“Sweet Blood: Toward an Environmental History of Diabetes, Chronic Disease, and Race in North America” Program on Health, Disease, and Environment in World History Center for Historical Research, The Ohio State University March 1, 2013 Matthew Klingle Bowdoin College
[email protected] In February 1963 a team of researchers from the National Institute of Arthritis and Metabolic Diseases, or NIAMD, a branch of the National Institutes of Health (NIH), arrived in Phoenix, Arizona. They were on a mission to study rheumatoid arthritis, or RA, a systemic inflammatory disorder now identified as an autoimmune disease that commonly strikes people in the prime of adulthood. The NIH team was part of a comparative epidemiological study of RA in two Native American communities: the Blackfeet Confederacy of Montana and the Pima or Akimel O’odham, living about thirty-five miles southwest of Phoenix on the Gila River Indian Reservation, which hugged the life-giving river for which it was named.1 Environment mattered because the NIH researchers speculated that RA incidence— expressed as the risk of developing the disease within a specified period of time—was lower in hot and arid climates (like Arizona) than cold and semi-arid climates (like Montana).2 Diagnosis of RA then was similar to methods today: patient and family history, plus radiographs and blood tests for rheumatoid factor (RF). The NIH scientists also tested sera for glucose levels of 969 Pima aged 30 years and older. Seemingly by accident, they discovered that “postprandial blood sugars” were “significantly elevated in 30 percent of subjects,” or approximately one in three Pima.3 Later sampling revealed what physicians and nurses working at the Indian Health Service of the U.S.