This November, I Am Thankful to be Advocating for Health Care Equity

Assistant Professor Lisa Scarton, PhD, RN, speaks about what the month of November means to her.

November is one of my favorite times of year: It is both Native American Heritage Month and Diabetes Awareness Month, and these events are of personal importance to me. During Native American Heritage Month, we recognize and honor the diverse cultures and traditions of Native peoples, as well as acknowledge their resilience in the face of challenges. As an enrolled tribal member of the Choctaw Nation of Oklahoma, I have seen the resiliency of this strong community firsthand. We are a sovereign nation with a vibrant, living language, as well as a proud heritage.

However, I also know of the challenges that we face, with one of the most significant being diabetes.


While Type 2 Diabetes affects more than 37 million people living in the U.S., its effects are especially prevalent in American Indian communities, affecting grandparents, parents and children alike.1 Due to a lack of access to nutritious food and high rates of poverty, among other factors, American Indians are nearly three times more likely than whites to have diabetes.2 This problem is becoming even more pronounced among our children. Research has revealed a 70% increase in diabetes among American Indian teens in just a recent, 10-year span 3. Health inequities are real and ever-present for underserved American Indian communities. High rates of diabetes also contribute to poor health outcomes in this population, such as an increased risk of heart disease compared to other ethnic groups.4

Although much still needs to be done to achieve true health equity, I am excited to be involved in research that can help make a lasting difference. Researchers like myself are discovering new ways to improve how to manage the disease, as well as develop approaches to prevent Type 2 Diabetes in adults and children.

 For example, we conducted six focus groups with a tribe in Southeastern Oklahoma to better understand what the community would find most helpful and relevant in addressing Type 2 Diabetes. We are now using the knowledge learned from this study to collaboratively develop with the tribe a culturally tailored multi-generational diabetes prevention and management program.5 Working with American Indian families and communities is a privilege and being able to make a difference in communities like my own is its own reward.

As a society, we need to work together to ensure that all communities have access to fresh fruits and vegetables and that quality health care is available to everyone. It is my hope that I, along with others, will be impactful in improving health outcomes for those with Type 2 Diabetes. I am thankful to be an advocate for eliminating health inequities among historically and intentionally excluded communities.

Lisa Scarton, PhD, RN

Assistant Professor, UF College of Nursing

  1. Centers for Disease Control and Prevention. National Diabetes Statistics Report website. Accessed [11/17/2022].
  2. Centers for Disease Control and Prevention. 2021. Summary Health Statistics: National Health Interview Survey: 2018. Table A-4a. Accessed [11/17/2022]
  3. Satterfield D, DeBruyn L, Santos M, Alonso L, Frank M. Health Promotion and Diabetes Prevention in American Indian and Alaska Native Communities — Traditional Foods Project, 2008–2014. MMWR Suppl 2016;65place_Holder_For_Early_Release:4–10. DOI:
  4. Poudel A, Zhou JY, Story D, Li L. Diabetes and Associated Cardiovascular Complications in American Indians/Alaskan Natives: A Review of Risks and Prevention Strategies. J Diabetes Res. 2018 Sep 13;2018:2742565. doi: 10.1155/2018/2742565. PMID: 30302343; PMCID: PMC6158951.
  5. Scarton L, Velazquez I, O’Neal LJ, Iyerm S, Cannady T, Choate A, Mitchell C, Wilkie DJ. Developing a culturally tailored multigenerational intervention to prevent and manage type 2 diabetes in American Indian families living in rural settings: Findings from a focus group study. Res Nurs Health. 2019 Jun;42(3):226-233. doi: 10.1002/nur.21941. Epub 2019 Mar 10. PMID: 30854672; PMCID: PMC6465130.