For the past forty years, the Pima Indians living in the Gila River Indian Community have been among the most consistently studied diabetic populations in the world. But despite many medical advances, the epidemic is continuing and prevalence rates are increasing. Diabetes among the Pima is the first in-depth ethnographic volume to delve into the entire spectrum of causes, perspectives, and conditions that underlie the occurrence of diabetes in this community. Drawing on the narratives of pregnant Pima women and nearly ten years’ work in this community, this book reveals the Pimas’ perceptions and understanding of type 2 and gestational diabetes, and their experience as they live in the midst of a health crisis. Arguing that the prenatal period could offer the best hope for curbing this epidemic, Smith-Morris investigates many core values informing the Pimas’ experience of diabetes: motherhood, foodways, ethnic identity, exercise, attitude toward health care, and a willingness to seek care. Smith-Morris contrasts gripping first-person narratives with analyses of several political, economic, and biomedical factors that influence diabetes among the Pimas. She also integrates major theoretical explanations for the disease and illuminates the strengths and weaknesses of intervention strategies and treatment. An important contribution to the ongoing struggle to understand and prevent diabetes, this volume will be of special interest to experts in the fields of epidemiology, genetics, public health, and anthropology. Click here for a Facilitator’s Guide to Diabetes among the Pima

The reported population of American Indians and Alaska Natives has grown rapidly over the past 20 years. These changes raise questions for the Indian Health Service and other agencies responsible for serving the American Indian population. How big is the population? What are its health care and insurance needs? This volume presents an up-to-date summary of what is known about the demography of American Indian and Alaska Native populationâ€"their age and geographic distributions, household structure, employment, and disability and disease patterns. This information is critical for health care planners who must determine the eligible population for Indian health services and the costs of providing them. The volume will also be of interest to researchers and policymakers concerned about the future characteristics and needs of the American Indian population.

Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.

We are what we eat. That old expression seems particularly poignant every time we have our blood drawn for a routine physical to check our cholesterol levels. And, it's not just what we eat that affects our health. Whole ranges of behaviors ultimately make a difference in how we feel and how we maintain our health. Lifestyle choices have enormous impact on our health and well being. But, how do we communicate the language of good health so that it is uniformly received-and accepted-by people from different cultures and backgrounds? Take, for example, the case of a 66 year old Latina. She has been told by her doctor that she should have a mammogram. But her sense of fatalism tells her that it is better not to know if anything is wrong. To know that something is wrong will cause her distress and this may well lead to even more health problems. Before she leaves her doctor's office she has decided not to have a mammogram-that is until her doctor points out that having a mammogram is a way to take care of herself so that she can continue to take care of her family. In this way, the decision to have a mammogram feels like a positive step. Public health communicators and health professionals face dilemmas like this every day. Speaking of Health looks at the challenges of delivering important messages to different audiences. Using case studies in the areas of diabetes, mammography, and mass communication campaigns, it examines the ways in which messages must be adapted to the unique informational needs of their audiences if they are to have any real impact. Speaking of Health looks at basic theories of communication and behavior change and focuses on where they apply and where they don't. By suggesting creative strategies and guidelines for speaking to diverse audiences now and in the future, the Institute of Medicine seeks to take health communication into the 21st century. In an age where we are inundated by multiple messages every day, this book will be a critical tool for all who are interested in communicating with diverse communities about health issues.