These trend lines for the prevalence of diagnosed diabetes show that diabetes for Native Americans in 1980 was nearly twice the level for Americans generally. During the following 27 years, the level of diabetes nearly doubled (from about 3%, to about 6 %) among Americans generally, but more than doubled (from about 5%, to about 13%) among Native Americans. For Americans as a whole, the diabetes rate was nearly flat, showing near stability, from about 1980 until about 1996. Then in 1996, the rate appears to have jumped significantly (by about 1 percentage point, or one-third over its previous level), and since that time ha been ramping up steadily (such that during the following decade or so, it has increased by about 2 percentage points more, bringing the rate to a level that is about double the 1980 rate). Given the relative stability of the general diabetes rate over the 15 years prior to mid-1990's, the observed level and ramp trend changes occurring around 1996 are undoubtedly both statistically and substantively significant. These trend effects - both the step and ramp changes in the trend line - are even more pronounced in the Native American diabetes rate (the upper line in the chart). However, the changes for Native Americans begin a few years earlier than for Americans overall (about 1994), and continue to increase at a steeper rate of increase than for Americans as a whole. Assuming some time lag between changes in peoples' diet, obesity, and the onset of diabetes, these data support the thesis that diet changes among Native Americans (due to the loss of Native farming and gardening opportunities, etc.) have led to these observed increased in diabetes. But what accounts for the similar, though less striking, diabetes rate changes among Americans generally? Perhaps these trend lines taken together point even more strongly toward the health impacts of processed foods (e.g., high fructose corn syrup and sugar) that have been increasingly replacing more natural foods since at least the 1960s and before. Thank you for providing this insightful article on the diabetes epidemic among our nation's Native Americans, as well as these intriguing related trend data. You Highlight a very important health problem for our entire nation.
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