Diabetes Among the Anishinaabek - The Need to Focus on Prevention



The Five White Gifts

There is a story among the Anishinaabek people that my relations shared with me called “The Five White Gifts.”  These gifts are flour, sugar, salt, milk and lard.  I was told that these gifts were introduced to Anishinaabek children in the Residential School System and once they returned home they found they could not return to their original ways of living off the land.  The traditional diet had been replaced.  My relatives relate how fifty years ago diabetes among the Anishinaabek people was virtually non-existent.  Today the disease is becoming an epidemic.  Diabetes rates among First Nations, Metis, and Inuit people are 3-5 times the national average for non-aboriginal people (Ottawa: Public Health Agency of Canada, 2011). These rates are staggering, but what is even more disturbing are the costs associated with treating this disease.  The costs, however, are not strictly monetary, as diabetes impacts on individuals, families, communities and nations.

In a 2010 report commissioned by the Canadian Diabetes Association, it is estimated that the disease had cost the healthcare system, and thereby the taxpayer, 6.3 billion dollars in 2005 and by 2020, that cost will rise to at least 16.9 billion dollars (Doucet, 2010).  The spending will be on complications resulting from diabetes, in essence, treating the symptoms or being reactive, rather than proactive.  “The cost of diabetes to Canadian society is staggering.  Although the human cost will always be the greatest of all, understanding the economic cost is critical to the development of policies that can reduce the impact of the disease on the lives of Canadians.  Without further action, diabetes will become a $17 billion annual drag on the Canadian economy.  Beyond the human toll of this disease, there is a strong economic argument for concrete action to stem the growth of the disease” (Doucet, 2010).

According to Stats Canada, the growth rate of the Aboriginal population is expected to be between 1.7 million and 2.2 million by the year 2031.  “All scenarios also show that the population of the three Aboriginal identity groups (First Nations/North American Indians, Metis, and Inuit) would remain younger than the non-Aboriginal population by 2031” (Caron Malenfant & Morency, 2011).  An alarming trend is that Diabetes is diagnosed earlier in Aboriginal people, that is Aboriginal people are becoming diabetic sooner in life.  The projected cost of diabetes ($17 billion dollars) is based on the current population, and only to the year 2020, and does not take into account the latest projections in the growth of the Aboriginal population.

An ounce of prevention is worth a pound of cure is a saying that has great merit when it comes to dealing with diabetes.  “The socio-cultural, biological, environmental and lifestyle changes seen in First Nations, Metis and Inuit populations over the last half century have contributed significantly to the increased rates of diabetes and its complications” (Public health agency, 2011).  The current response to the disease is to treat the symptoms, electing to deal with problems after the disease has been diagnosed, rather than preventing the disease from occurring in the first place.  This is seen as a liberal ideology.  Liberals believe in programs for rehabilitation to combat the effects of capitalism (Hick, 2007).  This institutional approach to social welfare assists in building a liberal state where programs, primarily focusing on teaching individuals about diabetes management, are abundant.  Prevention programs exist, providing repetitive messages about dietary changes, however, diet, especially in remote or fly in Aboriginal communities, is a costly and difficult approach to diabetes management.  For example, these programs will teach how a diet of whole foods such as fruits and vegetables is a key part of a diabetic diet; however, these programs do not take into account that Anishinaabe people in northern and remote communities cannot access such foods due to the high transportation costs or lack of availability.

Activity and exercise are two components of effective diabetes prevention.  Neither of these requires special training so the burden of training or replacing someone in the health care field, such as a diabetes educator, is removed.  Activity, such as traditional dancing, can be planned or organized to involve individuals or entire communities.  It doesn’t cost anything to take the time to go for a walk on a regular basis.  Promoting activity and exercise as well as promoting a healthy, plant based diet is a better approach than focusing on treatment alone.  It is far more cost-effective to take this approach.  Aboriginal communities may not be able to return to a point where they can be completely self-sustaining as they once were, but they can return to some of the traditional activities that once made diabetes virtually non-existent.

Lisa

References

Caron Malenfant, E., & Morency, J. Statistics Canada, (2011). Population projections by aboriginal identity in canada (92-552-XWE). Retrieved from Government of Canada website: http://www.statcan.gc.ca/daily-quotiden/111207/dq111207a-eng.htm

Doucet, G. (2010, March). Diabetes and society - the cost of diabetes in Canada: The economic tsunami. Retrieved from http://www.diabetes.ca/documents/for-professionals/CJD--March_2010--Beatty.pdf

Hick, S. (2007). Social welfare in canada. (2nd ed.). Toronto, Canada: Thompson Educational Publishing, Inc.

(2011). Public health agency of Canada, diabetes in Canada: Facts and figures from a public health perspective. Ottawa: Public Health Agency of Canada.

(2012). Aboriginal diabetes prevention. (2012). [Print Graphic]. Retrieved from http://www.floating-point.com/index.php/aboriginal-diabetes-prevention-2/