Indige-Nurse: Obesity is an Indigenous Health Crisis. So What Can We Do?

Indige-Nurse: Obesity is an Indigenous Health Crisis. So What Can We Do?

Indige-Nurse is a column published by and written by Jeanette Centeno, a Registered Nurse (RN) and Case Manager (CM) who holds a Bachelor of Science in Nursing (BSN). Centeno (Taíno) draws on her experience in the medical field and her own indigenous background to educate Native communities on the health issues that matter most. 

Native American communities face major health concerns that have disproportionately affected them for generations. Poor health choices, lack of proper medical interventions, minimal food alternatives, and access to healthy foods have placed many indigenous people in a perpetual health crisis.

According to the Department of Health and Human Services Office of Minority Health, 33 percent of all indigenous people are obese and by the age of 10, 50 percent of indigenous children suffer from weight issues.

Research shows several factors affect affect tribal communities:

  • Many reservations face food insecurity and poverty, which impact nutrition
  • Lack of supermarkets in reservations that provide healthy foods and alternatives
  • Environmental factors and lack of farmland that prevent the growth of fruits and vegetables
  • Lack of educational, nutritional, and health programs geared toward adults and children.
  • Fast food restaurants outnumber supermarkets
  • Lack of physical activity and funding for P.E. programs in schools.

According to Shervin Aazami, deputy director of congressional relations at the National Indian Health Board, forced assimilation and involuntary relocation have resulted in pervasive health issues in Native communities. Indigenous people no longer eat the same healthy foods or maintain the same diets so they've become dependent on tribal allocations and resources to stay healthy.

Tribal nations need interventions that serve everyone in the community effectively. For instance, the Navajo Nation recently approved a 2 percent sales tax on junk food sold in the reservation. They're also collaborating with the Northern Arizona University to research how the law can curb obesity. Other tribes, such as the Pima, are investing in gardening and harvesting fruits and vegetables.

Why do we need interventions?

  • Obesity threatens the greatest tribal resource: children. They will inherit the culture and language.
  • Growing health issues only project to be more costly
  • Food prices will continue to rise
  • Health education and programs must be tailored to specific nations, but they should also be further broken down by age groups and specific health needs
    To reduce co-morbidities that contribute to a shorter lifespan for Native Americans
  • To increase self-sustainability in tribal communities

A rampant issue in the indigenous community is the lack of visibility and representation in healthcare. Too often, indigenous people are excluded in medical data, evaluations, or research that impacts care and outcomes. According to the National Health and Nutrition Examination Survey (NHANES) Native Americans are not even included in the national surveys, and data is often generalized.

If they are not included, how are chronic diseases being addressed in this community? The scope of care needs to be redesigned in order to include indigenous people—especially children. Furthermore, education needs to include health issues that begin with poor nutrition, such as hypertension, high cholesterol, cardiovascular disease, endometrial cancer in women, and colorectal cancer in men.

Lastly, educational programs and interventions should be culturally sensitive, and they ought to include traditional foods and values. The health of the individual is tethered to the health of the tribe.

We must improve dietary health and physical activity. Our future depends on it. 

About Jeanette Centeno

Jeanette Centeno (Taíno) is a nurse with 18 years of experience, ranging from Spinal Cord Injury patients to case management. She is committed to advocating for adequate healthcare and proper intervention for all people. Centeno currently works at the Kessler Institute for Rehabilitation, one of the leading acute care hospitals in treating Spinal Cord Injury.

One Comment “Indige-Nurse: Obesity is an Indigenous Health Crisis. So What Can We Do?”

  • Avatar for Lynda Plummer

    Lynda Plummer


    As you wrote in this article, obesity is the number 1 health problem in indigenous communities. I assisted a group to write a grant to combat obesity in an indigenous community. It’s an excellent project linking clinics, gyms, hospitals, and churches. Social and emotional support through the arduous process of reshaping one’s lifestyle is vital. I am writing a new proposal to add supports to this project through strengthening ties within the indigenous community. With your knowledge of the obesity problem in these communities, how would you suggest we begin?

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