PART 3: Diabetes in Public Health
Tomaquag “Belonging(s)” Blog
March 2016 Part III
Belonging(s)
“A close relationship among a group and personal or public effects”
“Kunoopeam” (Welcome)!
This Belonging(s) Blog is a continuation of a three-part series by Brown University student Esmeralda Lopez. (Please see Tomaquag Museum Disclaimer below) Ms. Lopez’s blog is the result of an assignment from her class “Treaty Rights and Food Fights: Eating Local in Indian Country”. The course, taught by Elizabeth M. Hoover, PhD., Assistant Professor of American and Ethnic Studies explores the disparate health conditions faced by Native communities and the efforts by many groups to address these health problems through increasing community access to traditional food, whether by gardening projects or a revival of hunting and fishing traditions…”
Disclaimer: The opinions expressed by Guest Bloggers and those providing comments are theirs alone, and do not reflect the opinions of the Tomaquag Museum or any employee thereof. Tomaquag Museum is not responsible for the accuracy of any of the information supplied by Guest Bloggers.
As a recap, Part I titled Food as Medicineexplores an alternate Nutrition Model based on a combination of traditionaland contemporary foods. In Part II, Badly Made Indicator (BMI) of Health, Ms. Lopez discusses issues related to the Body Mass Index model or BMI. In our final guest blog, Part III, she presents the subject of Type II diabetes.
Part III No ‘thrifty’ explanations
This is a continuation of the broader discussion on the framing of disease introduced in “Badly Made Indicator (BMI) of Health”. The purpose of this blog is to talk a bit about how Type II Diabetes has been framed in public health with health transitions (explained below), and in biology with the “thrifty genotype hypothesis”. But more importantly focusing on 53 ethnographic interviews with tribal members (who participated extensively in studies of diabetes) on how they reinterpret genetic researchers’ narratives about them, to create their own accounts of their history and future (Sahota 824).
Frames of Type II Diabetes in Public Health & the “thrifty genotype hypothesis”
Globally we can observe the substantial changes in food systems and food intakes. For instance, the globalization of corn (originated in what is present day Mexico) and its production through GMO mono-cropping The difference in composition between the traditional corn and the genetically modified variety is the latter is high in carbohydrates and low in protein thus producing a sweeter-tasting corn. This modification of corn parallels the shift from traditional diets high in protein to contemporary diets high in carbohydrates. Diets high in carbohydrates contribute to excess calorie intake which is stored as fat in the body. The observed shift in dietary intake is what the field of public health calls— nutrition transition. The effect of this contributes to the health transition; two other transitions that occur simultaneously are demographic and epidemiological.
- Demographic transition is the shift from a pattern of high fertility and high mortality to one of low fertility and low mortality.
- Epidemiological transition is the shift from a pattern of prevalent infectious diseases associated with malnutrition, periodic famine, and poor environmental sanitation to a pattern of prevalent chronic and degenerative diseases (ex. diabetes, heart disease, cancers) associated with urban-industrial lifestyles.
The field of public health uses the 3 transitions to explain the high rates/prevalence of Type II Diabetes cases. Though most agree with this explanation, there is a group of geneticists, who favor the “thrifty genotype hypothesis”.
As the name suggests the “thrifty genotype hypothesis” seeks to explain the higher prevalence of Type II Diabetes in Native Americans is due to genetic adaptations from the traditional hunter-gather communities. In which communities had genetically adapted to resource-scarce environments. Originally a “helpful” adaptation is now “harmful” in modern abundant environments leading to the development of the disease.
How do tribal members interview reinterpret these narratives about them to create their own accounts of their history and future?
Puneet Chawla Sahota conducted 53 ethnographic interviews in an unnamed tribal community as part of the study, published as Genetic histories: Native Americans’ accounts of being at risk for diabetes. Tribal members were asked this broad question— what they believed/thought caused diabetes? In their responses 25% of the interviewees brought up the “thrifty genotype hypothesis” on their own. Some of the interviewees interpreted the “thrifty genotype hypothesis” to mean that Native Americans are vulnerable in the face of rapid historical change, while others viewed it as evidence of Native American resilience (833). How tribal members interpret the hypothesis matters because it shapes how they negotiate their susceptibility of developing diabetes (835).
Another key part in tribal members’ responses to the question was the loss of ‘traditional’ foods and lifestyles (831), there are efforts to revitalized lost traditions. As tribal members seek to revitalize traditions which is linked to their quest to defeat the diabetes epidemic and to maintain a distinct tribal identity (831).
To quote Winona LaDuke an indigenous (Anishinaabeg) scholar who writes, “the genetic complexity of Native communities has been the subject of many tests and studies, but Native communities have been clear to that a holistic approach to restoring Native health is essential to treatment of diabetes” (LaDuke198). With that said, it is necessary to collect different perspectives like those of tribal members for a holistic approach to restoring Native health.
STAGES OF HEALTH
References:
Sahota C. Puneet., 2012. Genetic histories: Native Americans' accounts of being at risk for diabetes. Social Studies of Science. 42(6), 821-842.
Laduke, Winona. 2005. “Food as Medicine: The Recovery of Traditional Foods to Heal the People.” IN Recovering the Sacred: The Power of Naming and Claiming. Cambridge MA: South End Press. P 191-212.
Kutaputush (Thank You) we hope you enjoyed this guest blog!
Kim Peters, Collections Manager
The Tomaquag “Belonging(s)” Blog, is a monthly conversation dedicated to the happenings, musings of staff, and a peek at the collections of the Tomaquag Museum. We welcome guest bloggers, and topics relevant to Native American Museums and Indian Country, especially those located in the New England area.
If you are interested in contributing to our blog please contact kpeters@tomaquagmuseum.org
Disclaimer: The opinions expressed by Guest Bloggers and those providing comments are theirs alone, and do not reflect the opinions of the Tomaquag Museum or any employee thereof. Tomaquag Museum is not responsible for the accuracy of any of the information supplied by Guest Bloggers.
