Within the four-state region served by Great Plains Quality Innovation Network (QIN), South Dakota has the highest percentage of American Indians diagnosed with diabetes. Nationally, the American Diabetes Association reported diagnosis of 15.1 percent compared to 23.4 percent in South Dakota, 20.3 percent in Nebraska, 16.6 percent in North Dakota and 14.8 percent in Kansas, according to 2017 Behavioral Risk Factor Surveillance System (BRFSS) data.
“My father was diagnosed with diabetes, which creates a negative stigma within the community,” stated Marie Zephier, MPH, community engagement advocate for the Partnership to Advance Tribal Health (PATH) team in South Dakota. “Access to healthy food and lack of education available in our rural communities are among the greatest challenges for individuals trying to manage or prevent diabetes.”
Future generations are already being impacted by the growing prevalence of the disease. From 1990 to 2009, diabetes diagnosis increased 110 percent among American Indian/American/Alaskan Native youth ages 15-19 years old. Providing education on nutrition, along with increased access to healthy foods are first steps toward developing a healthier community.
The PATH team collaborates with communities and Indian Health Services to decrease disparities among the American Indian population. Examples of community outreach include establishing a radio health show, assessing and mapping community needs and resources and enhancing the patient, family and tribal relationships through an integrated approach. As relationships continue to develop, the PATH team will work with communities to provide additional education, resources, and opportunities for improving health.
Making healthier lifestyle choices is essential as the rates of diabetes diagnosis continue to increase. Zephier added, “The financial aspect related to eating healthy is also a challenge since healthier food can be more expensive and difficult to access.”
Although these disparities cannot be reduced immediately, over time, small lifestyle changes can lead to change in an entire community. Choosing the right foods and increasing activity can impact individual health and the health of future generations as well.
Zephier’s father is already setting a good example. Zephier expanded, “He would pack a cooler with healthy food to make it easier to avoid the intake of processed food. He would make the healthy choice easier by eliminating high processed food from his home. He also created accountability partners to ensure he was maintaining his healthy lifestyle choices.”
Great Plains QIN works with community and healthcare partners to reduce disparities for individuals with diabetes and promote diabetes self-management education. South Dakotans can participate in Better Choices, Better Health, a free program to teach proven methods for lifestyle change in a small group setting.
Zephier summarized, “Facing an entire lifestyle change is challenging, but once a person is able to increase the network of support, the chances of success are higher.”