The Issue of Diabetes in Native Americans


Native Americans experience a significant burden of chronic diseases, which makes them one of the most threatened populations in the United States. In particular, diabetes is a prevalent problem in this population group, which requires a culturally-sensitive approach to prevention and management. The present paper explains the issue of diabetes and its effect on the Native American population while also explaining how culturally-sensitive care could positively impact the provision of care to Native American patients with diabetes. The text provides useful insights on applying culturally competent care and transcultural nursing theory to the nursing process. Based on research, the paper highlights the necessity for training nurses in cultural competency and encouraging them to learn more about various cultural and ethnic groups. Therefore, the paper contributes to efforts for improving the quality of care for Native American patients diagnosed with or at risk for diabetes.


Health disparities among various population groups is a popular subject of study in nursing research. American Indians are widely considered to have an increased burden of disease compared to other populations in America. For example, a report by Abbasi (2018) shows that the rate of premature deaths in American Indians has grown between 1999 and 2014, although it decreased in most other population groups. This suggests that Native Americans experience health disparities that must be addressed in nursing practice through health promotion initiatives. Culturally sensitive care could assist in promoting and improving health in Native American communities. The present research will show how culturally sensitive care can be used to enhance the nursing process in order to address the issue of diabetes in Native American patients.


Native Americans are subject to a number of health disparities, including increased tobacco and substance use, liver disease and cirrhosis, and mental health problems. This population also suffers from a high prevalence of diabetes. According to Spanakis and Golden (2013), the prevalence of diabetes in Native Americans is 33%, which is over four times higher than the rate of diabetes in white Americans. Thus, diabetes is a critical issue affecting the life and health of the specified population group.

Cultural competency is an important concept that can help nurses to address diabetes treatment and prevention in American Indians. According to Giger (2017), by using a culturally competent approach to nursing care, nurses can improve communication with patients and improve their adherence to recommendations for treatment and prevention. In particular, the transcultural nursing theory can be applied to the nursing process in order to achieve this effect. Thus, studying the application of culturally competent care and transcultural nursing to the nursing process could help to address the problem of diabetes in Native Americans.


The purpose of the present research is to apply the nursing process to the delivery of culturally competent care to Native Americans diagnosed with or at risk for diabetes. In particular, the paper will aim to outline the needs of the chosen population based on recent research in the area. Lastly, the paper will examine how transcultural nursing theory can be applied to the nursing process in order to fulfill these needs.

Research Method

The inquiry used a qualitative methodology, which is effective in discovering significant themes and trends in the nursing research. The university library and scholarly databases were searched for relevant articles and books on diabetes in Native Americans, cultural competency in nursing, and transcultural nursing theory application. The materials were then examined for their relevance to the topic, recency, and usefulness.

Review of Literature

The research reveals a high incidence of diabetes in the Native American population. The complications and deaths associated with diabetes are also prevalent in Native Americans. Spanakis and Golden (2013) report that Native Americans are 2.3 times more likely to die from diabetes than non-Hispanic white Americans. Some studies also explored the correlation between diabetes and risk factors in American Indians. For instance, according to Tiedt and Brown (2014), chronic stress associated with sociopolitical issues experienced by the Native American population could be related to the increased incidence of diabetes. Therefore, prevention of diabetes is of critical importance to improving population health. The main aspect of diabetes prevention and treatment that is applicable to Native American patients is the promotion of healthy eating habits. However, Satterfield, DeBruyn, Santos, Alonso, and Frank (2016) argue that it is critical to ensure a culturally-sensitive approach to diet management in American Indians.

Thus, culturally competent care is crucial to reducing the prevalence of diabetes among Native Americans. Douglas et al. (2014) provide a useful framework for incorporating culturally competent care into the nursing process. The researchers highlight the importance of cultural knowledge, training, and cross-cultural communication to the promotion of culturally competent nursing care. In addition, Giger (2017) reviews the application of transcultural nursing theory to the nursing process. The author states that in transcultural nursing, it is critical to take into account six cultural phenomena that vary across different cultural and ethnic groups: communication, space, social organization, time, environmental control, and biological variations (Giger, 2017). Overall, the research supports the importance of culturally competent care and transcultural nursing theory and provides valuable insights into their application to the nursing process.

Implications for Nursing Practice

The research will help to inform nursing practice, as it provides a framework to ensuring culturally-sensitive nursing care. The research shows that in addressing patients from other cultures, nurses should focus on collecting information about the patient’s culture. During all stages of the nursing process, nurses should use this knowledge to establish a cross-cultural communication with a patient, identify culture-related factors affecting his or her health, and develop a culturally-sensitive plan of care. This framework will be helpful in reducing the prevalence of diabetes among Native Americans, as it helps to ensure adequate assessment and treatment of a patient while also improving his or her adherence to treatment.


In addressing health problems specific to certain cultural groups, it is crucial for nurses to employ a culturally-sensitive approach. American Indian population suffers from a high prevalence of diabetes and requires a culturally competent approach to prevention and management of diabetes. Using an adequate framework and theory for implementing culturally-sensitive care, nurses can improve the nursing process, thus positively influencing the health of their Native American patients. The present paper provides useful recommendations on applying the principles of culturally-sensitive care to the nursing process. In particular, it emphasizes the importance of developing cultural knowledge and providing nurses with adequate training in cultural competency, which would help them to tailor the nursing process to patients from minority cultural groups. Thus, the paper has important implications for practice, as it aids nurses in enhancing their approach to patients from different populations.


Abbasi, J. (2018). Why are American Indians dying young? JAMA, 319(2), 109-111. Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M., Lauderdale, J.,… Purnell, L. (2014). Guidelines for implementing culturally competent nursing care. Journal of Transcultural Nursing, 25(2), 109-121.

Giger, J. N. (2017). Transcultural nursing: Assessment and intervention (7th ed.). St. Louis, MO: Elsevier Health Sciences.

Satterfield, D., DeBruyn, L., Santos, M., Alonso, L., & Frank, M. (2016). Health promotion and diabetes prevention in American Indian and Alaska Native communities—Traditional Foods Project, 2008–2014. MMWR Supplements, 65(1), 4-10.

Spanakis, E. K., & Golden, S. H. (2013). Race/ethnic difference in diabetes and diabetic complications. Current Diabetes Reports, 13(6), 814-823.

Tiedt, J. A., & Brown, L. A. (2014). Allostatic load: The relationship between chronic stress and diabetes in Native Americans. Journal of Theory Construction & Testing, 18(1), 22-27.

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