Increasing burden of type 2 diabetes in Navajo youth: The SEARCH for diabetes in youth study

Powell, Jill; Isom, Scott; Divers, Jasmin; Bellatorre, Anna; Johnson, Melissa H.; Smiley, Janelia; Begay, Quanna; Benally, Christine; Hu, Diana; Saydah, Sharon; Pettitt, David J.; Pihoker, Catherine; Dabelea, Dana; Study, Search for Diabetes in Youth

doi:10.1111/pedi.12885

Cited by 12 publications

(6 citation statements)

References 24 publications

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“…Traditionally, the Navajo people lived a healthy lifestyle characterized by physical activity and consumption of healthy, traditional foods. However, a combination of poverty [1], inadequate and discriminatory policies and disruptions in food systems [3] have led to high rates of food insecurity [4] and nutrition-related chronic diseases such as type 2 diabetes [5,6]. Currently, similar to many American Indian/ Alaskan Native (AI/AN) people, the Navajo experience limited access to healthy foods.…”

Section: Introductionmentioning

confidence: 99%

Changes in food pricing and availability on the Navajo Nation following a 2% tax on unhealthy foods: The Healthy Diné Nation Act of 2014

et al. 2021

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Introduction In 2014, the Navajo Nation Healthy Diné Nation Act (HDNA) was passed, combining a 2% tax on foods of ‘minimal-to-no-nutritional value’ and waiver of 5% sales tax on healthy foods, the first-ever such tax in the U.S. and globally among a sovereign tribal nation. The aim of this study was to measure changes in pricing and food availability in stores on the Navajo Nation following the implementation of the HDNA. Methods Store observations were conducted in 2013 and 2019 using the Nutrition Environment Measurement Survey-Stores (NEMS-S) adapted for the Navajo Nation. Observations included store location, type, whether healthy foods or HDNA were promoted, and availability and pricing of fresh fruits and vegetables, canned items, beverages, water, snacks and traditional foods. Differences between 2013 and 2019 and by store type and location were tested. Results The matched sample included 71 stores (51 in the Navajo Nation and 20 in border towns). In 2019, fresh produce was available in the majority of Navajo stores, with 71% selling at least 3 types of fruit and 65% selling at least 3 types of vegetables. Compared with border town convenience stores, Navajo convenience stores had greater availability of fresh vegetables and comparable availability of fresh fruit in 2019. The average cost per item of fresh fruit decreased by 13% in Navajo stores (from $0.88 to $0.76) and increased in border stores (from $0.63 to $0.73), resulting in comparable prices in Navajo and border stores in 2019. While more Navajo stores offered mutton, blue corn and wild plants in 2019 compared to 2013, these changes were not statistically significant. Discussion The findings suggest modest improvements in the Navajo store environment and high availability of fruits and vegetables. Navajo stores play an important role in the local food system and provide access to local, healthy foods for individuals living in this rural, tribal community.

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Section: Introductionmentioning

confidence: 99%

Changes in food pricing and availability on the Navajo Nation following a 2% tax on unhealthy foods: The Healthy Diné Nation Act of 2014

et al. 2021

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“…However, similar to many indigenous communities, 2 Western influences have resulted in dietary changes and an increasingly sedentary lifestyle, 3 increasing risk for many common chronic conditions such as type 2 diabetes. 4 In 2014, the Diné Food Policy Institute published a report making the case to "Rebuild a Self-Sufficient Food System for the Diné People." The report found that in most communities, there was farming of traditional foods and a strong interest in traditional food consumption, but high rates of poverty, food insecurity, food-related chronic illness, and only 10 full-service grocery stores on the Navajo Nation, an area the size of West Virginia.…”

mentioning

confidence: 99%

The Navajo Nation Healthy Diné Nation Act: A Description of Community Wellness Projects Funded by a 2% Tax on Minimal-to-No-Nutritious-Value Foods

Yazzie

Tallis

Curley

et al. 2021

Journal of Public Health Management and Practice

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Context: To promote the health of the Navajo people, the Navajo Nation passed the Healthy Diné Nation Act (HDNA) in 2014. The HDNA included a 2% tax on "minimal-to-no-nutritional-value" foods and waived 5% sales tax on healthy foods, the first such policy in the United States and any sovereign Tribal nation. Uniquely aligned with Tribal government structures, revenue was directly allocated to 110 small local government entities (Chapters) for self-determined wellness projects. Objective: To characterize HDNA-funded wellness projects, test for variation in project type, and funding amount over time by region and community size. Design: Longitudinal study assessing funded wellness projects from tax inception through 2019. Setting: The Navajo Nation. Participants: One hundred ten Navajo Nation Chapters receiving funding for self-determined wellness projects. Outcome Measures: The categories and specific types of wellness projects and funding over 4 years by region and community size. Results: Of revenue collected in 2015-2018, more than 99.1% was disbursed through 2019 ($4.6 million, $13 385 annually per community) across 1315 wellness projects (12 per community). The built recreational environment category received 38.6% of funds, equipment/supplies 16.5%, instruction 15.7%, food and water initiatives 14.0%, and social events 10.2%. Most common specific projects were walking trails ($648 470), exercise equipment ($585 675), food for events ($288 879), playgrounds ($287 471), and greenhouses ($275 554). Only the proportion allocated to instruction changed significantly over time (increased 2% annually, P = .02). Smaller communities (population <1000) allocated significantly higher proportions to traditional, agricultural, and intergenerational projects and less to the built environment. Conclusions: Through 2019, more than 99% of HDNA revenue was successfully disbursed to 110 rural, Tribal communities. Communities chose projects related to promoting the built recreational environment, agriculture, and fitness/nutrition education, with smaller communities emphasizing cultural and intergenerational projects. These findings can inform other indigenous nations considering similar policies and funding distributions.

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“…Both are related to a higher risk of type 2 diabetes and cardiovascular disease and hence COVID-19 morbidity and mortality. It is postulated that Obesity may slightly reduce the chances of COVID-19 infection through lower tidal volumes of gas exchange in the lungs [43][44][45][46][47].…”

Section: Covid-19 Cellular Pathogenesismentioning

confidence: 99%

The Pathophysiology of COVID-19

Soto¹,

Hakim²,

Boyd³

2020

J Viro Res Rep

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Background: On Dec 19, 2019, the public health department of China reported that an outbreak of pneumonia was caused by a novel Coronavirus. On March 11, 2020, the World Health Department (WHO) declared a worldwide pandemic. Understanding the pathophysiology of the SARS-COV-2 virus is necessary for understanding the transmission, clinical presentation, associated risk factors, predicted outcomes, and provides guidance for treatment protocols. Methodology: A comprehensive PubMed search was performed utilizing the terms: COVID-19 in combination with the terms virulence (507), and/or pathophysiology (490) leading to 997 results. These results were then screened for relevance. Categorized, and evaluated under the auspices of making good pathophysiological sense. Results: The SARS-COV-2 virus is much more virulent than either the SAR’s or MER’s virus with its ability to cause serious disease inversely dependent on a person’s ability to produce T-cells. The ability to produce T-cells declines linearly until the age of 65. The ACE-2 receptor binding site does not vary among different ethnic groups, but initial evidence suggests there may be differences ACE-2 expression levels. This variance in expression level may explain different infectivity rates but not clinical outcome. The clinical outcome seems more related to the cytokine storm. Obesity, asthma, and COPD may decrease one’s likelihood of being infected but increases the morbidity rates once infected along with poor diet, hypertension, diabetes, and immunodeficiency. Conclusions: The underlying pathophysiology of COVID-19 explains not only the virulence, and clinical presentation, and suggest adverse clinical responses are related to dysregulation of the immune response.

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Increasing burden of type 2 diabetes in Navajo youth: The SEARCH for diabetes in youth study

Cited by 12 publications

References 24 publications

Changes in food pricing and availability on the Navajo Nation following a 2% tax on unhealthy foods: The Healthy Diné Nation Act of 2014

Changes in food pricing and availability on the Navajo Nation following a 2% tax on unhealthy foods: The Healthy Diné Nation Act of 2014

The Navajo Nation Healthy Diné Nation Act: A Description of Community Wellness Projects Funded by a 2% Tax on Minimal-to-No-Nutritious-Value Foods

The Pathophysiology of COVID-19

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