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Tribe’s War on Diabetes Starts to Pay Off
by Jeremy Olson
In the days when they hoofed by the
thousands across Nebraska, buffalo meant
everything to Indian tribes: They were
spiritual symbols of freedom. Their furry
hides served as shelter and clothing.
Moreover, their low-fat, low-cholesterol
meat was the mainstay of a healthy diet.
But when the buffalo all but vanished
from the Great Plains, the food source
that replaced them proved far less healthy
- starting with the lower-grade beef and
salt pork provided to the reservations
by the federal government in the
late 19th century and evolving
into the cheap cheeseburgers and
microwave burritos of the modern
fast-food era.
This shift coincided with some startling health problems for American Indians, who were combining poorer eating
habits with inactive lifestyles on the reservations.
Diabetes took a particularly devastating
toll on the Indians, who consequently suffered kidney failure, blindness and amputation of feet and legs.
After watching beloved tribal leaders
die at age 40 or 50 because of the
disorder, members of the Winnebago Tribe
of northeast Nebraska declared a “war
on diabetes” over the past decade. At a
recent conference in Omaha, tribal leaders said it is a war they are starting to
win, and they encouraged other tribes
and communities to look at the physical,
emotional and spiritual efforts that have
helped them succeed.
“It’s that warrior spirit,” said Scott
Aldrich, Sr., a trainer for the Whirling
Thunder Wellness Program that is central
to the Winnebago Tribe’s efforts. “They
say that warriors will do anything possible
to survive.”
The tribe’s strategies include a blend of
modern health tips, such as exercising on
treadmills and stationary bicycles, and old
traditions. One of those is reintegrating
historical American Indian staples - such
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as buffalo meat - back into the diet.
“We didn’t start getting sick until that traditional food source was disrupted from
our diet,” said Lorelei DeCora, a Winnebago registered nurse. “So it makes
sense to renew our bodies with that traditional food source.”
By the state’s numbers, Indians are the
most unhealthy and the most economically disadvantaged people in Nebraska.
They die on average nearly 10 years
earlier than white Nebraskans. They suffer
proportionally higher risks of cancer, sexually transmitted diseases, heart disease,
homicides and fatal car accidents. One
in four American Indian mothers in
Nebraska receives inadequate prenatal
care.
But it is the frightening grip that diabetes has on the American Indian community that is particularly alarming. Indians are four times as likely as whites
to have diabetes and to suffer diabetesrelated deaths.
That is apparent when
looking at the 1,280-member
Winnebago Tribe. DeCora estimated that as many as two-thirds
of the people older than 45 have
been diagnosed with Type 2 diabetes.
The Indian Health Service hospital,
which is based on the Winnebago Reservation and serves Nebraska, Iowa and the
Dakotas, has a list of 827 registered diabetics. Most are from the Winnebago reservation.
Take the example of Cherie LaPointe,
who assists DeCora in setting up
“talking circles” so that Winnebago tribal members can deal
with diabetes as a community.
LaPointe doesn’t have diabetes
and is taking preventive steps by
riding a stationary bike once a day and
playing volleyball at the fitness center. But
her father died from complications of diabetes, and her mother, an older brother
and two sisters have it.
“It certainly motivates me to do my job,”
she said.
Diabetes is the result of the body’s
inability to produce enough insulin, which
regulates the body’s metabolism of glucose, or its inability to use insulin effectively. It is treatable - but so far, incurable.
DeCora said that is why the community
had to get involved. People needed to
learn that diabetes is treatable and preventable if they make the right health
choices.
To that end, DeCora established talking
circles at the Winnebago and three other
Midwest reservations to study whether
communication at the local level could
encourage efforts against diabetes.
She also encouraged tribal members
to plant gardens for exercise, to provide a
source of healthful food and to reestablish
a spiritual connection with the earth - a
connection she said is lost in the massproduced world of fast food.
“Before we can start talking about
nutrition, we have to renew the spiritual
connection our people had with food as a gift from our creator,”
she said. “People are getting sick because of the loss of spiritual
connection with food.”
It is a bit harder to reestablish a historical connection with
the level of fitness of American Indian ancestors, who on average
walked 10 miles a day, chased buffalo on foot and on horses, and
moved hundreds of miles to relocate their camps, Aldrich said.
“But we can still do the treadmills and the bikes, and we can
lift weights.”
The Whirling Thunder program and fitness facilities have grown
in popularity. Aldrich said an outdoor track was recently added to
the local school, and an indoor pool may be next.
And there is the buffalo program, which Winnebago leaders
said is a critical component of their war on diabetes because it
creates such a strong link to the past. Louis LaRose, head of the
Winnebago buffalo program, said more mainstream attempts to
lower diabetes have tried and failed, partly because they didn’t
have that cultural connection.
The Winnebago Tribe uses the buffalo (it has 66 now) for meals
that are served at powwows and community wellness programs.
LaRose said it is a matter of reestablishing the “circle of wellness”
that was broken when the buffalo disappeared from the Great
Plains.
“Part of dealing with diabetes,” he said, “is mending that
broken circle.”
Reprinted by permission of the Omaha World-Herald in Omaha,
Nebraska
Diabetes and American Indians
About 1 in 8 American Indian adults has diabetes (twice the
rate of Caucasians). For example:
• The Pima tribe in Arizona has the highest rate of diabetes in
the world. About 50 percent of Pimas between the ages of 30
and 64 have diabetes.
• There are approximately 10,000 diabetes patients within the
Cherokee Nation, almost three times the national average. The
number of patients diagnosed with the disease has increased
128 percent from 1989 to 1997, according to Cherokee Nation
Health Service statistics.
• Over 16 percent of Navajo adults have been found by glucose
tolerance testing to have diabetes.
• About half of American Indian adults have diabetes; most have
Type 2 diabetes. Rates vary markedly among tribes.
• American Indians and Alaska Natives have genetic, medical
and lifestyle risk factors for Type 2 diabetes, which in youth is
relatively rare; however, recent reports highlight an increasing
incidence of Type 2 diabetes in children and adolescents.
• American Indians and Alaska Natives with diabetes have a
high incidence of diabetes complications such as eye and kidney
disease, cardiovascular disease, and lower-extremity amputations.
• Cardiovascular disease is the leading cause of death in Ameri-
can Indians, and diabetes is a major contributing risk factor for
cardiovascular disease.
Diabetes and Hispanic Americans
• 1 in 4 Puerto Rican Americans has diabetes.
• 1 in 4 Mexican Americans has diabetes.
• 1 in 6 Cuban Americans has diabetes.
When compared with non-Hispanic Caucasians, rates of
diabetes are 50 to 60 percent higher in Cuban Americans and
110 to 120 percent higher in Mexican Americans and Puerto
Rican Americans.
Diabetes and Asian Americans, Pacific Island Americans
• Asian Americans are twice as likely to get diabetes as Caucasians.
• In Hawaii, Asian Americans and Native Hawaiians develop
diabetes much more frequently than Caucasians, and Native
Hawaiians have the highest diabetes rates.
Diabetes and African Americans
If you are African American, you have a greater chance of getting diabetes than Caucasians. Approximately 1 in 9 African
Americans has diabetes (compared with 1 in 16 Caucasians).
• 1 out of every 4 African American women age 55 years or
older has diabetes.
• 1 out of every 4 African American adults between the ages of
65 and 74 has diabetes.
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