There was no word for diabetes in traditional Native languages when the Europeans arrived on this continent. In 1933, a physician for the Indian Health Service (IHS) reported just one case in the entire state of Arizona.
And yet today, type 2 diabetes is devastating American Indians. The disease can lead to blindness, amputation, nerve and kidney disease, heart disease and stroke. The U.S. Health and Human Services says American Indian/Alaska Native adults are more than twice as likely as their white counterparts to get diabetes, and twice as likely to die from it. Sixteen percent of adults served by the IHS have diabetes, with rates varying from 5.5 percent among Alaska Native adults to 33.5 percent among American Indian adults in southern Arizona.
Why hasn’t the mainstream media paid attention?
Two Native academics are trying to find the answer. Following a pilot study last summer, they are in the second phase of data collection, to examine just how journalists portray Native Americans with diabetes.
“From what I’m reading and hearing from the American Indian medical community, diabetes is being framed by those on the front lines as a type of genocide and perhaps the final one for American Indians,” said University of Kansas visiting associate professor in journalism and social scientist Dr. Teresa Trumbly Lamsam, Osage. “It’s already an epidemic. We’re not affecting the trajectory fast enough.”
Lamsam has watched over the years as tribal members have been devastated. So has her research partner, Haskell Indian Nations University journalism instructor Rhonda LeValdo, Acoma Pueblo. As she began working with Lamsam, she found herself personally caught up with her research. She kept her diabetic uncle abreast of their findings during their pilot study; the former cross-country and track runner in turn took to reading a book on diabetes and started logging his exercise routine. From the sidelines, he offered LeValdo his advice as she participated in running competitions.
And then diabetes cut his life short. For LeValdo, who had already an aunt to diabetes, and two other uncles to heart complications, a common side-effect of diabetes and poor nutrition, it was almost too much to bear. Another elder was prematurely dead, his ancestral knowledge forever lost.
“I couldn’t wait for my son to spend time with him so he could learn the Acoma songs they sing at our ceremonies,” LeValdo said. “There’s a problem when our tribes and people are dying and we’re just ignoring it.”
LeValdo and Lamsam searched stories from 1997, the first year of the federally funded Special Diabetes Program for Indians, to 2011. Over the 15-year period, they found journalists have depicted American Indians as being responsible for their diabetes because of their eating habits, obesity, and sedentary lifestyles. But the two have also seen how reservations lack grocery stores that sell nutritious, healthy foods at affordable prices. Instead, convenience stores sell foods high in fat, calories and sugar. Studies have shown a direct relationship to significantly higher obesity and diabetes in those living near convenience stores rather than grocery stores and fresh produce markets.
In short, their research intends to shift the blame from Native diabetes sufferers. To that end, the two researchers hope to guide journalists toward reporting that doesn’t overlook the role of social, economic, historical and environmental factors in the current crisis.
“How mainstream journalists tell the story influences public policy,” Lamsam says. “Negative portrayals affect public opinion, and that can determine how policy-makers act.” She points to the 1960s, when the media hammered home the message that tobacco is highly addictive. As a result, the federal government funded nicotine treatment programs and the public took a sympathetic view of cigarette smokers who found themselves unable to quit.
Lamsam and LeValdo are not alone in their findings. Science journalist Sally Lehrman, a Santa Clara University professor in the communication department and the Knight Ridder/San Jose Mercury News endowed chair in journalism and the public interest, has determined that reporters still tend to regard diabetes as an issue of personal responsibility, with individuals and communities often indirectly blamed for poor decision-making. So she is working with journalists, educators and students on how to focus more effectively on the social forces that shape health. “When journalists can show the social and institutional factors that help shape the choices that an individual or community are able to make, then we give the public more context and better tools for policy-making,” she said.
Progressive voices like Lamsam, LeValdo and Lehrman face an uphill struggle. Many Native Americans, deprived of their language, land, livelihood and traditions have developed a fatalistic view about diseases like diabetes. Lamsam calls this resignation “historical trauma.”
Maria Yellow Horse Brave Heart, the associate professor of social work at Columbia University who developed internationally recognized theories about historical trauma and historical unresolved grief and interventions among American Indians, “defines historical trauma as ‘cumulative emotional and psychological wounding over the life span and across generations, emanating from massive group trauma,’?” said Lamsam. “This soul wound was inflicted through events that include forced relocations and boarding schools, land loss, smallpox, mass murders, force abortions and sterilizations, and the cumulative, continued loss of traditions, culture and language.”
Lehrman cautions journalists, however, that merely invoking such issues as historical trauma is just the tip of the diabetes iceberg. “It’s also important to point to policies, practices and procedures that might be keeping that trauma in place or to strategies communities are using to overcome its legacy,” she said.
“If we can get the tribal newspapers or journalists to encourage positive stories, maybe their journey to becoming healthier would encourage others,” LeValdo said. “Instead of blaming individuals, focus on community efforts to combat it; it could funnel more funds to help their efforts. We say it takes a village to raise a child. Well, it takes a village to combat this disease.”
To address historical trauma, Lamsam says tribal healers and health practitioners can use holistic, cultural, social and spiritual approaches as a supplement to current treatment protocols. Lamsam emphasizes, however, that these healing approaches do not take the place of current efforts, but rather supplement them with holistic, cultural practices.
LeValdo and Lamsam have found that journalists aren’t the only ones who have failed to accurately get the word out about the Native diabetes epidemic. For example, the sudden shift from subsistence to processed foods caused type 2 diabetes to soar in the Pima, in Arizona, to 70 percent of their adults today. The tribe has been a magnet for federal and university researchers for over 30 years looking for causes and future treatments. It led to findings in 2003 that diabetes was largely preventable. It infuriates LeValdo that they merely gathered data, without appealing to the medical community.
“They had the opportunity to educate that tribe about how to curb or stop the rise, but they didn’t help,” LeValdo said. “They let it balloon up. I understand they’re trying to follow certain regulations, but if people are dying because of those regulations, they need to find a way to step it up.”
IHS Director Dr. Yvette Roubideaux disagreed with the notion that journalists, researchers and other parties are merely passive observers. She said that the media has played an important role in drawing attention to various government-funded programs designed to prevent and treat diabetes.
“There is support for diabetes prevention and treatment programs because there is scientific evidence of how to prevent and treat diabetes,” Roubideaux told Indian Country Today Media Network. “IHS, tribal, and urban Indian health programs are implementing innovative strategies to prevent and treat diabetes, including community-based programs and culturally appropriate solutions. Media coverage of these programs has been positive and has helped our patients see hope for the future.”
For their part, Lamsam and LeValdo want to encourage storytelling around the issue of health in Indian country. “Think about how much health and healing power there can be in storytelling,” says Lamsam. In particular, they want to build a core of committed tribal journalists to use tribal media as a key player in improving wellness in Native communities. “The first thing we want to do is get their feedback. How do we reach those people with the types of media they’re using nowadays?”
Lamsam and LeValdo hope to include personal wellness narratives in the launch of their upcoming website. The beta version is expected to launch in spring. “We are making a commitment to wellness, and we want other tribal journalists and American Indian journalism professors to join us in a wellness pledge and serve as examples in their communities,” Lamsam said.
For more information, contact Professor Lamsam at firstname.lastname@example.org.