One important objective of national health initiatives is to reduce or eliminate disparities between different population groups in susceptibility to specific diseases, health-related behaviors, conditions that affect health, and treatment success ratios. The relatively high incidence of some diseases among Native American and Alaskan Native (NA/AN) populations compared to the general population is significant, as is the finding that cultural influence is an underlying cause of the differences.

 

Native American and Alaskan Native adults are 1.5 to 3 times more likely than Caucasians to suffer from heart disease, stroke, cancer or diabetes, the leading diseases and causes of death among NA/AN populations. There is also a higher prevalence of obesity, liver disease, hepatitis, tuberculosis, and sudden infant death syndrome (SIDS), as well as suicide and mental health concerns. Accordingly, attention has become focused on cultural factors underlying these disparities.

 

Of particular interest, during a cultural identity and diabetes control project with the Omaha Tribe in Nebraska, is the finding of three key (and interlinked) diabetes risk factors: obesity due to lifestyle changes; psychogenic responses to the stress of social and cultural changes; and heredity, in a genetic predisposition to store fat during times of plentiful food for sustenance when food supplies were sparse (“Reaching at risk populations: The Inconsistency of Communications Channels Among Native American Populations in Oklahoma”).

 

But 20^th century food-processing and preservatives curtailed famine; and, adoption of fast food along with a dietary switch from high fiber-low sugar to low fiber-high sugar, combined with a change from an active to sedentary lifestyle, gave rise to obesity and high blood sugar. These are known harbingers of diabetes, as well as risk factors in stroke, heart disease and other illnesses.

 

This determination of why Native Americans may be predisposed to particular diseases provides a valuable key for developing effective intervention and educational programs.  Targeted messaging, delivered by culturally-persuasive advocates, through familiar and trusted information channels is proving to be an effective means of bridging the cultural chasm.

 

Focus-group research in numerous sub-populations, including Native American groups, has demonstrated that an effective health-communication strategy is one in which a targeted audience can identify with the messenger or spokesperson. That is, a health message about a condition or disease is more readily accepted when delivered by “someone like me,” whether discussing potentially life-threatening illnesses or general wellness dietary and exercise advice.

 

Campaigns that utilize talking circles, storytelling, herbal and other traditional medicine lore ― such as "The Mother's Wisdom Breast Health Program" intervention designed by NA/AN women and funded by the California Breast Cancer Research Program ― are proving successful in capturing the interest and participation of Native American populations.