Dakota Indians; Diabetes; Health education; Health promotion; Health protection; Indians of North America; Native Americans; Non-insulin-dependent diabetes – Prevention; Older women; Teton Indians


Community-Based Learning | Gender and Sexuality | Medicine and Health | Public Health | Public Health Education and Promotion


Around the world, Type 2 diabetes is on the rise, affecting adults and youth from societies in the throes of industrialization. Over time, uncontrolled diabetes can leave in its wake people facing renal failure, blindness, and heart disease, and communities daunted by new, chaotic phenomena. Westernized lifestyles are a recognized explanation for the escalating prevalence. The web of causation, however, may be broader and thicker, woven by complex interactions with environmental, sociological, and historical roots. The purpose of this participatory ethnographic study was to document, understand, and support Lakota and Dakota elder women’s beliefs and knowledge about health protection and diabetes prevention. In-depth interviews were conducted with nine elder women to learn: (1) about the factors attributable to diabetes, (2) about related narratives addressing health protection and diabetes prevention, and (3) how knowledge about health protection is shared. The elders saw diabetes as an outside, unnatural disorder, the contributing influences of which are external as well as internal. They offered narratives about chaos, restitution, testimony, and quests for cures and meaning. The elders connected health to traditional values and ways, the land, and memory. Reservoirs of wisdom reside in the knowledge systems of tribal elders who remember when diabetes was unknown. Health leaders at local and national levels would be wise to respect and draw upon this knowledge for guidance in program planning and policy development.