KICKAPOO RESERVATION—When it comes to making healthy food choices in Indian country, Dr. Dee Ann DeRoin doesn’t mince words: “Stop the pop. Skip the chips. Dump the donuts. Shop, cook and eat together as a family again, instead of everyone ‘grazing’ for themselves. If it’s not healthy for everyone in the family, don’t bring it home from the store.”
DeRoin (Iowa) is a physician at the Kickapoo Nation Health Center in Brown County, Kansas, and a member of the Association of American Indian Physicians (AAIP). Heredity, poor lifestyle choices and a stagnant local economy are among factors that have led to a high rate of diabetes in the Kickapoo community, the AAIP has found.
“Historically, and for some still today, we ate lean game, fish, berries, nuts, tubers or root vegetables,” said DeRoin. “We did not eat refined sugar, refined flour, refined rice or white potatoes. When these were introduced in our diets, along with decreasing physical activity, health problems, especially diabetes, began to mount.”
The high diabetic rate caught the attention of the AAIP, who selected the Kickapoo Reservation as one of three Indian communities for its National Program to Eliminate Diabetes-Related Health Disparities in Vulnerable Populations, a five-year program funded by the Centers for Disease Control and Prevention (CDC). Other project sites are the Detroit Urban Indian community and the United Houma Nation of Louisiana.
Members of the Kickapoo Nation took a stand in the fight against diabetes at a Diabetic Awareness Walk, May 18 on the Kickapoo Reservation, sponsored by the AAIP. The walk was part of the events of Kickapoo Treaty Day 2012.
According to the County Health Rankings and Roadmaps website, Brown County, Kansas is among the least healthy counties in the state, ranking 89th out of 105 counties.
“It’s not just us who are having the problem,” said tribal member and AAIP Outreach Specialist Janis Simon. “It’s all of Brown County.”
She acknowledged that turning the tide of diabetes will be a long process. “Five years isn’t a lot of time to put into it, but it’s a start.”
Anthony Castro, a Kickapoo who participated in the walk, said it is especially important for young people to make healthy choices and to avoid alcohol and drugs. “It catches up with you.”
Simon said younger tribal members are beginning to develop the disease. “We just lost someone who was 37. It’s getting younger and younger. Here, it’s showing up in their 20s and 30s.”
“I’m most concerned about children and young adults,” added DeRoin. “As we see these young people developing diabetes, we are also seeing them start dialysis in their late 30s and in their 40s.”
The Kickapoo have partnered with the AAIP, Kickapoo Nation Health Center and other local entities to create a strategic plan based on a community diabetes-related survey taken in 2011. The survey of 110 tribal members found that more than 100 have diabetes, 86 percent have high cholesterol, 75 percent have high blood pressure and 54 percent are smokers.
The Center for American Indian Community Health has started a free weight loss program on the reservation. The strategic plan also includes renewing a community garden, increasing the availability of fresh fruits and vegetables through the Brown County Healthy Food Coalition and Harvesters, and working with the Kickapoo tribal council to develop policies that support healthy behaviors.
“Tribal leaders can make policy changes to help people get healthy—create playgrounds, walking and biking paths, give tribal employees a place to exercise,” DeRoin said. “Smoking is one of the most harmful choices a person with diabetes can make. ‘No Smoking’ policies in tribal buildings are a big step to help smokers cut down or even quit.”
Simon said the tribal council has been very supportive and noted that proceeds from the Kickapoo Golden Eagle Casino’s “Jackpot for Diabetes” promotion goes to the Health Center to assist with diabetes treatment.
About 16.1 percent of American Indians and Alaska Natives ages 20 years and older who are served by the Indian Health Service have diagnosed diabetes, according to the National Diabetes Education Program.
On the national level, Kickapoo Tribal Chairman Steve Cadue is teaming with the AAIP and Olympian Billy Mills (Lakota) in a fundraising effort designed to create a national diabetes prevention initiative. “The goal is healthy, sovereign, culture-rich communities,” said DeRoin.
The Conquering Diabetes in Indian Country national effort officially launched at the National Indian Gaming Association’s annual tradeshow and convention April 1-4 in San Diego, California.
“We can conquer diabetes,” DeRoin said. “We have the knowledge. We, tribal leaders and health professionals, have to help our community members make changes, one small step at a time.”