Senate Committee on Indian Affairs (SCIA) Chairman John Hoeven (R-ND) continued his rapid pace of hearings on issues important to Indian country with a March 29 meeting aimed at curbing Type II diabetes in Native youth.
It’s a major problem, noted officials with the Indian Health Service (IHS), who testified that while levels of obesity and Type II diabetes are generally leveling off in the adult American Indian population, the numbers continue to be staggering. The American Indian/Alaska Native population is still 2.3 times more likely to be diagnosed with diabetes than the general population, while Native youth aged 10-19 are nine times more likely to be diagnosed with Type II diabetes than their non-Native peers. The rate of Native youth aged 15-19 years diagnosed with diabetes more than doubled between 1990 and 2009.
Alton Villegas, an 11-year-old tribal youth from the Salt River Pima-Maricopa Indian Community, put the crisis in simple terms: “It’s kinda’ hard,” he told the senators. “I talk to a lot of people about going to camp and living healthy, but I’m not sure they listen because they don’t want to give up Hot Cheetos – they’re addicted to them….they buy four bags a day from the ice cream man. We must destroy the ice cream man!”
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Villegas said a tribal diabetes prevention camp helped him make significant lifestyle changes that have allowed him to drop weight and to make better food choices.
Chris Buchanan, acting director of the IHS, admitted during the hearing that the agency needs to be doing much better for Native youth. He said we need more studies focused on Indian young people.
Several tribal officials offered recommendations beyond studies.
Tribal communities must have the resources and support they need to access fresh and nutritious foods, safe places for physical activity, and quality diabetes treatment and intervention programs, said Vinton Hawley, chairman of the Pyramid Lake Paiute Tribe and chair of the National Indian Health Board.
“Because American Indian/Alaska Native traditional subsistence lifestyles have been replaced with federal programs such as the Food Distribution Program on Indian Reservations, the Food Stamp Program, and the Commodity Supplemental Food Program, many tribal communities have a new reliance on store‐bought foods, poor access to fresh produce, and have increased consumption of fast foods,” Hawley said.
Hawley believes that the innovative, holistic, community- and evidence-based approaches that tribal programs nationwide are implementing for all ages will be key to routing the disease in youth. He promoted the sharing of ideas being piloted amongst several tribes.
Jared Eagle, program director of the Fort Berthold Diabetes Program for the Three Affiliated Tribes, pointed out one of the more significant issues plaguing his community. “We live in a food desert, and of the six communities on Fort Berthold only two have grocery stores and access to fresh produce and healthy food options,” he said. That doesn’t sound too bad until you consider that 6,000 people inhabit a reservation of nearly a million acres (over 1,500 square miles).
Martin Sensmeier, Tlingit, Koyukon-Athabascan, and ambassador of Boys & Girls Clubs of America discussed the role of poverty. He noted that in the 2013 U.S. Census, American Indians and Alaska Natives had a higher rate of poverty than any other racial group, which was 29 percent as compared to the national poverty rate of 15 percent.
Add the extreme poverty issues facing many reservations, and there is little surprise that cheap staples like flour, white rice, pasta, cereal, dry beans, sugar and bottled or canned goods like oil, hydrogenated fats, and fruit along with shelf-friendly food like processed cheese are what fills the shelves in Indian country groceries and United States Department of Agriculture (USDA) food distribution centers.
SCIA Vice Chairman Tom Udall (D-NM) acknowledged “the need to look for more ways to engage Native youth in healthy lifestyles,” especially those like the successful Special Diabetes Program for Indians (SDPI) and other culturally-based programs. He argued for a seven-year funding authorization for the SDPI so that tribes would have “peace of mind and the ability to plan” long-term.
The SDPI, established by Congress in 1997, has provided grants for more than 300 tribal programs, and it has made a measurable dent in the “troubling statistics” across Native communities, Hawley said, but he believes more focus is needed specifically on younger Native Americans.
Hawley believes that while several programs funded by the SDPI have resulted in visible progress at the adult level, they have yet to halt the epidemic of Type II Diabetes in Native youth under age 20. And while deficit funding is and will likely remain a large problem in the near future, it would likely benefit tribes to share across the table what is working well to stem this slow killer.
Meanwhile, SDPI funding is due to expire in September. If it does, it will “result in the loss of staff for many SDPI programs living in rural areas and will cause disruptions to patient care,” Udall said, adding that he worries how “flat funding” of the SDPI program for the past decade had impacted it, and what the future of funding held.
One thing is sure: tribes cannot wait another 20 years for progress. Doing so will cost them a generation of their most precious asset.