Culture of Diabetes – Native Americans and Futurelessness

Culture of Diabetes – Native Americans and Futurelessness


DR. DONALD WARNE
When we look at the tremendous historical and cultural
changes that have occurred in American Indian communities, that has a significant impact
on self esteem, self identity and a sense of empowerment
or hope for the future. And when we have
a population of people that feel disenfranchised
or disconnected from tradition and from
hope for a healthy future that’s going to have an impact
on social behavior and whether or not people
live in a healthy way. So not only is there unhealthy
components of diabetes, there is also
so much diabetes that what we’ve seen
is a culture of diabetes. And when people grow up
in a community where their grandparents, their parents,
their aunts, uncles, siblings, even children
have all gotten diabetes, they’ve gone through the complications
including blindness, amputations, kidney failure and dialysis
and early death, If you have a non-community member
who is a healthcare professional telling them that
this is preventable, Well that might not be
very believable based on the culture of
diabetes and living with it. For example, in my own
medical practice, I’ve had quite a number of
patients who say things like: “I don’t have diabetes yet.” and what are they telling me?
That they believe that they are going to
get to diabetes. And when you think about
things historically and things from
a cultural perspective, really, the culture of
diabetes has created generations of people who
believe that it is inevitable and in many ways it is. If we don’t have
healthy choices, we don’t have community
control and self-determination, In many ways, for some people,
it seems like it is inevitable. But it doesn’t have to be that way. And part of the social
determinants of health is also a sense of
hope for the future And if people lose
that sense of hope and their self-esteem
is lowered, that’s going to have an impact
on self-destructive behaviors and it’s also going to make
people think less about things like diabetes prevention. So we have to look at this from
a much broader perspective. To not just think about physiology
and food intake and physical activity, but what is going on in
the behavioral health realm, in the mental health realm,
of a community. Because that’s going
to have a direct impact on health related behaviors.

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