Indigenous communities in the United States face a disproportionate burden of type 2 diabetes (T2D), with rates far exceeding those of other racial and ethnic groups. According to national surveys, Indigenous adults are more than twice as likely to be diagnosed with diabetes compared to non-Hispanic white adults. Among youth aged 10–19, the prevalence of T2D in Indigenous populations is 1.20 per 1,000—over seven times higher than in white youth.
This disparity is not just statistical—it reflects deep-rooted social and historical inequities. Researchers point to colonization, displacement, and loss of traditional foodways as contributing factors. “Food insecurity and colonization have contributed to health disparities,” the authors note, highlighting that nearly 77% of reservation residents live more than a mile from a grocery store.
Obesity, a major risk factor for T2D, is also more common in Indigenous communities. Adults are 50% more likely to be obese than their white counterparts, and adolescents 30% more likely. Complications from early-onset diabetes are severe, including higher rates of kidney disease and vision loss. In one study, 67% of end-stage renal disease cases in Indigenous populations were caused by diabetes.
Efforts like the Special Diabetes Program for Indians have shown promise, with culturally tailored interventions reducing diabetes incidence. Still, the authors stress that future research must engage Indigenous communities directly and address the intergenerational transmission of risk.
See: “Epidemiology of type 2 diabetes in Indigenous communities in the United States” (November 22, 2022)
