The health of Native Americans has undergone substantial change from pre-Columbian times to the present. Contact with Europeans had brought along new communicable diseases, often with devastating effects on population size, social organization, and the cultural life of various peoples on the North American continent. Between the seventeenth and nineteenth centuries there was considerable variation between tribes with regard to onset, severity, and duration of disease effects. Since the beginning of the twentieth century there had been a general recovery among native groups in the United States. As in the general population, when infectious diseases became better controlled, the disease burden shifted to the chronic diseases. In addition, rapid social changes led to new epidemics of injuries and social pathologies, the control of which has proved far more intractable than for infectious diseases. Though, Diabetes and tuberculosis are very common chronic disease among Native Americans.
Diabetes is an example of a chronic disease with a multifactorial etiology. Native Americans are genetically heterogeneous, and they live in diverse physical and sociocultural environments. The frequencies of genes involved in predisposition to diabetes may vary not just within, but also between, Native populations.
Native Americans are more susceptible to diabetes is open to debate. Native Americans are not only more likely to have diabetes, they are also more likely to be poor, overweight, and less well educated—a deadly combination. They may not have access to information about proper nutrition needed to stay healthy and to control weight, or they may not be able to afford appropriate foods. The cheapest products often undergo the most processing—which strips foods of vitamins, minerals, and fiber—and are the highest in salt, sugar, fat, and starch. Native Americans restricted to reservations have lost the protection against diabetes that their traditional way of living and eating probably provided them......
