Prevention efforts promoted for Native kids

WASHINGTON - The diabetes epidemic in Indian country continues, but officials with the Centers for Disease Control and Prevention and its partners are not sitting still. Health educators nationwide are stepping up promotion of prevention tools aimed at young American Indians.

In late June, the CDC issued a report that indicated the rate of diagnosed diabetes is highest among American Indians and Alaska Natives, at 16.5 percent. This rate is followed by blacks (11.8 percent) and Hispanics (10.4 percent), which includes statistics for Puerto Ricans (12.6 percent), Mexican-Americans (11.9 percent) and Cubans (8.2 percent).

The rate for Asian-Americans was 7.5 percent, while the rate for whites stood at 6.6 percent. The rates for Indians were largely measured using IHS outpatient data from 2007.

Kelly Acton, director of IHS' Division of Diabetes Treatment and Prevention, said she believes the numbers for Natives are extremely accurate and noted that IHS participated in the workgroup that developed the CDC report.

Overall, the number of Americans with diabetes has grown to about 24 million people, or roughly 8 percent of the U.S. population. The total number of diabetics has risen about 3 million over two years, according to the CDC, which also estimates that another 57 million people have blood sugar abnormalities called pre-diabetes. This condition puts people at increased risk for the disease.

Adding to the bad news: American Indian children have the highest risk factors for the disease, which kills more than 200,000 people per year, according to the U.S. Department of Health and Human Services.

Partially in response to the latest research, the CDC is increasing efforts focused on young Native populations to help prevent onset of the disease. The agency, in conjunction with IHS, the National Institutes of Health and tribal and mainstream colleges, is currently reaching out to school districts nationwide with large Indian student populations to offer free, culturally relevant prevention materials.

NIH, IHS, CDC and eight tribal colleges are also expected to release a separate wide-ranging K - 12 ''Diabetes Education in Tribal Schools Curriculum,'' focused partly on Native youth diabetes prevention, later this year. Tribal leaders have long been pushing for coordinated action in this area.

As part of the efforts, the Central Consolidated School District in New Mexico has worked with the University of Oklahoma to incorporate into its curriculum culturally relevant teaching materials created by CDC. Nearly 900 CCSD elementary school students will be targeted this school year with a curriculum designed to decrease their risk for getting diabetes. The district serves a 90 percent Navajo student population.

The CCSD school board voted in June in favor of distributing a series of four CDC-created eagle-themed picture books to all students in the fourth and fifth grades. The books, which have been around for about two years, feature American Indian youngsters who learn about their ancestors' healthy habits.

Barb Walker, CCSD student services coordinator and a nurse, said the CDC books are one tool to help young people think about health and try to be fit. The stories have been used for some time with young people as part of the IHS diabetes prevention program in Shiprock.

''Any way that we can give positive messages about nutrition and exercise is critical,'' she said. ''We want to give a consistent message to our young people that their health is very important.''

Walker said that in addition to providing healthy messages, it is important for adults and educators to realize that a ''healthy child can learn.''

''If we promote the health part of learning, then the kids have a better chance at succeeding. We have to be willing to plant the seed.''

In developing the books, the CDC consulted with IHS officials and commissioned Native writers and illustrators. CDC spokeswoman Rachel Ciccarone noted the books are available to anyone who requests them by calling (800) CDC-INFO.

''The messages [of the books] are focused on positive nutrition, physical activity, and a return to traditional ways as a means to prevent diabetes,'' said Ciccarone, who noted that American Indian children have the highest rates of Type 2 diabetes of any race and ethnicity group in the U.S. She said that Type 2 diabetes, once known as adult-onset diabetes, is rather uncommon in children.

''It's the preventable type of diabetes, which is why these messages are so very important,'' Ciccarone said. ''We know that through good nutrition and physical activity, you can prevent or delay the onset of diabetes.''

Ciccarone added that the overarching goal of the CDC is to stabilize the diabetes rate among Indians, then decrease it.

''We want to educate the young people as quickly as we can about nutrition and exercise,'' she said. ''We believe teaching through story books with a cultural theme is a positive step to reach

Native children.''

In addition to the children's books, the CDC offers a guide for educators. It is available online at www.cdc.gov/diabetes/pubs/eagle.htm.

Ciccarone noted that the diabetes epidemic is best managed through prevention. The disease is marked by high blood glucose and risk factors include age, obesity, level of physical activity, diet and ethnicity. It can be prevented by making simple lifestyle changes, especially early on in life.