Diabetes
Type 2 diabetes disproportionately affects Indigenous populations, with documented rates in Canada 3–5 times higher in Indigenous compared with non-Indigenous populations.
(Canadian Medical Association Journal, 2017, E106)
Social Determinants
"Evidence showing the connections between childhood hunger and chronic disease risk both in adult-hood and in succeeding generations, we can now be fairly certain that the elevated risk of obesity, early-onset insulin resistance and diabetes observed among Indigenous peoples in Canada arises, in part at least, from the prolonged malnutrition experienced by many residential school survivors." (Mosby, I., & Galloway, T. 2017)
"Aspects of residential school socialization such as regimentation at meal times, the use of food in punishment, hunger, and stealing food to survive, left a legacy of negative relationships with food counterproductive to the contemporary work of preventing and managing diabetes"
Howard, H. A. (2014)
Social Determinants
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Gender
Health Services
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Education
Healthy Child Development
Many indigenous communities are located in remote and rural areas. This along with their small population make it difficult to recruit and retain health professionals, which leaves many of these communities underserved and with a shortage of medical personnel.
(National Collaborating Centre for Indigenous Health, 2019, pg.3)
Personal Health Practices
The epidemic of type 2 diabetes in indigenous communities is directly related to poor diet and lack of exercise.
(Reading & Wien, 2009/2013, pg 11.) #
Diabetes is more common is indigenous females than indigenous males, which is not the case in the non-indigenous population. This is believed to be because indigenous females have higher rates of obesity than indigenous males. (Government of Canada. Public. 2009.)
Income and Social Status
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Almost 1/4 of indigenous youth drop out or are pushed out of high school. The effects of this can last a life time, as lack of education lessens career opportunities and increases the likelihood of living in poverty in future generations. (Reading & Wien, 2009-2013, pg. 15)
Indigenous peoples do not have equitable access to health services compared to the general Canadian population
due to geography, health system deficiencies, and inadequate health human resources.
(NCCIH, 2019, pg.3)
Proper nutrition and healthy food preparation skills may be lacking as a result of inadequate education. (Reading & Wein, 2009-2013, pg. 15)
Indigenous people do not receive the same opportunities and resources as other Canadians when it comes to education. (Reading & Wien, 2009-2013, Pg 15)
Living in poverty makes it more difficult to buy nutrient dense food, resulting in higher rates of obesity and diabetes (Reading & Wein, 2009-2013, pg.13) #
In many indigenous communities that are located rurally, especially in the nothern regions, food is priced much higher than what you'd see in the average grocery store due to transportation costs. This makes it even more challenging to buy a variety of healthy and nutritious foods. (Melillo, 2018, Pg 10)
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Many of the other social determinants such as education, income and personal health practices will affect children too.
Parents are models for their children and their actions influence their children greatly. Poor nutrition and lack of activity will be seen as normal to children who grow up in that environment.
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Parents with low education are more likely to live in poverty and lack knowledge regarding nutrition. Living in poverty makes it more difficult to provide nutritious foods for children in their care. (Reading & Wien, 2009-2013, pg 15)
The transition from a traditional indigenous diet consisting of foods that were gathered, hunted, fished and gardened to the diet issued by the residential schools, a diet consisting of heavily processed foods, simple carbohydrates and preservatives, has been associated with the ethology of diabetes among many indigenous peoples. Howard, H. A. (2014)
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Children in Canada's residential schools were continuously exposed to caloric restriction which has shown to produce metabolic changes that increase risk of obesity and chronic disease, including diabetes. (Mosby, I., & Galloway, T. 2017)
. Aboriginal females experience higher rates of gestational diabetes than non-Aboriginal females. (Government of Canada. Public. 2009.)
"Indigenous children in Canada (First Nations, Inuit, and Métis) are disproportionately affected by nutrition-related chronic diseases such as obesity and diabetes". (Gillies et al., 2020)