State of the Science: A Cultural View of Native Americans and Diabetes Prevention

By Edwards, Karethy; Patchell, Beverly | Journal of Cultural Diversity, Spring 2009 | Go to article overview
Save to active project

State of the Science: A Cultural View of Native Americans and Diabetes Prevention

Edwards, Karethy, Patchell, Beverly, Journal of Cultural Diversity

Abstract: The purpose of this article is to present a review of the literature on diabetes type 2 prevention interventions for Native American populations. The interrelation of the cultural role of food in Native American diets, educational policies related to food, outcomes of federal policies, and the historical background of diabetes are addressed. In addition, published studies of diabetes prevention interventions with Native American populations are examined. Lastly, exemplars of programs that represent best practices in the prevention of diabetes are described.

Key Words: Native America, Type 2 Diabetes, Prevention Programs, Cultural


Much has been written about American Indians and Type 2 diabetes. Search engines bring up hundreds of articles and internet sites on this topic. How do these published reports really impact diabetes prevention for Native Americans? Has what is known gone from awareness to intervention to success in preventing diabetes? The purpose of this article is to present a review of the périment published literature about the prevention of Type 2 diabetes (hereafter called diabetes) among Native Americans and to highlight exemplar programs and empirically tested interventions in the literature that could make a difference. The impetus for this process is the authors' work as Co-Directors for the nursing research training core of the American Indian Diabetes Prevention Center. The mission of the American Indian Diabetes Prevention Center is to prevent or delay the onset of diabetes in American Indians and Alaska Natives. The goal of this project is to teach tribal nurses, who work with Native Americans, about research methods, the process of implementing evidence-based practice, and the ethical conduct of research in the practice setting. In learning about any issue, it is important to review its historical background.


Native Americans have a rich history of healthy food systems and prosperous agricultural economies. By 800 A.D., North American Indian farmers from Florida to Ontario, Canada were cultivating several crops and developing varieties that were appropriate for the growing season where they lived (Keoke & Porterfield, 2002). Explorers landing in the so called "new world" marveled at the abundance of agricultural crops and the advanced agricultural technology. As a result, many explorers and settlers were aided by Indian farmers' "bounty (Keoke & Porterfield, 2002).

This changed as colonization was established and the Indigenous people were pushed out of their traditional nomelands, subject to war and disease and finally, containment on reservations or city slums. Surveys of Native American diets from the 1920s into the 1950s found staples of canned meat and fish, bread, beans, sugar, and coffee or tea (Prucha, 1986). On many reservations, malnutrition and nutritional deficiencies were endemic. Despite recommendations to improve Native American diets, food aid provided to the tribes was usually insufficient and of low quality. Also, the food aid did not include traditional roods, leading to further deterioration in health. The history of food insecurity for Native Americans that began with the establishment of reservations continues today. Until the 1950s, malnutrition and hunger were the primary food issues facing tribes (Prucha, 1986). After the 1950s, Native American dietary patterns were increasingly dictated by "the arrival of welfare checks and the distribution of government commodities" (Bass, 1974 p.37). To the contrary, despite the increase in federal rood aid, Native American diets remained inadequate to their needs.

By the 1960s most Native Americans had diets similar to those of the non-Indian population. This trend continues. For example, documented reports indicate that as recently as the late 1990s, almost one-fourth of Native American households were food insecure, meaning that they did not have access to enough food to meet their basic needs and one out of twelve experienced food insecurity coupled with hunger (Henchy, Cheung, & Weill, 2002").

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

State of the Science: A Cultural View of Native Americans and Diabetes Prevention


Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?