Analyzing Diabetes Among Native Americans: Health Disparities & Equity

This report critically examines the public health issue of diabetes among Native Americans, highlighting the significant disparities and social determinants contributing to its prevalence. It discusses how individual factors like poor health literacy and lifestyle choices, interpersonal factors like religious beliefs, community factors like poor socioeconomic status, and policy factors all contribute to the increased vulnerability of Native Americans to diabetes. The report emphasizes the need for targeted policies and interventions that address these social determinants to reduce the burden of diabetes within this population. It cites various studies and data to support its claims, underscoring the importance of healthcare professionals advocating for policies tailored to the specific needs of Native American communities.

Running head: DIABETES AMONG THE NATIVE AMERICANS
DIABETES AMONG THE NATIVE AMERICANS
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Diabetes is one of the most common and costly chronic ailment that had resulted in huge
burden on the healthcare system of the nation of United States. This disorder results in increase
of the blood glucose level of the body. Under normal condition, insulin hormone released from
pancreas helps the cells of the body to become responsive to glucose in the blood and accept the
glucose inside them for cellular respiration and production of energy. In this way, the blood
glucose level is maintained. In diabetes, the cells of the body become insulin resistant and hence
they cannot take to glucose increasing their level in blood (James, 2015). This action results in
abnormal physiological interactions of the body where organs do not get energy to function and
fail in course of time leading to threatening situations. In the present date, various studies are of
the opinion that social determinants of health contribute to development of diabetes. Therefore,
only caring for biological determinant cannot ensure quality life of the patients. Healthcare
professionals need to address such social determinists of health successfully to ensure lowering
the prevalence of diabetes in nation. This assignment will show hoe various determinists need to
be addressed to reduce the burden of the disorder among American natives.
About 23.1 million people in the nation are diagnosed with diabetes that cost around
$245 billion every year. The CDC had estimated that another 7.2 million people have diabetes
but they are still undiagnosed while another 84.1 million adults of 18 years and above have pre-
diabetes. The main ethnic population that is found to be mostly affected by this chronic ailment
is the Native Americans comprising of the American Indians and the Alaskan Natives. Data by
American Diabetes organization had showed that Native Americans comprise of the 15.1% of
the affected population by diabetes (Pollack, 2018). This is then followed by 12.7 5 of the non-
Hispanic blacks. Such percentage is seen to decrease further among the Hispanics, Asian
Americans and the non-Hispanic whites. Data has also found that they are almost twice likely to

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die from diabetes as that of the non-Hispanics. The Native Americans are 2.4 times as likely as
white adults to be diagnosed with diabetes. High prevalence of kidney disorder is present among
the Native Americans as a complication arising from unmanaged diabetes. In the year 2010,
Native Americans were found to be 2.7 times more likely to be diagnosed with end stage
disorder than the non-Hispanic whites (Ehrhart et al., 2017).
The social ecological model has four important domains that need to be analyzed to find
out the causes of increased vulnerabilities of the Native Americans towards diabetes. One of the
individual factors that contribute to the disorder is poor health literacy and lack of completion of
education. An important social determinant of health is lack of education that is also seemed to
be associated with high rate of diabetes among the Native Americans. It has been found that the
percentage of the Native Americans who had attained an associate degree or higher in the year
2017 was 27% as compared to that of 54% of the white students (Strings et al., 2016). Only 165
of the Native Americans had attained a bachelor’s degree in 2017 to that of 42% of the white
students. Therefore, it can be found that health literacy among the Native Americans is also quite
low because lack of proper education among them. Poor lifestyle choices and inappropriate
health behaviors like sedentary lifestyles make them prone to develop obesity and diabetes and
they are also not aware of the significance of screening sessions. These make them more prone to
develop the disorder.
Another important causal factor that falls in the category of interpersonal factors of the
social ecological model of diabetes occurrence is the religious beliefs that are harbored among
their families, friends and societies. Their religious belief is another social determinant. They
believe that disorders take place when people fall out of the systems of the universe set by the
Great spirits due to their improper practices in lives. Their beliefs entirely on natural healers and

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not undertaking medicine treatment are annoyer factor for increased diabetes prevalence among
them (Jaacks et al., 2016).
Another important domain is the community domain and the causal determinant may be
the poor socio-economic status shared by the people of the community. One of the most
important social determinants of health that expose the Native Americans to the development of
diabetes is their poor socioeconomic status. Poor socioeconomic cohort of people is found to be
more vulnerable to the development of diabetes (Daley et al., 2017). Native Americans are found
to belong to such cohort in the nation. Another social determinant of health that contributes to
diabetes among the group is lack of employment and income opportunities. This social
determinant share positive correlation with that of the development of diabetes. It has been found
that people belonging to such cohort and with poor income cannot buy quality organic and
nutrient dense food that are expensive. They have to settle with cheap calorie dense fast foods or
take-away foods that increase the chances of obesity. Obesity is one the risk factor for diabetes
and hence such social determinants make the ethnic group more vulnerable to the disorder. Race
and ethnic background of people is also a contributing risk factor where Native Americas are
more vulnerable to develop the disorder than whites.
Another important domain that needs to be discussed is the policy or the enabling
environment. It has been found that this ethnic group is more vulnerable to develop diabetes than
their white counterparts. Hence, a policy that addresses diabetes issues of the entire nation would
not be beneficial. It is important for the government to not provide the entire responsibility on
the Indian health services but also develop policies exclusively for Native Americans (Mercader
et al., 2017). Healthcare professionals should advocate for the need of a policy for prevention of

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diabetes exclusively for them that would address their needs as well as the social determinants
that affect them.
From the above discussion, it has been found that Native Americans are more prone to
developing diabetes than that of the whites. Therefore, professionals need to be research about
the social determinants of health and then allocate interventions that would help in addressing
such issues successfully. This would help in reducing the diseases burden of diabetes from
United States successfully.

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References:
Daley, C. M., Hale, J. W., Berryhill, K., Bointy, S., Clark, L., Chase, B., ... & He, J. (2017).
Diabetes Self-Management Behaviors among American Indians in the Midwestern
United States. ARC journal of diabetes and endocrinology, 3(1), 34. doi: 10.20431/2455-
5983.0301005
Ehrhart, M. D., Shah, V., Colip, L., Sandy, P., Ghahate, D., Bobelu, J., ... & Burge, M. R. (2017).
Predictors of Physical Fitness among Southwestern Native American Adolescents at Risk
for Diabetes. Journal of pediatric endocrinology (Jersey City, NJ), 2(1).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5722221/
Jaacks, L. M., Siegel, K. R., Gujral, U. P., & Narayan, K. V. (2016). Type 2 diabetes: a 21st
century epidemic. Best Practice & Research Clinical Endocrinology &
Metabolism, 30(3), 331-343.
https://www.researchgate.net/profile/Johnny_Deladoey2/publication/
316311754_Disorders_of_Thyroid_Morphogenesis/links/5a2d8382a6fdccfbbf8989db/
Disorders-of-Thyroid-Morphogenesis.pdf
James, K. (2015). Science and Native American Communities. In Science, Religion and
Society (pp. 68-80). Routledge.
https://www.taylorfrancis.com/books/e/9781317460138/chapters/10.4324/978131570086
1-15 https://www.frontiersin.org/articles/10.3389/fpubh.2017.00329/full
Mercader, J. M., & Florez, J. C. (2017). The genetic basis of type 2 diabetes in Hispanics and
Latin Americans: Challenges and Opportunities. Frontiers in public health, 5, 329.

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Pollak, M. (2018). Care in the Context of a Chronic Epidemic: Caring for Diabetes in Chicago's
Native Community. Medical anthropology quarterly, 32(2), 196-213.
https://doi.org/10.1177/014572170002600112
Strings, S., Ranchod, Y. K., Laraia, B., & Nuru-Jeter, A. (2016). Race and sex differences in the
association between food insecurity and type 2 diabetes. Ethnicity & disease, 26(3), 427.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948811/