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Abstract:
This paper explores the state of the science on the relationship between stress, allostatic load and diabetes in the Native American population. The physiology of stress and allostatic load related to specific chronic stressors relevant to Native Americans is explored. Research supporting the relationship between susceptibility to diabetes and chronic stressors such as multi-generational trauma, political oppression, epigenetics, social-economic-status, and resource alienation is presented. Finally, implications for Native American health are explored. Further investigation on the effects of chronic stress in the development of diabetes within the Native American population may inform health programs.
Keywords: Allostatic Load, Stress, Diabetes, Native Americans
Despite advances in treatment; the Native American population suffers disproportionately from diabetes (Berry et ah, 2004). Research suggests that this health disparity is rooted in racial discrimination, residential segregation, poverty, life-style choices and cultural issues (Tashiro, 2005). Native Americans have survived generations of oppression, racism, genocide and forced relocation. As tribes were displaced and were unable to access their traditional food sources, they received government subsidized food assistance that contained highly refined food items. Until these subsidies were initiated in the 1940s, diabetes was non-existent in Native Americans (Young, 1994). These events caused generations of chronic stress. Studies have found a relationship between poverty, chronic stress and increased incidence of diabetes among Native Americans (Krieger, 2001; Szanton, Gill, & Allen, 2005). The purpose of this paper is to present the state of the science on the relationship between chronic stress and diabetes in the Native American population. The physiology of stress and allostatic load, as they relate to specific chronic stressors that are relevant to Native Americans is presented. Research that supports the relationship between these stressors and increased susceptibility to diabetes is explored. Finally implications for Native American health are discussed.
Historical Perspectives of Stress
The works of Hans Selye, Richard Lazarus and Bruce McEwen are instrumental for understanding the physiological and psychological reactions to stress and the development of chronic diseases. Selye introduced the idea of stress in his early studies about the body's reaction to noxious stimuli called stressors. Selye described three stages of stress. The initial alarm reaction to a stressor is the "fight or flight" mechanism. In the second stage, the body either adapts to or resists...