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The change on the tax on beer also appears to have had an effect, lowering consumption from 1.09 gallons per capita in 2009 when the tax on beer was $0.26 to 0.93 gallons of pure alcohol consumed per capita in 2011 when the tax rate was $0.76 per gallon

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According to the 1997 study, "genetic susceptibility plays a significant role in some diseases, such as diabetes, while for others, the generally lower socioeconomic status, higher prevalence of certain health risk behaviors and lower utilization of preventative services in the Native American population are important determinants." [10] Also, before WWII, diabetes in Native American Communities was essentially non-existent