Indian Country suffers from highest diabetes rate as key program hangs in limbo

Friday, July 21, 2017  

A new report once again confirms that American Indians and Alaska Natives are disproportionately impacted by diabetes.

According to the Centers for Disease Control and Prevention, 14.9 percent of Native men over the age of 18 have been diagnosed with diabetes, the highest among all racial and ethnic groups in the United States. And 15.3 percent of Native women suffer from the condition, again the highest rate in the nation.

“Although these findings reveal some progress in diabetes management and prevention, there are still too many Americans with diabetes and prediabetes,” Brenda Fitzgerald, the director of the CDC, said in a press release on Tuesday, when the new report was released.

While rates indeed remain high, management and prevention efforts have made a difference in Indian Country. That's largely because tribal and urban Indian health providers have tapped into the Special Diabetes Program for Indians (SDPI), a federal initiative, to help their communities battle an entirely preventable disease.

"Diabetes health outcomes have improved significantly in American Indian / Alaska Native communities since the inception of the SDPI," Michael Weahkee, the "acting" director of the Indian Health Service, said in written testimony to Congress last week. "Within our communities, the longtime trend of increasing rates of diabetes ended in 2011."

Despite the successes, the program hangs in limbo. Unless Congress takes action, it is due to expire at the end of September. If that happens, Indian Country would lose out on $150 million in annual SDPI grants.

“SDPI works, because it provides locally managed, culturally relevant services that have proven to be a strong return on federal investment by decreasing the likelihood of complications from this preventable disease," said Rep. Norma Torres (D-California), the top Democrat on the House Subcommittee on Indian, Insular and Alaska Native Affairs. "SDPI is transforming communities and saving lives, and we must continue to provide much-needed resources and support for this proven program.”

In May, Torres introduced H.R.2545, the Special Diabetes Program for Indians Reauthorization Act . The bill would extend the program through 2024 and would even increase funding levels in the coming years, something Indian Country has been asking for.

But even though H.R.2545 and prior SDPI efforts have always drawn bipartisan support, tribes have run into resistance on Capitol Hill, where budget constraints have made it harder to secure the funds for the program. So they have had to settle for two-year and even one-year extensions, instead of the five-year extensions that were common in the past.

And it's not just Indian Country calling on Congress to take action. The Trump administration's fiscal year 2018 budget for the IHS anticipates a renewal of the program, which helps boost its bottom line in light of proposed cuts to the agency's funding levels.

The Trump team, though, dropped a request for a "permanent reauthorization" of the program, a proposal that surfaced last year but never became law. A permanent extension is something the National Congress of American Indians, the largest inter-tribal organization, endorsed in the past. Last month, the organization reaffirmed its support for renewal of SDPI.

The figures in the CDC's report came from the IHS National Data Warehouse. According to the data, 6 percent of Alaska Native adults have been diagnosed with diabetes, the lowest rate in Indian Country. On the other end of the spectrum, the rate soars to 22.2 percent among certain tribal populations in the Southwest.

The report also indicated that American Indian youth suffer from the highest rate of Type 2 diabetes in the nation. But the CDC cautioned that the data, which was drawn from the SEARCH for Diabetes in Youth Study, is "not representative of all AI youth in the United States."

"Thus, these rates cannot be generalized to all AI youth nationwide," the report said.

Still, tribes have noted a rise in diabetes among their youngest citizens. The Senate Committee on Indian Affairs looked closer at the issue during a hearing in March.

“My mom and my grandma have diabetes, a lot of people in Salt River have diabetes, sadly,” Alton Villegas, an 11-year-old from the Salt River Pima-Maricopa Indian Community, told the committee, Cronkite News reported.

Through an SDPI grant, his tribe offers screening for diabetes, which indicated Villegas was at risk for the disease, But he didn't take the news as discouraging -- it inspired him to attend the Youth Wellness Camp in Arizona and now he encourages fellow youth on the reservation to lead healthier lives.

“I wanted to be healthier, so I went to camp,” Villegas told the committee, Cronkite News reported. “I wanted to be able to help my mom and my grandma be healthier.”

The Senate version of the SDPI reauthorization bill is S.747.

Centers for Disease Control and Prevention Documents:
New CDC report: More than 100 million Americans have diabetes or prediabetes | PDF: National Diabetes Statistics Report, 2017

Related Stories:
Lawmakers push to renew Special Diabetes Program for Indians (May 18, 2017)
Chris Buchanan: Indian Health Service sees progress on diabetes (March 31, 2017)
Cronkite News: Tribes pushing for renewal of key diabetes funding (March 30, 2017)
Senate Committee on Indian Affairs schedules hearing on diabetes (March 21, 2017)
Tribes receive grants from Special Diabetes Program for Indians (January 28, 2016)