Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this study. We found commonalities among all of the cultural/ethnic groups in their experiences of the difficulties of caregiving. However, there were some significant differences in the cultural values and norms that shaped the caregiving experience. We categorized these differences as: (a) cultural embeddedness of caregiving, (b) cultural determinants of caregiving responsibilities or taxonomy of caregiving, and (c) cultural values and norms underlying the decision to provide care. The significance of this study is that it highlights the culturally perceived mandate to provide care in the African, Asian, and Hispanic American cultures.

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Rare in Indian country just sixty years ago, type 2 diabetes mellitus is now woven into the fabric of losses in tribal communities across North America. Westernized lifestyles, with coincident obesity and physical inactivity, are powerful risk factors for this relatively new "disease of civilization." The web of causation is thicker and wider than obesity and physical activity alone, intertwined by historical, economic, environmental, and sociological roots. As diabetes-related morbidity, disability, and mortality continue to increase in communities around the globe, many tribal elders recall when diabetes was almost unknown. They remember being taught how to stay healthy, lessons that were part of their "traditional ecological knowledge," a symbolic and informational knowledge that is grounded in cultural values and practices, and refined through generations of observation, experimentation, and adaptation. In these conversations, the elders' traditional ecological knowledge richly illustrates the cultural capital that supported their survival and helped maintain the health of their communities even when they had to face challenging times. The purpose of this article is to describe a number of dynamic, tribally driven efforts that draw on traditional ecological knowledge to address the problem of diabetes in American Indian and Alaska Native communities.

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