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"Bad Sugar" Produced and Directed by James M Fortier
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"Bad Sugar" Produced and Directed by James M Fortier

Understanding Health Determinants Beyond Diet and Exercise

The Role of Structures in Health

  • Traditional views on health often focus on diet, exercise, and medical care, but economic, political, and social structures significantly influence health outcomes.
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  • These structures are often invisible yet serve as powerful determinants of individual and community health.

Diabetes in the Tona aam Tribe

  • Terell du Johnson discusses the alarming diabetes rates among the Tona aam tribe, with half of adults affected by type 2 diabetes.
  • Historically self-sufficient through local agriculture, the tribe's lifestyle has drastically changed, contributing to rising diabetes rates.

Personal Impact of Diabetes

  • Many individuals express feelings of inevitability regarding diabetes due to family history; some refer to it as "bad sugar" rather than acknowledging it as a disease.
  • The Hila River Reservation is home to another tribe facing similar issues; their historical connection to water is crucial for understanding their current health challenges.

Historical Context of Water Rights and Health

Water Management by Pima Ancestors

  • Henrietta Lopez highlights how Pima ancestors were adept at transforming desert land into farmland through sophisticated water management techniques.
  • Despite extensive research into genetic factors related to diabetes among the Pima, no definitive cause or cure has been found.

Socioeconomic Factors Contributing to Diabetes

  • Research indicates that various populations globally experience high rates of diabetes due to dispossession from land and culture.
  • Displacement leads to a loss of identity and cultural practices that historically supported healthier lifestyles.

Poverty as a Risk Factor for Diabetes

Economic Challenges Faced by Native Communities

  • Many members of the Tona aam live below the poverty line; this socioeconomic status is a significant risk factor for developing diabetes.
  • Dr. Donald Warren emphasizes that health issues arise long before patients reach medical facilities; they stem from systemic poverty.

Biochemical Connections Between Stress and Health

  • Chronic stress linked with low income can lead to elevated blood sugar levels due to hormonal responses in the body.

The Epidemic Nature of Diabetes in America

National Statistics on Diabetes

  • Over $32 billion is spent annually on treating diabetes in America; obesity is a known risk factor alongside low income.

Personal Stories Reflecting Broader Issues

  • Individuals share personal experiences with managing diabetes amidst systemic challenges faced by Native American communities.

Historical Events Shaping Current Health Outcomes

Impact of Water Diversion on Tribal Health

  • The diversion of water from the Hila River since the 1890s has had dire consequences for tribal agriculture and overall health.

Consequences Following Dam Construction

  • After construction projects like Coolidge Dam, tribes experienced severe water shortages leading directly to increased cases of diabetes within decades.

Food Insecurity and Its Effects

Commodities Program Influence

  • Government food programs provided unhealthy options that contributed significantly to rising obesity rates among Native Americans.

Cultural Changes Due To Food Supply

  • Traditional diets have been replaced by processed foods due to lack of access; fry bread symbolizes this shift away from healthy eating habits.

Empowerment Through Community Action

Barriers To Healthy Living

  • Limited access to fresh produce and safe exercise environments disempowers communities struggling with diseases like diabetes.

Importance Of Self-Empowerment

  • A sense of control over one’s life impacts self-identification and hopefulness about future health outcomes.

Hope Amidst Struggles

Managing Diabetes With Optimism

  • Margaret Aosta shares her determination not let diabetes define her life despite its challenges. Studies show hopefulness can aid in managing chronic conditions effectively.

Long-Term Solutions Needed

  • Addressing infrastructure needs such as water delivery systems is essential for improving overall community health outcomes over time.

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Video description

EPISODE FOUR of "Unnatural Causes: Is Inequality making us Sick", 29 MINS The Pima and Tohono O'odham Indians of southern Arizona have arguably the highest diabetes rates in the world -- half of all adults are afflicted. But a century ago, diabetes was virtually unknown here. Researchers have poked and prodded the Pima for decades in search of a biological -- or more recently, genetic -- explanation for their high rates of disease. Meanwhile, medical-only interventions have failed to stem the rising tide not just among Native Americans, but globally. What happened to the health of the Pima? During the 20th century, the diversion of river water to upstream white settlements disrupted the Pima's agricultural economy and customary ways. Local tribes were plunged into poverty and became dependent on the U.S. government. Healthy traditional foods like tepary beans, cholla buds, and wild game were replaced by surplus commodities like white flour, lard, processed cheese and canned foods -- a diabetic's nightmare. A sense of "futurelessness" took hold, and so did diabetes. According to Dr. Don Warne, a trained physician and traditional Lakota healer who works with the Pima, health problems like diabetes begin long before people get to the clinic or the hospital. While obesity and diet are risk factors, so is poverty. People in the lowest income brackets are at least twice as likely to become diabetic as those in the highest. For the O'odham and other Native Americans, the stress of living in poverty is compounded by a history of cultural, economic and physical loss, which researchers believe magnifies its impact on health. Attorney Rod Lewis has spent the last several decades fighting to restore his tribe's water rights. In 2004 he helped negotiate the largest water settlement in Arizona history, which not only guaranteed the return of water but provided crucial funds to build roads, dams and other infrastructure. Now the Pima are beginning to farm again. Leaders are cautiously optimistic that community empowerment, along with sustainable and culturally appropriate development can help restore prosperity, hope, and health.