Kickapoo in a race to stem the tide of diabetes

Effort part of CDC-funded initiative to slow spread of the disease among American Indians

0 | Community Health, Foundations, Health Disparities

— It’s early on a Saturday morning and about 100 people – most of them members of the Kickapoo tribe – are gathering for the dedication of a new walking trail on the reservation, situated on about 20,000 acres in the glacial hills of northeast Kansas near Horton.

On hand to help with the ceremony is an athlete whose name may have faded a bit from public memory, but who still qualifies as a living legend here.

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Billy Mills, in white shirt and khaki pants, walks along the new Kickapoo Diabetes Walking Trail during a dedication event. Others participating in the walk included, front from left, Miss Kickapoo Daryl Hooper, Kickapoo Chairman Steve Cadue and fitness director Lucas Holmes.

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Billy Mills, looking much younger than his 76 years, steps to the microphone and starts to speak. He talks about how the values and spirituality of his Lakota Sioux culture sustained him as he fought to overcome poverty and prejudice on his way to winning an Olympic gold medal. And about his personal struggle with Type 2 diabetes, which wasn’t diagnosed until decades after his improbable victory in the 10,000 meters at the 1964 Tokyo Olympics.

Mills says the media of the day used to attribute his tendency to fade at the end of long races to a lack of character, when low blood sugar was the real cause. He thought about quitting but kept running.

“It’s our virtues and values that give us confidence, that give us direction and clarity of mind to start a project and stay the course,” says Mills, his voice rising with conviction. “I want us all to take the virtues and the values of our culture – and our traditions and spirituality – on our journey to defeat and control diabetes.”

Mills, co-founder of the nonprofit organization Running Strong for American Indian Youth, finishes his remarks and heads toward the new Kickapoo Diabetes Walking Trail to lead an initial group of walkers.

Agreeing to an interview while he walks, Mills says he hopes that his presence helps inspire people “to take control of their health.” But, he says, it’s the inspiration that he draws from people he meets that motivates him to spend Saturdays like this one far from his Sacramento, Calif., home.

“What inspires me is a lady who has lost 100 pounds and asks me to enter a fun run with her,” he says. “I enter the fun run and she beats me. That’s a true story.”

‘Creeping’ into youth

American Indians need all the star power and inspiration they can draw from it to reverse a disease trend that is devastating their communities. American Indian and Alaska Native adults are more than twice as likely as non-Hispanic whites to develop diabetes, according the Centers for Disease Control and Prevention.

But it’s the increasing number of American Indian children being diagnosed with diabetes that is perhaps most alarming. The rate of diabetes among American Indian and Alaska Native youth between 15 and 19 years old has jumped by more than 100 percent since 1990.

“Before, it (diabetes) had been largely with the adults, but now it’s creeping its deadly way into the youth,” says Steve Cadue, the Kickapoo chairman. “It’s terrible. We’re seeing diabetes getting down into the grade school ages.”

The half-mile walking trail and other initiatives, including diabetes management and cooking classes, demonstrate the Kickapoo’s determination to stem the tide. As does Cadue’s directive that gives Kickapoo Nation employees three hours a week to exercise or attend the classes during the workday.

Several of the anti-diabetes initiatives were catalyzed by a multiyear “vulnerable populations” grant from the Centers for Disease Control and Prevention. Administered by the Association of American Indian Physicians (AAIP), the goal of the project, which is entering its fifth and final year, is to help the Kickapoo initiate sustainable programs to combat diabetes. This year's grant amount is $466,667.

‘Seeing a difference’

Dr. Dee Ann DeRoin sees patients every Friday at the Kickapoo Nation Health Center. She says the project has helped people with diabetes and those at risk for the disease to make big changes in diet and lifestyle.

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Dr. Dee Ann DeRoin, center, walks along the trail with Joseph Simon, right, an emergency medical technician for the Kickapoo tribe who recently has lost more than 100 pounds by walking more and changing his diet.

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“I’m definitely seeing a difference,” says DeRoin, an AAIP member and a leader of the project. “It’s sort of like diabetes (awareness) is in the air. There are people who I had not seen as patients until they began to make significant changes who are now coming to me and saying with great pride, ‘This is what I’ve been able to do.’”

Partnerships also have been important to the project, DeRoin says. For several years, AARP Kansas has partnered with AAIP to bring Richard Hetzler – head chef of the Mitsitam Café at the Smithsonian National Museum of the American Indian – to Kansas to help members of four tribes learn how to prepare ancestral dishes using nutritious ingredients.

“AARP has just been a total surprise and a fabulous partner,” DeRoin says. “In November, we’ll hold our fourth annual diabetes cooking class sponsored entirely by AARP Kansas.”

The walking trail project was done in partnership with AAIP and the Sunflower Foundation, which has invested more than $2 million since 2005 in public trails and other building projects that help Kansans to be more physically active.

“It isn’t enough to have a program. You actually have to change the environment in which people live, work and play,” says Sunflower program officer Elizabeth Stewart, explaining the foundation’s commitment to “built environment” projects.

The Kickapoo trail project, she says, grew out of a chance meeting she had at a conference with someone who was working with the tribe on its efforts to curb diabetes.

“We were talking about trails and they said, ‘Gosh, we have no place to walk on our reservation. We have a lot of land but no place safe to walk,’” Stewart recalls. “So we went to work and came up with a plan and were able to partner with them to build this half-mile trail – the first on the reservation.”

Planning already is under way, Stewart says, to expand the trail system.

Dr. Ronnie Bell, an epidemiologist from Wake Forest University, is in charge of evaluating the five-year project. A member of the Lumbee Tribe of North Carolina, Bell says the data so far confirm DeRoin’s observations that progress is being made.

“I think there has been a tremendous amount of change as evidenced by a gathering like this,” Bell said. “In rural communities like this, oftentimes there aren’t resources to support exercise and healthy eating. So I think this is a great sign that people are embracing what’s going on here.”

It’s not reasonable to expect a five-year project to produce a significant reduction in the prevalence of diabetes among the Kickapoo, say Bell, DeRoin and others. What’s important, they say, is whether the tribe has institutionalized the kind of changes in diet, exercise and lifestyle that can lead to better health.

“Our goal for year five is to help the coalition look at all the varieties of ways they can sustain these efforts,” DeRoin says.

Video

Kickapoo Nation walking trail dedication

Joseph Simon, an EMT for the Kickapoo Nation, discusses how he lost more than 100 pounds through lifestyle changes that include walking. He participated in events Saturday, August 30, surrounding the dedication of a new half-mile oval trail on the Kickapoo Nation reservation near Horton.




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