American Indigenous Communities: Diabetes and Food Insecurity

Emmanuel Osemota
4 min readAug 3, 2023

As the sun sets over the seemingly endless expanse of the reservation, the picturesque vista hides a bitter truth. A silent epidemic is brewing in the heartland of America’s indigenous communities — a juxtaposition of food insecurity and rising diabetes rates.

This cocktail of circumstances, a product of historical and ongoing systemic disparities, presents an immediate and devastating threat to the health and future of Native Americans.

As we continue our deep dive into the world of underrepresented groups across the United States, it is essential to consider the underlying causes of severe medical conditions.

Diabetes, though common in today’s parlance, is nothing to take for granted. There are real concerns about the longevity and quality of life indigenous communicates experience. In most cases, there is a lack of healthy, nutritious food.

The Persistent Challenge of Food Insecurity

In the first decade of the new millennium, a staggering 25 percent of American Indians and Alaska Natives (AIAN) grappled with consistent food insecurity, twice the rate of their white counterparts.

This is usually because the only available stores on a reservation were generic corner stores instead of grocery businesses along major shipping routes.

Today, the situation remains grim. As the Census Bureau reports, there are 6.79 million Native Americans, constituting nearly 2% of the U.S. population, still battling the specter of food scarcity due to the complex web of historical and present-day systemic and institutional inequities.

These are people like you and me doing their best to provide for their families and create a life worth enjoying. That cannot be easy when getting quality food involves a long trip and rising costs.

What is Food Insecurity? Why is it a Concern?

The Interagency Working Group on Food Security and Food Security Advisory Committee (1999) defines food insecurity as either Type I or Type II. In Type I, individuals or groups lack sufficient food.

Type II food insecurity, however, is less overt but equally damaging. Here, individuals or groups lack access to nutritional and culturally appropriate food. This is the primary problem we need to address.

Such shortages are exacerbated by ‘food deserts’ — regions deprived of fresh fruit, vegetables, and other healthful whole foods, typically due to a lack of grocery stores, farmers’ markets, and healthy food providers.

This desertification of nutritious options often occurs in impoverished areas, effectively stymieing the health of the community members and forcing them to rely on less healthy alternatives.

It is a cascading effect where the only quality food available is shipped, requires long drives, or might be grown in small patches subject to weather conditions.

The Dual Threat: Rising Diabetes Rates

Against this backdrop of food scarcity and nutritional dearth, a silent stalker lurks: diabetes. Native Americans — American Indians and Alaska Natives — are more likely to have diabetes than any other U.S. racial group.

This chronic condition leads to a cascade of health problems, most significantly kidney failure, necessitating costly treatments like dialysis or kidney transplantation. None of these maladies are easy to handle if your local community doesn’t have quality healthcare providers in residence.

Remarkably, the prevalence of diabetes among Native Americans surpasses the national average of 6.6 percent. Of the 5.7 million Native people in the U.S., almost 15% battle some form of this debilitating disease.

Battling Food Insecurity: Governmental and Community Efforts

Despite these challenges, efforts are underway to alleviate food insecurity and its attendant health repercussions.

The two primary food assistance programs serving Native Americans are the USDA’s Supplemental Nutrition Assistance Program (SNAP) and the Food Distribution Program on Indian Reservations (FDPIR).

However, SNAP’s effectiveness is hamstrung in tribal areas due to its low population densities, high poverty rates, and the resulting lack of large grocers. Here, the FDPIR steps in.

USDA purchases and ships selected healthful foods to Indian Tribal Organizations or State governments, which distribute these essential provisions via warehouses, tribal stores, and local sites.

In 2019, about 276 Tribes received benefits through FDPIR, aiding an average monthly tally of 83,800 individuals.

These programs are critical to the infrastructure of indigenous communities and, unfortunately, under constant threat of defunding due to the political football it becomes when in the hands of Capitol Hill.

Gardens of Hope: Cultivating Solutions within Indigenous Communities

Within the communities themselves, a green revolution is taking root — gardening. The Project Grow service of Partnership With Native Americans (PWNA) and its Northern Plains Reservation Aid (NPRA) program fosters a culture of gardening as a viable solution to the dearth of locally available fresh produce.

Over the past five years, Project Grow has facilitated the tilling of more than 500 individual gardens on three reservations, proving that self-reliance and self-sufficiency are not just lofty ideals but achievable goals.

An 800-square-foot garden, for instance, can feed a family of four, directly mitigating food insecurity.

Forward Steps: Reducing Diabetes and Food Insecurity

As a nation, we need to acknowledge that hunger is preventable and food security is achievable with the right interventions.

Our strategy should incorporate the reduction of poverty, creation of accessible and affordable food production and distribution systems, addressing climate change impacts, and improving market competition.

Reducing diabetes rates in Indigenous communities also necessitates promoting healthy eating habits, encouraging exercise, and building trust with quality and incentivized healthcare providers available to minority populations.

To bring about lasting change, we must ask ourselves: How can we foster an environment enabling Indigenous communities to retain their cultural heritage while promoting food security and reducing diabetes rates?

It’s time for us to recognize the urgency of this crisis and take decisive action. The future of America’s Indigenous communities depends on it.

Written by: Emmanuel J. Osemota

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Emmanuel Osemota
Emmanuel Osemota

Written by Emmanuel Osemota

data analyst, epidemiologist, and health policy advisor. Learn more at: emmanuelosemota.com

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