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Fighting the Plague of Diabetes in Indian Country

Diabetes is a terrible disease, and one that has afflicted American Indian and Alaska Native communities since the disruption of their traditional cultures centuries ago. That’s why I recently introduced legislation to ensure stable and continuous funding for the Special Diabetes Program for Indians. 

We must continue this critical initiative that is helping improve the health of Indian country.

As Chairman of the Senate Indian Affairs Committee, I know the health challenges facing American Indian and Alaska Native communities. Individuals living in these communities have significantly higher rates of chronic health issues, such as obesity, high cholesterol, chronic liver disease, and especially, diabetes.

On average, American Indians are two times more likely to be diagnosed with diabetes than other ethnicities. And once they have diabetes, their rate of kidney failure is nearly double the national average. It is compounded by the fact that nearly 30 percent live in poverty, many of them in rural areas with limited access to healthcare. There are some pockets of Indian Country where the rate of the disease is as high as 60 percent of the population.

Beginning in 1965, the Pima Indians of the Gila River Indian Community participated in a 30-year study to examine how changes in diet and exercise impact the onset of diabetes. One-half of adult Pima Indians had diabetes and 95 percent of those with the disease were overweight.

The study found that changes in diet and erosion of tribal land holdings and water reserves led to lower incomes and reliance on low-cost processed foods. All of these factors lead to a decline in health status.

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In 1997, Congress established the Special Diabetes Program for Indians to help combat this health epidemic in Indian Country. The program has been reauthorized each year since 2008 at $150 million, but there have been unacceptable funding delays. This bill permanently reauthorizes the program.

We have already seen this program’s positive impact on Native populations. Between 1999 and 2006, the rate of end-stage renal disease due to diabetes fell by 28 percent. That was a more significant drop than any other ethnic group over the same time period. We must work to ensure such progress can continue without interruption from folks in Washington.

The Indian Family Health Clinic in Great Falls, Montana receives vital funding from the Program. They’ve developed creative solutions to barriers to health care including a "kiosk" in the clinic with a computer for patients to use to apply for Medicare and Medicaid, download forms, and register as new patients and for diabetes classes.

One of the best steps Congress can take is provide tribes and tribal organizations with the tools that they need to help prevent the spread of diabetes. More than 80 percent of grant programs within the Special Diabetes Program for Indians are used to implement health strategies to prevent diabetes in Native youths. And with Native children and young adults ages 10 to 19 nine times more likely to be diagnosed with diabetes than any other race, we know more needs to be done.

This program has served the Native population well, but it can’t be subject to the constant threat of budget cuts or elimination. In the long run, this program saves money by reducing medical costs. Studies show that the cost of medical care for people with diabetes is more than two times higher than for those without the disease. That’s why guaranteeing funding isn’t just the right choice, it’s the smart choice.

We have treaty and trust obligations to the tribes of this nation to ensure they not only survive, but also thrive. I look forward to continuing work with tribes and tribal organizations to improve the health outcomes for American Indians and Alaska Natives. I hope you will join me in supporting permanent reauthorization of the Special Diabetes Program for Indians.

Jon Tester (D) is the senior United States Senator from Montana.