February 27, 2020
Impact of Poverty and Stress on Diabetes among Native Americans

Impact of Poverty and Stress on Diabetes among Native Americans

In looking at diabetes from a broader perspective
of poverty and despair and other types of issues
that communities face, there is a connection between
all of those experiences and the biochemistry and
the physiology in the body. PHOTOGRAPHER:
She used to live here. She used to make baskets. GIRL: how come she moved?
PHOTOGRAPHER: She died. WARNE: When we think
about living in poverty and the stress that
people are under, this is not just a public
health measure this is a way of life. PHOTOGRAPHER: It was
a dirt floor. So I remember We never swept the floor.
We always just got the hose and went inside and
sprinkled it with the water. WARNE: And people are worried
about whether or not they’re going to be able to feed their children,
or clothe their children, or survive a winter. Also, in American Indian populations
we have higher rates of other types of terrible diseases and problems.
things like infant mortality. And what a lot of us observe is that
these terrible things that happen in terms of the health of
a family and a community have an impact on
the entire community and we see things like more
self-destructive behaviors, more alcohol and drug intake. PHOTOGRAPHER: Probably
somebody drinking and they got out of hand, probably
smoking or something. GIRL: Were they in here
PHOTOGRAPHER: Probably WARNE: And what we see is that
early death in communities seems to facilitate more
early death in the community. And this is not an objective
public health measure, this is a reality of life
for people. And it’s terribly
emotionally charged. And it has all kinds of stressful
impact on the body. When we look at
measures of stress, we look at different types
of hormones, like cortisol or epinephrine which
is adrenaline, all of those chemicals
increase blood sugar. So not only are
people faced with diabetes and
high blood sugar, they are faced with stressful
living environments in the communities
and in the families and it’s those stressors
that make the challenge of controlling diabetes that
much more difficult. PHOTOGRAPHER:
I think it was a bunch… You know she drank a lot too.
It was all that stuff altogether you know… WARNE: So there is a direct
biochemical connection between the trauma
that people face living within a culture
of poverty and blood sugar control. And we have to be
cognoscente of that when we are looking at
trying to manage these types of diseases in
impoverished communities. But even beyond the
cultural differences in beliefs and values,
there’s also differences in the availability
of things like healthy food. So if you are living in an
impoverished community, your schools, for example,
might not have the resources to pay for physical education
and healthy food in the schools. And perhaps they use things
like vending machines to try to raise money. So there’s a lot of other
competing agendas. Just because these
children are born into impoverished communities does not mean that they
should have to choose between health and education.
And that’s essentially the circumstances that we
put the communities in.

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