The Role of Traditional Foods in Diabetes Prevention and Management among Native Americans

Comparing Wild and Cultivated Food Plant Richness Between the Arid American and the Mesoamerican Centers of Diversity, as Means to Advance Indigenous Food Sovereignty in the Face of Climate Change

Climate change is aggravating agricultural crop failures, and the paucity of wild food harvests for Indigenous desert dwellers in Mexico and the U.S. This food production crisis challenges ongoing efforts by Indigenous communities in obtaining greater food security, prompting them to reconsider the value of traditional Indigenous food systems in both Mesoamerica and Arid America, two adjacent centers of crop diversity. While food production strategies in these two centers share many features, the food plant diversity in the Western Mesoamerican region appears to be greater. However, a higher percentage of plants in Arid America have adapted to water scarcity, heat, and damaging radiation. The phytochemical and physiological adaptations of the food plants to abiotic stresses in arid environments offer a modicum of resilience in the face of aggravated climate uncertainties. By comparing food plant genera comprising Western Mesoamerican and Arid American diets, we detected a higher ratio of CAM succulents in the wild and domesticated food plant species in the Arid American food system. We conclude that food plant diversity in the ancestral diets of both centers can provide much of the resilience needed to advance Indigenous food sovereignty and assure food security as climate change advances.

"Making Sense of a Disease That Makes No Sense": Understanding Alzheimer's Disease and Related Disorders Among Caregivers and Providers Within Alaska Native Communities

BACKGROUND AND OBJECTIVES

With the rate of Alzheimer's disease and related dementias (ADRD) increasing among Alaska Indian/Alaska Native (AI/AN) people, the Alaska Native Health system is ill-prepared to meet the challenges associated with the growing population at risk of ADRD. The high cost of care, inadequate training of health care providers, and lack of supportive services for caregivers are especially concerning.

RESEARCH DESIGN AND METHODS

Interviews were conducted with 22 AN caregivers for ANs with ADRD and 12 ANs and non-Native health care providers in communities across Alaska. Interviews lasted approximately 60 min and were transcribed verbatim. We employed directed content analysis to examine the major agreements and disagreements between the participants' understandings of ADRD in each of the domains of Kleinman's Explanatory Model of Illness.

RESULTS

Caregivers and health care providers expressed concerns about the lack of understanding, resources, and awareness of ADRD among ANs in rural and urban communities. Both caregivers and providers recognized the need to obtain an early diagnosis, blend Western and traditional medicines, promote lifestyle and dietary changes, and foster training for caregivers. Health care providers acknowledged their limited exposure to AN understanding of ADRD and wish to receive culturally relevant training to better serve AN.

DISCUSSION AND IMPLICATIONS

As the older AN adult population grows, the need for culturally responsive training and support services will continue to increase. We recommend establishing rural outreach and support groups for caregivers, developing an understanding of how ANs view ADRD to train and educate health care providers, and implement screening early for memory loss during routine medical examinations.

Health measures of Eeyouch (Cree) who are eligible to participate in the on-the-land Income Security Program in Eeyou Istchee (northern Quebec, Canada)

BACKGROUND

Participation in on-the-land programs that encourage traditional cultural activities may improve health and well-being. The Income Security Program (ISP) - a financial incentive-based on-the-land program - for Eeyouch (Cree) hunters and trappers in Eeyou Istchee was created as a result of the 1975 James Bay and Northern Quebec Agreement to help mitigate the effects of hydroelectric development on the Cree people of northern Quebec, Canada. Beyond the ISP's financial incentives, little is known about the health measures of those who are eligible to participate in the ISP (i.e. spent ≥120 days on-the-land during the previous year). Therefore, this paper's objective was to assess the health measures of northern Quebec Cree, who were eligible for participation in the ISP.

METHODS

Using participant data (n = 545) compiled from the Nituuchischaayihtitaau Aschii Multi-Community Environment-and-Health Study, we assessed 13 different health measures in generalized linear models with the independent variable being the eligibility to participate in the ISP.

RESULTS

Participants in the present study who were eligible for the ISP had significantly higher levels of vigorous and moderate activity per week, and higher concentrations of omega-3 polyunsaturated fatty acids in the blood compared to those ineligible for the ISP (i.e. spent ≤119 days on-the-land during the previous year). Encouragingly, following model adjustment for age and sex, participants eligible for the ISP did not have higher blood concentrations of mercury than those who were not eligible for the ISP.

CONCLUSIONS

Our results suggest that the participants eligible for participation in the ISP are likely to be healthier than those who are ineligible to participate - and are promising for on-the-land programs for Indigenous peoples beyond a financial incentive - with no apparent higher risk of increasing contaminant body burden through traditional on-the-land-activities (e.g. fish consumption).

United States Indigenous Populations and Dementia: Is There a Case for Culture-based Psychosocial Interventions?

Dementia is an issue of increasing importance in indigenous populations in the United States. We begin by discussing what is known about dementia prevalence and elder family caregiving in American Indian, Alaska Native, and Native Hawaiian populations. We briefly highlight examples of culture-based programming developed to address a number of chronic diseases and conditions that disproportionately affect these communities. These programs have produced positive health outcomes in American Indian, Alaska Native, and Native Hawaiian populations and may have implications for research and practice in the dementia context of culture-based interventions. Evidence-based and culture-based psychosocial programming in dementia care for indigenous populations in the United States designed by the communities they intend to serve may offer elders and families the best potential for care that is accessible, respectful, and utilized.