MGH Guides: Native American Health Resources: Chronic Diseases and Native Americans

General Chronic Diseases Related Content for Native American Communities

The following tabs contain articles, books from our collection, and videos that provide an insight into some of the various chronic diseases found in Native American communities.

Use the tabs to navigate between content types. For more detailed instruction, return to the instructions on the guide's home page.

Diabetes in Native American Communities

Living well with diabetes in Alaska
A majority of Alaska Native people with DM had none of four major complications over a 20-year period. Lower BMI and use of diabetes medications were associated with higher hazard for some deleterious outcomes. This suggests that goals in care of elders should be carefully individualised. In addition, we discuss several programme factors that we believe contributed to favourable outcomes.
Evidence-based screening, clinical care and health education recommendations for Alaska Native peoples with prediabetes living in southcentral Alaska: findings from the Alaska EARTH follow-up study
A substantial portion of the rise in pre-DM found among urban southcentral AN peoples in the EARTH follow-up study was due to the addition of A1c testing. Pre-DM by A1c alone should be used to motivate behavioural changes that address modifiable risk factors, including smoking cessation, physical activity and weight management.
Systematic review of disparities in continuous glucose monitoring and insulin pump utilization in the United States: Key themes and evidentiary gaps
This study reveals critical disparities in diabetes technology use across race, ethnicity and insurance type, particularly among people with type 1 diabetes. Evidentiary gaps assessing disparities in diabetes technology use persist, particularly concerning people with type 2 diabetes, Native American/American Indian and LGBTQ+ populations, and in outcomes related to continuation of use. Social and digital determinants of health, such as income, transportation, residential location and technological literacy, are crucial to achieving equitable access. Future research should focus on the patient journey to identify opportunities for equitable access to diabetes technology as its use grows.
Racial and ethnic representation of youth in type 1 diabetes interventional trials
Historically marginalized racial and ethnic youth were underrepresented in T1D trials. Strategies to improve recruitment of these populations are needed to reduce inequities in diabetes treatment and outcomes.
Relationship Between Food Insecurity and Healthy Eating Behavior for Gestational Diabetes Risk Reduction Among American Indian and Alaska Native Adolescent and Young Adult Females: A Qualitative Exploration
Three themes included (1) diet and nutrition habits are formed through intergenerational food preferences and are driven by lasting implications of colonization; (2) young people are influenced by what their peers eat and the food environment, including outside of the home; and (3) the methods used to understand household food insecurity and nutrition habits in the parent study were likely limited.
Heart Failure Risk Prediction in a Population With a High Burden of Diabetes: Evidence From the Strong Heart Study
This prospective study of HF risk factors in American Indian communities identifies that smoking, body mass index, and indicators of diabetes control and kidney damage (glycated hemoglobin and albuminuria) are major determinants of HF. Our findings can improve HF risk assessment in populations with a high burden of diabetes.
Evaluating Disparities in End-Stage Kidney Disease Survival Among American Indian/Alaska Native Persons with Diabetes
The findings reveal that AI/ANs have better survival outcomes than NWH, explained in part by initiating dialysis earlier than NHW. Additional research is needed to explore factors (e.g., social determinants; cultural; physiologic) that contribute to earlier diagnosis of ESKD-D in AI/ANs and the impact of prolonged dialysis on quality of life of those with ESKD-D.

Heart Disease in Native American Communities

Barriers and strategies for engagement and retention of rural Latino and Native American dyads in psychosocial interventions after stroke.
• Diverse/rural dyads experience barriers to engagement and retention in interventions.
• These barriers can be overcome by providers using specific communication strategies.
• Effective communication builds trust and may lead to better outcomes.
The association of Native American genetic ancestry and high-density lipoprotein cholesterol: A representative study of a highly admixed population
Native American genetic ancestry seems to play a small but distinct role in the development of low HDL cholesterol levels.
Heart Failure Risk Prediction in a Population With a High Burden of Diabetes: Evidence From the Strong Heart Study
This prospective study of HF risk factors in American Indian communities identifies that smoking, body mass index, and indicators of diabetes control and kidney damage (glycated hemoglobin and albuminuria) are major determinants of HF. Our findings can improve HF risk assessment in populations with a high burden of diabetes.
Systematic Review of Health Disparities for Cardiovascular Diseases and Associated Factors among American Indian and Alaska Native Populations
Rates of obesity, diabetes, cardiovascular disease, and metabolic syndrome are clearly higher for AI/AN populations. Hypertension and hyperlipidemia differences are more equivocal. Our analysis also revealed that there are likely regional and gender differences in the degree of disparities observed.

Cancer in Native American Communities

Breast Cancer Screening and Outcomes Disparities Persist for Native American Women
In order to provide equitable breast health care, more awareness and widescale initiatives are needed and can be championed by breast radiologists.
Disparities in Access to Radiation Therapy by Race and Ethnicity in the United States With Focus on American Indian/Alaska Native People
Cancer patients in block groups with AI/AN-majority populations, nonmetropolitan location, and low socioeconomic status experience substantial travel disparities in access to RT. Future research with more granular community- and individual-level data should explore the many other known barriers to access to cancer care and their relationship to the barriers posed by distance to RT care.
Great Plains American Indians’ Perspectives on Patient and Family Needs Throughout the Cancer Journey
To provide high quality cancer care to AI patients in their home communities, oncology clinicians should collaborate with local care providers, relevant organizations, and the Indian Health Service to identify and develop essential services. Future efforts must emphasize culturally responsive interventions in which Tribal community health workers serve as navigators to accompany patients and families during treatment and in survivorship.