The leading health problems in the United States are cardiovascular disease, cancer, diabetes, obesity, depression, and accidents. American Indians experience these problems in disproportionately greater numbers. For example, the incidence of diabetes among American Indians is about 3 times that of the U.S. population as a whole. In the Dakotas, about 40% of American Indians over the age of 45 years have been diagnosed with diabetes. Long-term effects of diabetes include heart disease, stroke, hypertension, blindness, kidney disease, amputation, dental disease, and complications of pregnancy. Genetics, nutrition and physical activity play an important role in the development of diabetes and its complications.
Unfortunately, there is little information about the relationship between major health problems and nutrition and physical activity in Northern Plains Indians. Further, cultural differences are an important part of designing and implementing research studies with American Indians. There are over 550 federally recognized American Indian tribes and Alaskan Native villages in the U.S. In addition to differences between tribal and majority cultures, many cultural differences exist between tribes. Research methods and approaches developed for use with the majority culture may not be appropriate or productive when conducting research in other cultures.
The Grand Forks Human Nutrition Research Center (GFHNRC) is ideally situated to spearhead research on nutrition and health of American Indians. As an American Indian psychologist with an interest in Native wellness, I share the GFHNRC vision of developing a community-based, culturally relevant research program to address the role of nutrition in Native health. During the past two years, I have traveled to Native communities throughout North Dakota and Minnesota, establishing relationships and developing partnerships with tribal leaders, educators and health professionals to address health and nutrition needs. Further, an organization of Native and non-Native researchers from the region was created to share research, exchange ideas, mentor future Native researchers, and promote partnerships with Native communities.
A two-year study was conducted to determine the relationship between dietary intakes and health, fitness and socioeconomic status in more than 500 Native adults. The GFHNRC Mobile Nutrition Research Laboratory (MNRL) played an integral part in this research as we traveled across the region to Native gatherings, such as powwows and health conferences. We collected needed information about Native diets, physical and mental health, physical activity, and access to healthy foods. For example, although several measures of depression are routinely used in mental health settings, including Indian Health Service, these need to be validated with American Indians to ensure they are actually measuring depression and not some other form of physical and/or emotional distress. When the data are analyzed we will return to those communities to share with them information that will be helpful to that community in addressing health problems, providing services, and seeking funding and other resources to implement effective prevention programs. The MNRL dramatically increased participation in the study and provided the GFHNRC with a visibility in Native communities that would not have happened if the study remained within the walls of the Center and we expected participants to come to us. In addition, the employment each year of two undergraduate students from the University of North Dakota as summer interns to work with the research project provided training opportunities for Native students to learn about research and provide services to their communities.
Future studies will determine the nutrient content of traditional Native foods and whether these traditional foods may prevent and/or reduce the incidence and severity of health problems. A related issue for many Northern Plains Indians, whose poverty rate is twice the national average and the highest of any group in the U.S., is the availability and affordability of healthy foods. If Native people want to prepare and eat healthy foods, are those foods available on reservations and if available are they affordable? The answers to these questions may reveal constraints faced by Native people to change their diets and lifestyles to lead healthier lives.
By determining the role of nutrition and physical activity in the development and course of diabetes, heart disease, depression and other health problems faced by American Indians, and by identifying current limits on adopting healthier diets and lifestyles, we can provide Native people with information they can use to implement effective programs to help prevent the major health problems facing their communities.
Hopefully, we have taken the first steps in a process that will result in a strong and positive relationship between the GFHNRC and the Native peoples in the Upper Midwest.