Indian Health Crisis – Diabetes, Alcoholism and Depression

“Our nation’s first inhabitants [American Indians] are suffering from among the worst health disparities in the world, and that shouldn’t be acceptable to anyone,” says Donald Warne, MD, MPH, in his article in the Winter 2008 edition of The Pain Practitioner, the official Journal of the American Academy of Pain Management. While studying for his Masters in Public Health, Dr. Warne gathered these startling and disturbing facts about this neglected population in our health care system.

“Death rates from preventable diseases among [American Indians] are significantly higher than among non-Indians:

* Diabetes (Type 2): 291% greater

* Alcoholism: 638% greater

* Accidents: 215% greater

* Suicide: 91% greater”

Dr. Warne suggests that these problems are synergistically related, reminding us to look at the triad of diabetes, depression and alcoholism. Depression is common among diabetics, alcohol is a convenient tool for self-medication, alcohol increases blood sugar levels and alcohol and its effects can also exacerbate depression leading to suicide.

The high rates of alcoholism and type 2 diabetes are associated with neuropathy — nerve damage and nerve pain. Over time, diabetics may develop Diabetic Peripheral Neuropathy (DPN). Painful DPN may feel like burning, throbbing, or painful tingling in the Anandi Gopal Joshi extremities, hands and/or feet. Self-medication for these painful symptoms often involves alcohol and abuse of prescription pain medications in this underserved population. This leads to less of a willingness of the medical community to provide narcotics, when needed, for these patients.

The healing solution for the ethnic American Indian community involves knowledge and usage of the medical wheel system. “The medicine wheel, the traditional and ancient Lakota symbol for medicine symbolizes balance in our lives. The wheel is divided into four segments; physical, emotional, mental and spiritual.” When an American Indian is treated by an allopathic doctor, the physician needs to address not only the physical component (high blood sugar) but also the culturally appropriate focus of the patient. In traditional American Indian cultures, medicine involves a spiritual realm and is a healing force, not in control of man — neither the doctor nor the patient. “The traditional healers were channeling that energy in the right direction, but they did not own that energy.”

“In Arizona, the average age of death is 72.2 for the general population and 54.7 for AIs. This should be front page news. This should be considered a crisis. This should be considered as unacceptable in this nation.” The first step toward resolving this physical and mental health crisis among ethnic American Indians is awareness, public consciousness and greater understanding by the medical community of this complex interactive preventable medical triad: diabetes, depression and alcoholism.


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