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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