Native Americans Have the Highest Risk for Diabetes Among Ethnic Groups
Native Americans have the highest prevalence of diabetes among all ethnic groups in the United States at 15.1%, significantly higher than other racial/ethnic populations. 1
Prevalence Rates by Ethnicity
According to the Centers for Disease Control and Prevention (CDC) data from 2015, diabetes prevalence rates among adults aged 18 years and older vary significantly by ethnicity:
- Native Americans/Alaska Natives: 15.1%
- Non-Hispanic Blacks: 12.7%
- Hispanics: 12.1%
- Asians: 8.0%
- Non-Hispanic Whites: 7.4%
Evidence Supporting Native Americans' Higher Risk
Multiple sources confirm that Native Americans face the greatest diabetes burden:
The 2015 CDC report consistently shows Native Americans/Alaska Natives having the highest prevalence of diabetes among all ethnic groups 1
Research from the California Health Interview Survey found that among all ethnic groups, Native Americans had the highest prevalence of diabetes (14.9%), compared to 10.1% in African Americans, 8.0% in Hispanics, 6.5% in Asians, and 6.0% in Caucasians 2
Even after adjusting for age, gender, other risk factors, and lifestyle characteristics, Native Americans still had the highest likelihood of diabetes with an odds ratio of 3.09 compared to Caucasians 2
Historical data shows this disparity has existed for decades, with diabetes-associated mortality rates among Native Americans being 4.3 times higher than whites and 2 times higher than blacks 3
Clinical Implications and Complications
The high prevalence of diabetes among Native Americans has significant clinical implications:
Native Americans with diabetes have higher rates of diabetic complications, including diabetic retinopathy 4
Among adults with diabetes, Native Americans had the highest prevalence of high cholesterol (42.1%) 2
There is evidence suggesting that diabetes develops at earlier ages and carries a higher incidence of complications among ethnic minorities, including Native Americans 1
Native Americans and Alaska Natives showed approximately a 45% increase in diabetes prevalence from 6.4 per 1000 in 1990 to 9.3 per 1000 in 1998 in children and young adults under the age of 35 years 1
Risk Factors in Native American Populations
Key risk factors associated with diabetes in Native Americans include:
- Age (increasing risk with advancing age)
- Male gender
- Lower intake of vegetables and fruits
- High blood pressure 2
- Socioeconomic factors, with higher rates among those with less education 1
Clinical Recommendations
Given the disproportionate burden of diabetes among Native Americans:
- Implement more aggressive screening protocols for Native American patients, starting at younger ages
- Focus on modifiable risk factors, particularly diet and blood pressure management
- Consider earlier intervention for prediabetes (HbA1c levels between 5.7% and 6.4%) in this high-risk population
- Develop culturally appropriate diabetes prevention and management programs 5
The evidence clearly demonstrates that among the ethnic groups listed (Hispanic, Caucasian, African American, and Native American), Native Americans face the highest risk for developing diabetes and its complications.