The ongoing impacts of colonization have created inequities in social, cultural, historical, economic and political determinants of health that play a major role in the diabetes epidemic seen in Indigenous populations1. Not only have we taken their land, but we’ve taken their health too. Before colonization, diabetes was virtually unheard of among Indigenous populations. But as lifestyles are quickly shifting from traditional to modern, the diabetes epidemic among Indigenous populations is becoming a great cause for concern.
Historically, traditional Inuit and Métis diets have been studied extensively for their benefit of fighting against chronic diseases. The high omega-3 content of traditional foods such as seal, whale, caribou, fish and berries were found to play a role in lowering levels of cholesterol and protecting against other chronic diseases like hypertension and diabetes2. However, over the last couple of decades, the rate of morbidity caused by diabetes among Canadian Indigenous populations has increased significantly.
So, what's changed?
Environmental changes have resulted in the displacement of Indigenous communities, creating restrictions on hunting and fishing and the loss of harvesting capabilities. Colonization has added stress to the Indigenous communities with the development of residential schools, abundance of processed foods, and the increased cost of their daily living expenses. Indigenous children were exposed to unfamiliar diets and forced into modern day schools rather than living their traditional hunter-gatherer lifestyles.
In addition to these environmental changes, one notably popular genetic hypothesis that may be contributing to this epidemic is the “thrifty gene theory”2. This gene variant has been commonly found in Oji-Cree people of north-western Ontario and has been associated with the early onset of type 2 diabetes2,3. This genetic evolution originally occurred in response to the long periods of starvation caused by their hunter-gatherer lifestyle. The “thrifty gene” worked to increase energy conservation to help during these periods of starvation. However, with the transition from traditional to non-traditional diets, this gene is having the opposite effect on Indigenous people. Consuming more energy-dense foods combined with lower levels of physical activities and the effects of this gene could partly explain this dramatic increase in the prevalence of diabetes among Indigenous populations in the last several decades3.
Indigenous communities have become disadvantaged by the modernization that is impeding on their natural ecosystems by reducing their hunting, fishing, and harvesting abilities and rendering them reliant on low quality, processed foods. The prevalence of diabetes among Indigenous people is, on average, 4 times higher compared to the general population4. The severity of this problem is heightened by the existing stigma around diseases among Indigenous communities. The traditional Indigenous concept of health states that for something to be deemed a disease it must cause some sort of pain. In the case of diabetes, there are typically no symptoms of pain associated with it. And as such, diabetes continues to go on untreated among many Indigenous peoples5.
We need to work with Indigenous communities to find ways to tackle these issues and put a stop to the collateral damage imposed on them by colonization. With the help of Indigenous knowledge and government participation, we can reconcile this broken relationship between the communities and start actively working together. Organizations such as Diabetes Canada and the Aboriginal Diabetes Initiative (ADI) are working to help improve the quality of life of Indigenous people and reduce the prevalence of diabetes and other diseases among them.
If you want to learn more, you can visit the two cites posted below for more information on diabetes in Indigenous communities
https://www.fnha.ca/wellness/our-history-our-health
http://guidelines.diabetes.ca/cpg/chapter38
Reference