseases. When most of us think of the great Indians of the last century, we think of a thin, well-defined figure standing stern and serious. When we think of a modern Indian, we have an image of a larger, more rounded type of person. Of course this is not the description of many Indians, but many would agree this is the image many people have. A rounded, non-chiseled face has replaced the classic Indian, high cheekbone, profile.
Being overweight makes it harder for bodies of Native Americans to keep blood sugars at a normal level. The result is type 2 diabetes, which Native Americans most commonly get. Type 2 diabetes is not as serious as type 1, but still has serious affects if not properly attended. Today, diabetes has become widespread among Native Americans. The problem seems to be growing faster than the resources for dealing with it. Complications from diabetes are a major cause of death and can cause serious health problems in most Native American populations.
On average, Native Americans are 2. 2 times more likely to have diagnosed diabetes as non-Hispanic whites of similar age. 12. 2% of American Indians over 19 years of age suffer from type 2 diabetes.
A tribe in Arizona, the Pimas, has the highest rate in the world. About 50% of Pimas between ages 30 and 64 have diabetes. According to Joe Jacobs, “The disease is real to our children. They ” ve seen what it does to family members.
Our leaders need to open their eyes and hearts and slow this disease.” More and more young people are starting to realize the severity of this disease by watching their family members go through all of the effects. “My grandparents on both sides and both my mom and dad have it, so there are lots of points against me,” says Donna Young, a 25 year old Pima Indian. The biggest changes in the families with children who are at risk are a change in the diet and physical fitness, even though diabetes can be hereditary. “Women who were drinking sugar-sweetened soft drinks every day, or more than once a day, had an 80% increase in risk of diabetes compared with women who hardly ever drank sugared sodas,” said Dr. Meir Stamp her of Harvard School of Public Health in Boston, following the release of new national research. The consumption of too much sugar without proper exercise can lead to excess sugar in the blood cells causing poor circulation.
This causes wounds to improperly heal, which can result in infection and possibly amputation. Diabetes is the most frequent cause of non-traumatic lower limb amputations. The risk of a leg amputation is 15 to 40 times greater for a person with diabetes. Each year 82, 000 people lose their foot or leg to diabetes. Amputation rates among Native Americans are 3 to 4 times higher than that of the general population. In addition, diabetic subjects with amputation had a higher death rate than that among non amputees.
Some of the earliest symptoms of diabetes include extreme thirst and frequent urination, caused by the body’s attempts to flush out the accumulated glucose in the blood. Diabetics are susceptible to tiredness and even blackouts because of low blood sugar. Heart disease strikes people with diabetes twice as often as people without diabetes. People with diabetes are five times more likely to suffer strokes, and once having had a stroke, they are two to four times as likely to have a recurrence. Kidney disease is also a major problem with diabetic Native Americans. Pima Indian men and women with diabetes have higher death rates than those without.
The major cause of this higher risk of death among diabetic subjects is increased deaths from kidney disease, ischemic heart disease, and infections. With the discovery of all the known consequence of diabetes, doctors are working on ways to prevent the disease so many people will not have to deal with the long term effects. According to studies, about 50 percent of the diabetic population remains undiagnosed. “It becomes progressively more difficult to take care of this enormous population. Once people develop diabetes, it’s almost too late. They probably had diabetes four to five years earlier.
So whatever damage it is doing is already under way.” Says David M. Nathan, the chief investigator for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) study and director of the diabetes center at Massachusetts General Hospital in Boston. People with diabetes can reduce their risk for complications if they are educated about their disease, learn and practice the skills necessary to better control their blood glucose, blood pressure and cholesterol levels, and receive regular checkups from their health care team. Smokers need to stop smoking and overweight people need to develop a moderate diet and get plenty of exercise. People could also reduce their consumption of carbohydrates, which raise blood-sugar levels. Ginger Kenzer-Lewis, president of the American Association of Diabetes Educators, stated “Diabetes is often controlled by how patients eat and exercise and their commitment to control their diabetes.” Studies have also shown that many patients with diabetes also have depression and that depression may affect their control over diabetes.
In this case, doctors are working on screening and treatment for depression, which will in turn help the patient treat diabetes. The government has also gotten involved. The Balanced Budget Act of 1997, signed by President Clinton on August 5, 1997, made available $150 million of new funding to the Indian Health Service (IHS) through Grants for Special Diabetes Program for Indians. The purpose of this legislation was to provide “services for the prevention and treatment of diabetes.” These services were to be provided at Indian health facilities operated by IHS, Indian tribe or tribal organizations, and urban Indian organizations. The funds were to be distributed as grants over a five year period, at a rate of $30 million a year. In December, 2002, Congress took a step by expanding the Special Diabetes Program for Indians to include $100 million to tribes and tribal organizations for diabetes treatment, research, and prevention.
However, it is not just the government who has ideas on prevention. Gina Gabreille, the head of the Department of Justice at Leech Lake Tribal College, said “Indigenous populations all had their own specific diets.” Gabrielle holds a doctorate in homeopathy and master’s degrees in Oriental medicines and criminal justice. By going back to natural food sources she said she believes Indigenous people will lose their dependency on pharmaceuticals and processed foods. “With herbs, you are going to bring the body back to a natural balance.
All our bodies want to do is heal and work right.” However, she also says you should not self dose and do not run out to the nearest health food store and start buying vitamins and herbs indiscriminately. Parents and children should take control over their lives and make the kind of decisions that will lead to long, healthy, and productive lives. Former NFL all-star Nick Lowery believes a healthy start for kids involves the emotional, mental, physical, and spiritual part of the child, with sports being the catalyst. Fitness centers on reservations are becoming increasingly popular. Fitness is a major factor in reducing glucose in the blood. Statistics show that exercise will reduce type 2 diabetes by about 45%.
Exercise at a young age can prevent the onset of type 2 diabetes and at the age when the diabetes has developed it can reduce the effect. Native Americans need to learn to prepare and eat different foods in order to eliminate this problem. They need to learn to adapt to their new situation in order to survive. One of the hardest obstacles to overcome is getting the people to alter their diet before they enter into a higher-risk category, or who have already developed the disease.
The sudden and recent change in the Native American way of life has prompted many problems, with diabetes being one of the most serious. Through education of the disease, and strict dietary and exercise routines the problem can be controlled. American Indians need to take these steps to make sure their culture is preserved. The global death toll from diabetes exceeds the 3 million killed by AIDS. Nobody can change what has happened to the Native Americans in the past, but they can change what will happen to them in the future.
Great Spirit: We thank you for your blessings that have provided the healthy foods to nourish our bodies. May we learn to appreciate and not take for granted all that we know to us healthier. May we open to accept change that will benefit not only ourselves, but also our children as well. Georgia Perez Nambe Pueblo, NM Bibliography Primary Source: Indian Health Service, “IHS Standards of Care for Patients with Type 2 Diabetes (August 2003) “; available from web; Internet; accessed 23 November 2004.
National Institute of Diabetes and Digestive and Kidney Diseases, “The Pima Indians: Pathfinders for health”; available from web Internet; accessed 23 November 2004. Newspapers: Campbell, Senator Ben Night horse. “Campbell: Working together for healthy youth, healthy tribes.” Indian Country Today, 29 September 2003; available at web Grief, Christine. “Traditional wampum carries message of health.” Indian Country Today, 19 June 2003; available at web May, James. “Urban Indians suffer health problems at higher rates.” Indian Country Today, 21 April 2004; available at web M elmer, David. “The War against diabetes.” Indian Country Today, 17 November 2001; available at web Nor rell, Brenda.
“Soft drinks- Diabetes in a can.” Indian Country Today, 09 September 2004; available at web Pier point, Mary. “Leech Lake woman links health and non-traditional diets.” Indian Country Today, 14 June 2000; available at web Ross, Matt. “Diabetes education with a twist.” Indian Country Today, 22 April 2004; available at web Reynolds, Jerry. “Washington in brief.” Indian Country Today, 23 July 2004; available at web Books and Journals: Jost, Kenneth. “Diabetes Epidemic: why is this serious disease on the increase?” The CQ Researcher (March 9, 2001): 185-200 IHS National Diabetes Program. Special Diabetes Program for Indians.
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Changing Numbers, Changing Needs: American Indian Demography and Public Health. Washington, D. C. : National Academies Press, 1996. Seiffge-Krenke, Inge.
Diabetic Adolescents and Their Families: Stress, Coping, and Adaptation. Cambridge, New York: Cambridge University Press, 2001. Internet Sources: American Diabetes Association, “Native Americans and Diabetes”; available from web Internet; accessed 11 November 2004.