Genetic histories: Native Americans’ accounts of being at risk for diabetes

Abstract

In an age of genetic medicine, ethnic groups are increasingly being labeled at risk for chronic diseases. Biomedical and genetics research studies have had a significant impact on Native Americans’ perceptions of diabetes risk. Ethnographic interviews with 53 Native Americans were conducted in a tribal community that has participated extensively in studies of diabetes. Tribal members had varying reactions to research labeling them at risk genetically for diabetes, from fatalism to motivation for changing diet/exercise habits. Interviewees spontaneously discussed the ‘thrifty genotype’ hypothesis in diverse ways. Some felt Native Americans had ‘weak genes’ that made them ‘poorly adapted’ to modern society’s diet, while others stated that Native Americans had ‘survival genes’ that historically helped them thrive in harsh environments. Interviewees used genetics as a metaphor for expressing vulnerability in the face of a challenging history that resulted in rapid changes to Native American lifestyles. Interestingly, some tribal members saw biomedical research as a tool to help them ‘adapt’ to the modern world. Collaborative research may provide tribes with unique opportunities to actively address the diabetes epidemic. Researchers’ and healthcare providers’ descriptions of diabetes risk have important implications for how community members perceive their ability to prevent or manage the disease.