History: A determinant of diabetes in an American Indian nation

Tennille Larzelere Marley


American Indians and Alaska Natives are at an increased risk of developing type 2 diabetes and are more likely than the general U.S. population to suffer from diabetes-related complications. Although the association among diet, physical activity, and diabetes are well established, the social determinants of health provide another explanation of the disproportionate risk of diabetes and diabetes-related disparities among American Indians. Few studies have examined other contributing factors, such as colonisation. In this study, a critical Indigenous framework that includes historical events and policies as primary social determinants to explain diabetes-related disparities within a contemporary American Indian/Alaska Native context was applied. Twenty-eight interviews were conducted with citizens of an American Indian nation to examine the relationship between local history and diabetes. Drawing from this data, a new framework is provided to understand the root causes of the diabetes epidemic that has meaningful application to public health. 

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