Abstract

This paper argues that Type 2 diabetes disparities in Native American communities and Chinese

ethnic minority communities are produced by structural inequality, specifically being reshaped

by shifting political policy and cultural disruption. Through a comparative analysis of the Pima

and Cherokee tribes in the United States and the Miao and Manchu populations in China, this

study examines how forced assimilation, relocation, and market-driven modernization have

destabilized traditional food systems and constrained access to consistent healthcare. Although

these communities exist within differing political and economic environments, they face similar

struggles when institutions prioritize socioeconomic development over local continuity. By

challenging narratives that individualize blame, this research reframes diabetes partially as an

illness shaped by the conditions under which people are made to live. Finally, the paper draws

implications for intervention: solutions must address root causes by working alongside affected

communities to rebuild trust, by providing them with food sovereignty and a suitable healthcare

support system.

Keywords: Type 2 diabetes mellitus (T2DM), forced assimilation, Food Distribution Program

on Indian Reservations (FDPIR), Pima (Akimel O’odham), Cherokee Nation, Miao, Manchu,

blood quantum level, screening uptake, traditional healing

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