Diabetes in First Nations
Eating well on a low income is a special challenge for many First Nations and Inuit elders as is meeting their specific nutritional needs, especially in remote communities where the variety and availability of affordable and nutritious store bought foods are particularly limited. Moreover, many elders may be unaware of the hazards of processed �convenience� foods, particularly those who do not speak or read English or French fluently. (Ship, 2002)
The degree to which obesity is a risk factor for diabetes depends greatly on the location of the excess weight. Central or upper-body obesity is a stronger risk factor for type 2 diabetes than excess weight carried below the waist. Waist-to-hip ratio, a measure of central obesity, was more strongly associated with diabetes than body mass index, a measure of overall obesity. (Canada, 2001)
The erosion of traditional ways of life related to hunting trapping and fishing, as a result of cultural disruption, cultural change and environmental
damage has entailed a shift toward less physical active lifestyles and lower
levels of fitness. (Ship, 2002). Many middle aged and older Aboriginal people experience decreased mobility that is akin to being disabled, a consequence of poor health. Moreover, several studies have found that nearly half of the older Aboriginal people almost never leave their house for more than an hour a day. This may result from physical health problems, lack of affordable transportation, lack of social, recreational and fitness activities or programs for elders and in some cases the weather.
An insightful lesson came from the Haida Project on the Queen Charlotte Islands. A community health representative stated that it is necessary to let people grieve the losses of their former carefree habits before moving on to learn about, deal with, and live with diabetes. Community members described strong emotional feeling regarding diabetes; of grief, fear of dying, and loss of freedom. It was a turning point in the project to ask the people affected by diabetes what to do, and to listen to and act on their answers, they needed to be understood in relationship to their world. Their customs, beliefs and practices needed to be understood . The health models lacked Native cultural integrity. Diabetes does not happen in isolation in people�s lives. It can affect a person�s whole life, and their whole life can affect the diabetes.(Hooper, 1995). It is important to learn about culturally based psychological responses in order to develop effective program ideas. There is support that it has to be the people living with diabetes who must "keep the drum going�.