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Dr. Donald Warne talks about how cultural loss impacts the health of Native American tribes in Arizona. The damming of rivers plunged local tribes into poverty, dependence and ultimately poor health. Deprived of their language, land, livelihood and traditions, many Native Americans have developed a fatalistic view about diseases like diabetes.
In some Native American communities, diabetes is so common that people grow up feeling that it is in some ways, inevitable. "I don't have diabetes yet," is what Dr. Warne often hears from his patients. Yet hope for the future is an important factor in preventing and controlling diabetes - something health care practitioners need to take into account when treating patients.
The U.S. government has spent hundreds of millions of dollars over the past 40 years trying to uncover a biological explanation for why the Pima Indians of southern Arizona have one of the highest rates of diabetes in the world. But as Dr. Donald Warne tells us, diabetes was extremely rare here 100 years ago. What's changed? Not biology but environment.
Competing agendas drive the distribution of resources when it comes to diabetes care and prevention. We spend most of our dollars on late-stage care, which not coincidentally is highly profitable to companies that provide those services. To reduce diabetes rates among Native Americans and other populations, we have to advocate for policies that will invest more resources in primary prevention and underlying social conditions.
Historically, federal Indian policies have been destructive to Native American communities - ranging from removal to assimilation and termination. These policies have had a negative impact on health and health-related behaviors. More recent trends towards self-determination and tribal control provide reason to hope.
The Gila Crossing Elementary School in southern Arizona was once operated by the Bureau of Indian Affairs. When the local tribe took it over, community members created a gardening program to teach children about their cultural heritage as farmers, to encourage healthy eating, and to foster their development and future interest in agriculture.
As Dr. Donald Warne explains, there is a direct biochemical connection between living in poverty and blood sugar levels. The stress of being poor and of having family members die young creates a complicated web of cultural values and beliefs that make controlling diabetes more difficult. Add to that the lack of availability of healthy food and it's no wonder diabetes rates are high.
Modern medicine teaches a rigid, scientific approach to disease prevention. Yet practitioners like Dr. Donald Warne argue that to be effective, health care programs must be locally controlled and responsive to the needs and beliefs of diverse individuals and groups. For Native Americans in particular, role models and interventions must come from within the community.
Dr. Donald Warne explains that Native Americans are the only U.S. group born with a legal right to health care. Historically, however, American Indian health care programs have been inadequately funded, especially compared with other federally subsidized health care.
Terrol Dew Johnson, featured in the "Bad Sugar" segment of UNNATURAL CAUSES, is co-founder of TOCA, a community-based organization focused on cultural renewal as key to empowerment and better health. TOCA has four primary program areas: basketweaving, traditional foods, youth/elder outreach and traditional arts and culture. www.tocaonline.org
The Tohono O'odham and Pima Indians of southern Arizona have perhaps the highest rate of diabetes in the world. Yet the disease was virtually unknown here 100 years ago. Over the last century, the diversion of river water to upstream white settlements cost the O'odham their crops, livelihood, traditional diet, culture and health. Today, community advocates hope that restoring water and renewing culture can help improve health.
DID YOU KNOW:
The richest Americans live on average 6.5 years longer than the poorest; two years longer than the middle classes.