Type 2 Diabetes and Indigenous Peoples

Crowshoe, Lynden; Dannenbaum, David; Green, Michael E.; Henderson, Rita; Hayward, Mariam Naqshbandi; Toth, Ellen L.

doi:10.1016/j.jcjd.2017.10.022

Cited by 75 publications

(65 citation statements)

References 113 publications

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“…It has been clearly demonstrated in reviewing the literature and further confirmed through interactions with the participants that colonization has impacted them in several ways (Bartlett et al, 2007;Crowshoe et al, 2018;Smith, 1999). Despite being provided with a significant number of examples of negative colonial impacts on ways of living, eating, and accessing health care when it comes to diabetes, there was very little discussion of decolonization from the participant's perspectives.…”

Section: Discussionmentioning

confidence: 87%

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Decolonizing Diabetes

Pilon

Benoit

Maar

et al. 2019

IJIH

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This article presents insights into the colonial experience of Indigenous Peoples living with type 2 diabetes within seven First Nation communities in Northern Ontario. A constructivist grounded theory methodology, guided by a decolonizing and participatory action approach to conducting research with Indigenous Peoples, was utilised in this study. Twenty-two individuals with type 2 diabetes were interviewed. The main research question explored the impact of colonization on the lived experience and perceptions about developing type 2 diabetes for Indigenous Peoples. Using semi-structured interviews, the three main categories that emerged from the analysis of the interview transcripts were changing ways of eating, developing diabetes, and choosing your medicine. A substantive theory was developed that suggests that Indigenous Peoples, with type 2 diabetes, often live with the perception that there is ‘no going back’ to the way things once were prior to European contact. As a result, they have adapted the way they live with diabetes which can, at times, be at odds with Indigenous world views. An adaptation that considers a complementary approach to the way individuals live and manage diabetes including both Traditional and Western ways may provide a framework for a decolonized model of type 2 diabetes care for Indigenous Peoples.

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Section: Discussionmentioning

confidence: 87%

“…Diabetes and its complications have a disproportionate impact on Indigenous Peoples around the world (Crowshoe et al, 2018). A "radical redefinition of what diabetes is and what it represents for Indigenous people" is necessary (Ferreira & Lang, 2006, p. 8).…”

Section: Introductionmentioning

confidence: 99%

Decolonizing Diabetes

Pilon

Benoit

Maar

et al. 2019

IJIH

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“…Further, our analysis of the free-text responses suggests that standard physician goals in treating the biological aspects of the disease may not match the goals of Indigenous patients, whose distinct cultural approaches may uphold different sets of values and expectations of medicine and healing. 17 This difference in goals between western practitioners and Indigenous patients has been extensively researched in Canada with regards to Indigenous peoples with diabetes, 3,18 with current clinical practice guidelines upholding that it is fundamental that diabetes care for Indigenous people be delivered in a manner that includes traditional and cultural approaches to wellness. 4,18,19 However, the qualitative results do suggest support for "patientcentered care," whereby rheumatologists who engaged their patients in conversations about Indigenous healing practices felt that they provided those patients with more agency in their care.…”

Section: Discussionmentioning

confidence: 99%

“…17 This difference in goals between western practitioners and Indigenous patients has been extensively researched in Canada with regards to Indigenous peoples with diabetes, 3,18 with current clinical practice guidelines upholding that it is fundamental that diabetes care for Indigenous people be delivered in a manner that includes traditional and cultural approaches to wellness. 4,18,19 However, the qualitative results do suggest support for "patientcentered care," whereby rheumatologists who engaged their patients in conversations about Indigenous healing practices felt that they provided those patients with more agency in their care. These findings parallel a recent study showing that support for and access to Indigenous healing practices in an urban setting increases empowerment and selfdetermination within healthcare relationships.…”

Section: Discussionmentioning

confidence: 99%

Creating space for Indigenous healing practices in patient care plans

et al. 2020

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Background: The Truth and Reconciliation Commission of Canada’s Calls to Action ask that those who can effect change within the Canadian healthcare system recognize the value of Indigenous healing practices and support them in the treatment of Indigenous patients. Methods: We distributed a survey to the Canadian Rheumatology Association membership to assess awareness of Indigenous healing practices, and attitudes informing their acceptance in patient care plans. Results: We received responses from 77/514 members (15%), with most (73%) being unclear or unaware of what Indigenous healing practices were. Nearly all (93%) expressed interest in the concept of creating space for Indigenous healing practices in rheumatology care plans. The majority of support was for the use in preventive or symptom management strategies, and less as adjuncts to disease activity control. Themes identified through qualitative analysis of free-text responses included a desire for patient-centered care and support for reconciliation in medicine, but with a colonial construct of medicine, demonstration of an evidence bias, and hierarchy of medicines. Conclusions: Overall, respondents were open to the idea of inclusion of Indigenous healing practices in patient’s car plans, emphasizing importance for patient empowerment and patient-centered care. However, they cited concerns that provide the indication for further learning and reconciliation in medicine.

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“…It was the nutrition experiments in residential schools that shaped the diabetes incidence in Aboriginal populations [36]. Diabetes Canada's 2018 CPGs state we need to recognize that colonialism is the origin of much of the incidence of diabetes in Canada's Aboriginal population [37].…”

Section: Weight Bias Amongst Health Professionalsmentioning

confidence: 99%

Listen… and Speak: A Discussion of Weight Bias, its Intersections with Homophobia, Racism, and Misogyny, and Their Impacts on Health

Kasten

2018

Canadian Journal of Dietetic Practice and Research

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This article is a version of the Ryley-Jeffs Memorial Lecture, delivered on 8 June 2018. It discusses weight bias and the intersections with homophobia, racism, and misogyny, and how these impact health. While the dominant discourse attests that people can lose weight and keep it off, evidence informs us that maintenance of weight loss is unlikely. Using a flawed epistemological framework, obesity has been declared a disease, and weight bias been perpetuated. Weight bias is pervasive, both in the general public and amongst health professionals, often using inappropriate tools to assess the impact of weight on health. This contributes to overlooking the life circumstances that truly cause morbidity: social determinants of health such as income, social connectedness and isolation, adverse childhood experiences, and cultural erasure. A variety of tools dietitians can use to appropriately assess health risk are provided, along with examples of actions that can be taken to reduce weight bias. Dietitians who are leading the profession in taking action against weight bias and stigma are profiled.

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Type 2 Diabetes and Indigenous Peoples

Cited by 75 publications

References 113 publications

Decolonizing Diabetes

Decolonizing Diabetes

Creating space for Indigenous healing practices in patient care plans

Listen… and Speak: A Discussion of Weight Bias, its Intersections with Homophobia, Racism, and Misogyny, and Their Impacts on Health

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