Type 2 Diabetes in First Nations of Canada: Healthcare Report

This report investigates the incidence of Type 2 diabetes within the First Nations populations of Canada, examining it through a social determinants of health perspective. The report highlights the historical context of colonization and its impact on Indigenous health, including lower levels of education, income disparities, socioeconomic status, and lack of access to healthcare. These factors contribute to the higher prevalence of diabetes in First Nations communities. The report also analyzes the impact of the Indian Act and residential schools. It further explores interventions to improve the current health conditions of the First Nations, emphasizing the need for culturally sensitive healthcare, primary prevention strategies, and community-based programs. The report underscores the importance of addressing social determinants to reduce health inequalities and improve diabetes management within these communities.

Running head: HEALTHCARE
HEALTHCARE
Name of the Student:
Name of the University:
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Introduction
The first journal of the State of the World’s Indigenous Peoples (SOWIP) has
been issued in the year 2009 and its foremost emphasis has been on issues related
to economic deficiency and welfare, principles, environment, modern learning, health
in addition to human rights as well as developing problems. Around the world,
diabetes prevalence rates are a number of times higher amongst Indigenous peoples
in comparison to the general populace (State of the World's Indigenous Peoples
2009). The higher percentage of hostile health effects in Aboriginal communities is
linked to range of factors that take in their lifestyle, genetic vulnerability and historic
radical and psychosocial influences thus instigating from a past of colonization that
rigorously destabilized Aboriginal morals, philosophy and spiritual practices.
Aboriginal groups living in Canada are amongst the utmost risk inhabitants for
diabetes and associated problems. Only 70 years ago, type 2 diabetes has been
exceptional in Indigenous peoples in Canada. Conversely, diabetes currently affects
a major section of First Nations, Métis as well as Inuit, in addition to has increased to
epidemic extents in several communities (Halseth 2019). Aboriginal women in
Canada also encounter Gestational Diabetes Mellitus (GDM) rates which is 2 to 3
times higher than others in part associated with an contact of Aboriginal civilization
with pre-gravid adiposity (GDM) rates that is around 2 to 3 times greater as
compared to others, in part connected to a contact of Aboriginal ethnicity with pre-
gravid adiposity (Harris, Tompkins and TeHiwi 2017). The following report will focus
on incidence of Type 2 diabetes in First Nations populations of Canada from a social
determinants perspective. Additionally, the paper will offer relevant interventions to
improve their current health conditions.
Discussion

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Understanding Diabetes in First Nations Canada from Social Determinants
Perspective
Before the European arrival, Indigenous peoples also known as the First
Nations of Canada practiced their peculiar methods of health knowledge.
Nonetheless, the out-dated health systems had been shattered during colonization
as illnesses as well as battles severely affected the Indigenous peoples (Dyck et al.
2015). In present day, healthcare system of First Nations in Canada remain a highly
complex and a diverse issue. Although the health conditions of Indigenous peoples
in Canada have seen progress in current times, they still encounter significantly
lower health results as compared to the non-Indigenous Canadians. Furthermore,
while assessing the broader society to Indigenous peoples on numerous health
indicators, the First Nations continue to face higher life loss due to cigarette smoking,
diabetes, and hypertension, cardiac and chronic renal disease. While there are
inadequate information on the rates of diabetes in Métis as well as Inuit groups,
type2 diabetes is considered to have touched the severe epidemic level amongst the
Indigenous Canadians (State of the World's Indigenous Peoples 2009). In a number
of First Nations communities, suicidal acts by youths are taking place at a rate which
is 800 times more than the national average. The suicide rate amongst Inuit groups
in Arctic Canada is accounted to be around 10 times more in comparison to the
overall Canadian population.
Thus, considering the context of Social Determinants of Health in Canadian
First Nations necessitates a thorough assessment of the Canadian history
subsequent to the 1867 Indian Act. As per studies, the Act enabled and imposed the
acclimatization of Indigenous communities into the European cultural pattern by a
number of ways such as by turning First Nations individuals into divisions of the

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state, changing customary power organization with federally executed reserve
organizations, making First Nations peoples to surrender their ‘status’ and tradition
(Rivera, Lebenbaum and Rosella 2015). Till 1996, almost 130 residential schools
had been services all through Canada in addition to controlled children from
following their traditional standards, innate values and linguistic through physical
costs. McConkey (2018) has mentioned in their studies that several children faced
austere physical, mental, spiritual as well as sexual exploitation. Moreover, when
First Nations children left inhabited institutes at the age of 16 years, several had
settled without funds due to the entrenched destructive opinions of their inheritance
and problems in dealing with customary life on funds (Kolahdooz, F., Nader, F., Yi,
K.J. and Sharma, S., 2015).
Lower level of Education of First Nations linked to Type2 diabetes in First Nations
Canadians
A lower level of education is perceived as one of the social determinant
factors of health which results in high incidence of type 2 diabetes amongst First
Nations communities in northern Alberta. Moreover, inadequate culturally-centric
health educational occasions are accessible for Native Albertans. Studies on First
Nations community of Canada revealed a severe lack of understanding of the
educational likings, requirements and aspirations of young learners (Jacklin et al.
2017). Consequently, there has been noticed a significant gap between educational
understanding and community understanding within community-level wellbeing
learning amongst Indigenous Albertans. These researchers pointed out that an
insufficient racial specificity that led to inopportune and detached knowledge
transformation. According to studies, the First Nations individuals residing in
metropolitan centres had a tendency of facing additional healthcare encounters

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related to be subjected to prejudice or discernment in healthcare encounters, with
inadequate access to appropriate and continuing culturally complex diabetes care as
well as education or the need to go to several locations to obtain care services
(Kulhawy-Wibe et al. 2018). These inadequacies have resulted in overlooked
appointments and hindrance in receiving care delivery.
Income factors linked to Type2 diabetes in First Nations Canadians
Research has revealed that urban Indigenous individuals who have inferior
household earnings in addition to a lower education achievement are less probable
to avail healthcare services. On the other hand, studies related to employment status
wherein few First nations individuals who have receive employment services tend to
seek healthcare provisions more in comparison to the unemployed individuals
(Leung 2016). Approximately 15.3% of Indigenous adults devoid of any funds have
been unemployed, while around 7.8% of non-Indigenous adults did not receive any
employment opportunities in Canada. Furthermore, it is significant to note that rate of
unemployment has decreased with higher educational completion. Investments on
the First Nations Canadian are seen as a critical issue. According to Kulhawy-Wibe
et al (2018), the First Nations Canadians are identified to have a considerably inferior
level of aggregate yearly income in than the non-First Nations Canadians accounting
CAD $19,114 in comparison to around CAD $33,394. These inadequacies have led
them to face critical structural obstacles to access diabetes self-management.
Socioeconomic status linked to Type2 diabetes in First Nations Canadians
Undoubtedly, diabetes is extremely common amongst the economically
deprived and excluded groups. Additionally, diabetes risk issues have been revealed
to be most predominant in the majority of the socioeconomically underprivileged.
Furthermore, when clinically diagnosed with diabetes, people of subordinate

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socioeconomic status tend to be at more threat of death than the ones belonging to
higher socioeconomic status (Rivera, Lebenbaum and Rosella 2015). In the view of
Slater et al (2019), income being an indicator of socioeconomic status, directly
reveals resources obtainable and in consequence a deficiency of funds tend to
create barriers in obtaining optimum health. For instance, a condition of prolonged
risky employment and monetary uncertainty changes the priorities of the First
Nations in Canada away from developing the capacity to strategize and prepare
healthy meals and involve in physical activity.
Since last five decades, the standards of non-Aboriginal Canadian living has
severely affected the living standards of the Aboriginal population related to
nourishment, physical activities in addition to additional social lifestyles. As per
studies, food items which are locally harvested known as customary food in the
Aboriginal groups are characteristically high in protein, vital micronutrients, vitamins
as well as polyunsaturated fatty acids and chiefly in the omega-3 fatty acids
(McConkey 2018). These nutrients protect humans from increasing their sugar
levels, obesity as well as cardiovascular morbidity. On the other hand, the availability
of locally grown food for Aboriginals is frequently scarce. Marushka et al. (2017)
have found that lack of food provision for around 62.6% of Inuit from almost 36 Arctic
communities. This data reveals reasons to which Aboriginal people tend to incline
towards handy as well as processed food in stocks which have low dietary value and
contains lower fibres and contains high level of salt and refined sugar. In recent
times, their lifestyles have shifted from being physically severe hunter-gatherer-
harvester to contemporary times Aboriginals who are extremely sedentary and
dependent on mechanical transport that has radically diminished their daily level of
actions as well as caloric expenditure.

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Lack of access to health care
In the view of Sellers et al (2016), it is an upsetting fact that health inequalities
are major amongst the First Nations in Canada. Their poor health conditions are
well-illustrated by the greater incidence and illness or death percentage of conditions
linked to diabetes, obesity as well as substance abuse. In the last 15 decades, the
supremacy of imperialism as well as colonialism on Canadian Aboriginal soil has led
to fluctuating rate of cultural discrimination and communal control have resulted in
the continuing rate of health and social discriminations in relation to teaching,
occupation, housing as well as additional admission to social and healthcare
services (Slater et al. 2019)
In addition, absence of trust and self-assurance in Canadian government is
still prevalent in the minds of the First Nations Canadians. Such lack of confidence
has resulted in overdue determinations and unproductive collaboration. Such
absence of trust and self-assurance can be understood from continuing bottleneck of
the Giant Mine between the Canadian Government and the First Nations people
living in Northern Territories of Canada. As per studies, diabetes examination and
supply of injections have not only been the primary factor of healthcare to which First
Nations people have been experiencing financial barriers (Turin et al. 2016). In
addition to this, First Nations have been encountering an excessive financial
obstacle in availing one of dental, vision or foot care provisions within their Non-
insured health benefits (NIHB) policies and restricted treatment. These related
healthcare services are particularly vital in the context of diabetes illness since these
healthcare facilities help in detecting and treating end organ damage which causes
due to diabetic micro-vascular problems. For example, First nations suffering from
diabetes require continuous foot care as well as ulcer treatment since the illness is

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described by poor wound soothing along with an amplified probability of getting foot
ulcers, with a probability of increasing infections (Kulhawy-Wibe et al. 2018).
Interventions to treat diabetes amongst First Nations Canadians
While several First Nations people have executed health advertising
interventions in order to focus on diabetes as well as its impacts. These interventions
have been restricted due to several profound underlying obstacles (Harris, Tompkins
and TeHiwi 2017). Thus, there is a requirement to re-assess all healthcare plans
which affect the various aspects that intensify the susceptibility of First Nations
inhabits and groups to deprived health as well as also impact their capacity to select
better life choices. The cost of Type 2 diabetes is getting unprecedented levels in
Canada as well as on global level. Hence, strategies must take in a focus on primary
avoidance of Type 2 diabetes in addition to decrease in risk factors as well as
optimum controlling of the illness in order to lessen diabetes-centric problems as well
as death (Tait et al. 2018). These policies need to be contextualized within primary
healthcare because it creates the basis of any high-performing treatment distribution
system. It further offers as the principal point of exchange for First Nations patients
suffering from continuing illness and diabetes. Thus, reinforcing primary healthcare is
important to lessen health inequalities of Native populate with diabetes. Wicklow et al
(2018) have identified the Forge Ahead research program as a prominent illustration
of a nationwide research cooperative approving a programmatic lens that has put
emphasis on First Nations community authorization and formation of community
organizations. Forge Ahead has been highlighted the central programmatic lens
essential to form dimensions at the Indigenous communal level. It has been
designed in order to evaluate a national population health intervention with an aim of
improving the health conditions of First Nations people suffering from Type 2

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diabetes as well as chronic illness. Furthermore, in order to improve the condition,
Government of Canada has introduced the Aboriginal Diabetes Initiative (ADI) to
improve prior detection and avoidance of diabetes along with improved management
of illness and greater attention on complications transmission.
Conclusion
Thus, it can be concluded that, a subordinate level of education is perceived
as one of the social determinant factors of health which results in high occurrence of
type 2 diabetes amongst First Nations groups in northern Alberta. Moreover, scarce
culturally-centric health informative chances are accessible for Native Albertans.
Studies on First Nations community of Canada showed an austere lack of
understanding of the educational likings, requirements and aspirations of young
learners. While several First Nations people have executed health advancement
intermediations in order to report on diabetes as well as its impacts. These
mediations have been restricted due to several intense underlying obstacles. Thus,
there is a prerequisite to re-assess all healthcare plans which affect the various
factors that intensify the susceptibility of First Nations occupies as well as
communities to deprived health and also impact their capacity to select better life
choices.

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