SAN DIEGO—While the high rates of obesity among Native Americans propels forward the population’s chronic disease rates, a recent report provides a better state-by-state glimpse of how obesity is impacting Indian Country.

According to data released by the Centers for Disease and Control and Prevention, and analyzed in the annual State of Obesity report by the Trust for America’s Health and the Robert Wood Johnson Foundation, in Arizona, North Carolina and New Mexico at least 75 percent of Native American adults are overweight or obese. Texas had the lowest obesity rate for Natives at 51 percent.

“This is the first time that we have had some real data that looked at the Native American population for each state,” said Rich Hamburg, deputy director of Trust for America’s Health, who added that, of the 25 states with reportable data for Native Americans, all reported obesity rates above 50 percent.

Dr. Sheila Fleischhacker, Senior Public Health and Science Policy Advisor at the National Institutes of Health Division of Nutrition Research Coordination states “where Native people live also plays a crucial role in obesity rates.”

Another report on food systems in tribal communities, Feeding Ourselves, published earlier this year, details the stark reality for many Natives to access healthy and affordable foods in their own community.

According to the U.S. Census, about 78 percent of American Indians and Alaska Natives do not live on reservations and instead live in urban areas.

“There are also more than 500 tribes and Native villages in the U.S., and each has their own unique tribal structure, assets and challenges relating to the prevention and treatment of nutrition-related chronic diseases,” Fleischhacker said.

The most recent national data available show that over half of American Indian and Alaska Native adults are obese, compared to roughly one third of all U.S. adults.

For childhood obesity, the report does show the rates beginning to level off for a few age groups among Whites, but rates for several age groups of Blacks, Latinos, and Native children remain high and may have yet to peak. According to the report:

•One in four Native American 2 to 5-year-olds is obese;•Nearly a third of Native children 6 to 11 years old and a third of those ages 12 to 19 are obese.

But there is some good news to report for children’s obesity overall, Hamburg said. “We are beginning to see some successes, particularly among kids in areas where we know there has been a prevention effort through programs and policy,” he said.

For both Native American adults and children, food access and physical inactivity are often cited as some of the greatest challenges in overcoming obesity in Indian Country. Policies to increase the tax on sugary foods and drinks, such as in the Navajo Nation, and programs aimed at increasing children’s health and fitness continue to be implemented in tribal communities to combat the rising rates.

One organization leading the charge to improve Native American nutrition and physical activity is the Native-led Notah Begay III Foundation, which also focuses on reducing type 2 diabetes rates.

Olivia Roanhorse (Navajo) directs one of NB3’s programs called NativeStrong, which provides grants for grassroots programs targeting children’s nutrition education, access to healthier foods, increased physical activity, and culturally-based youth and community leadership development.

More than 40 Native communities have carried out community-led programs with the support of NB3, but despite their efforts, one of the biggest struggles to overcoming obesity among Native Americans continues to be the lack of funding for prevention, Roanhorse said.

“That is a challenge because [the Indian Health Service] just can’t do all the things our people need, so we know we can’t rely on the Indian Health Service for everything,” Roanhorse said.

Studies have shown that diet and nutrition have also undergone a transformation in many Native communities over the last 50 years. What was once a diet of Native traditional foods has shifted into one much higher in fat, sugar and sodium, and lower in fruits, vegetables, lean proteins and whole grains.

Freda Carpitcher (Seminole) is the Health Promotion and Disease Prevention Coordinator for the Indian Health Service’s Oklahoma Area. In the State of Obesity report, Oklahoma is listed as having the fourth-highest rate of obesity for Native American adults, exceeding 76 percent.

Carpitcher and her team work to educate hundreds of Native American families across Oklahoma, Kansas and parts of Texas about healthier lifestyles, including the return to indigenous foods.

“If you look back 60 to 70 years, our disease rates were much lower than they are now,” she said. “My hope is that we, as all Natives, will return to indigenous foods, the ones that our grandparents grew themselves and consumed. If we return to indigenous foods, it’s going to contribute to lowering disease rates.”

Although the report helps shed more light on obesity among Native Americans, it’s still difficult to say which states are seeing any signs of progress for the Native population.

“It’s been a different society for the last couple of decades, and I think that’s the same for Native Americans,” Hamburg said. “We’re driving less and fewer people are living in areas where you could walk to school or work. Over time, we just need the kids and the population to be more active and eat healthier. That’s still the bottom line.”

But until those healthy indigenous foods are more accessible to everyone and communities are built to encourage people to walk, it’s an uphill battle for families trying to eat healthy and be active.

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