Mitchell Felicia M
University of Kansas, School of Social Welfare, Lawrence, KS 66044, USA.
Health Soc Work. 2012 May;37(2):71-9. doi: 10.1093/hsw/hls013.
American Indians and Alaska Natives (AI/ANs) experience some of the greatest health inequities of any group within the United States. AI/ANs are diagnosed with diabetes more than twice as often as non-Hispanic white Americans. Diabetes is a chronic preventable disease often associated with individual risk factors and behaviors that indicate what interventions are needed to prevent or manage the disease. Individual ameliorative strategies in diabetes prevention and management do not fully address the fundamental causes and complexity of diabetes in American Indian communities. Through the application of a social determinants of health paradigm, social work has the opportunity to reframe diabetes and begin to understand it as a product of and a response to unjust conditions and environments, rather than as a disease rooted solely in individual pathology and responsibility.
美国印第安人和阿拉斯加原住民（AI/ANs）在美国所有群体中面临着一些最严重的健康不平等问题。AI/ANs被诊断出患有糖尿病的几率是非西班牙裔美国白人的两倍多。糖尿病是一种慢性可预防疾病，通常与个体风险因素和行为相关，这些因素和行为表明需要采取哪些干预措施来预防或管理该疾病。糖尿病预防和管理中的个体改善策略并不能完全解决美国印第安社区糖尿病的根本原因和复杂性。通过应用健康的社会决定因素范式，社会工作有机会重新审视糖尿病，并开始将其理解为不公正状况和环境的产物以及对这些状况和环境的反应，而不是仅仅植根于个体病理和责任的疾病。
