The Pima Indians on the Gila River Reservation in Arizona have the highest recorded rate of diabetes of any population in the world – but before World War II, diabetes was rarely seen among the 12,000 Indians who live there.
The decline of farming set the stage for the crisis, says Carolyn Smith-Morris, assistant professor of anthropology at SMU and author of Diabetes Among the Pima: Stories of Survival (University of Arizona Press, 2006). The dramatic change of diet and activity levels, as well as a genetic predisposition to the disease, led to the epidemic that affects 50 percent of the adults on the reservation.
"This epidemic is about a culture defining its path in an industrial world," says Smith-Morris, a medical anthropologist who has spent the past 10 years studying the causes and conditions of the health crisis and developing appropriate preventive strategies. She sees positive signs of change as tribal officials take more control of their health care system and health education.
Diabetes among the Pima is the first in-depth ethnographic volume to delve into the entire spectrum of causes, perspectives, and conditions that underlie the occurrence of diabetes in this community. Drawing on the narratives of pregnant Pima women and nearly ten years’ work in this community, Smith-Morris's book reveals the Pimas’ perceptions and understanding of type 2 and gestational diabetes, and their experience as they live in the midst of a health crisis.
Arguing that the prenatal period could offer the best hope for curbing this epidemic, Smith-Morris investigates many core values informing the Pimas’ experience of diabetes: motherhood, foodways, ethnic identity, exercise, attitude toward health care and a willingness to seek care.
Smith-Morris contrasts gripping first-person narratives with analyses of several political, economic, and biomedical factors that influence diabetes among the Pimas. She also integrates major theoretical explanations for the disease and illuminates the strengths and weaknesses of intervention strategies and treatment.
Learn more at her faculty Web site.
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