Preventing Diabetes inAboriginal Communities:To Screen or Not To Screen Adrian Jacobs – Community LiaisonMDSi Field Team,...
Preventing Diabetes inAboriginal Communities: To Screen or Not To Screen
To Screen or Not To ScreenYes, as long as it is an act of empowerment that resources the Aboriginal community to mak...
The Screening Debate 2003 CDA guidelines recommend community- based screening 2008 CDA guideline do not recommend...
Why not? Potential poor patient follow-up Uncertain health impact Fear of  Labeling  Stigmatization  ...
Reasons to screen Cost effectiveness of prevention Current and projected costs of extant diabetes Socio-cultural ...
My Own Diagnosis
“Your mother has it. You have it. You are Aboriginal. You are genetically pre-disposed.”
“The White Man did this to you.”
Lifestyle change. Active lifestyle  Hunting  Fishing  Nomadic life  Horticulture  Natural...
Change of DietFROM TO Lean wild meats  White fat Fish  White flour Fr...
Disempowerment Colonialism Treaty breaking Indian Act Residential Schools Racism Poverty
“We did this to you.”
Colonialism Another people’s agenda Another people’s values Another people’s norm  Creation of a norm makes a...
“I take responsibility for this.”
Blame-deflecting I was not there. We did not make these decisions. That happened so long ago, you just need to ge...
Healthy immigrant effect Immigrants to Canada are healthier than Canadians when they arrive After being here a nu...
Who is making them sick? Western culture?  European immigrants suffer less  Non-European immigrants suffer more...
What is making them sick? Western medicine’s “norm making?”  What happens if you use a northern European as “t...
Aboriginal Diabetes Pre-Disposition I lamented  My grandmother’s diabetes  My mother’s diabetes  My diabete...
“No (not bad genetics)! Good genetics – bad diet and lifestyle!” This turned everything completely around in me ...
Decolonized Thinking I am Ongwehohweh and I am not a deviation! Our Aboriginal heritage is our asset. We are how ...
Decolonization Prime Minister Harper apologized for the “policy of assimilation” as expressed in the Residential ...
RCAP (Royal Commission on Aboriginal Peoples) A return to the treaty relationship  Nation to Nation...
Ruppert Ross“while western psychology’s discussions about thingslike Complex PTSD might help non-aboriginal peopleundersta...
Empowerment The locus of control for Aboriginal Health needs to be in the Aboriginal community not outside.  ...
Colonialism in Health
Aboriginal Control
To Screen or Not To Screen MDSi produces a data resource for Aboriginal control Community Based Research and Educati...
Adrian Jacobs – ajacobs@ualberta.ca www.braiddm.ca“Restoring Aboriginal culture through communit...
Nia:wen Gowa
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Preventing Diabetes in Aboriginal Communities: To Screen or Not To Screen

2010 (Oct) Canadian Diabetes Association Annual Conference, Aboriginal health Symposium facilitated by BRAID Research, presentation by BRAID Research
Published on: Mar 4, 2016
Source: www.slideshare.net


Transcripts - Preventing Diabetes in Aboriginal Communities: To Screen or Not To Screen

  • 1. Preventing Diabetes inAboriginal Communities:To Screen or Not To Screen Adrian Jacobs – Community LiaisonMDSi Field Team, BRAID Research Group University of Alberta
  • 2. Preventing Diabetes inAboriginal Communities: To Screen or Not To Screen
  • 3. To Screen or Not To ScreenYes, as long as it is an act of empowerment that resources the Aboriginal community to make Health Agenda decisions.James Lamouche Dr. Daniele Behn Smith Dr. Dawn Martin-Hill
  • 4. The Screening Debate 2003 CDA guidelines recommend community- based screening 2008 CDA guideline do not recommended community-based screening ADA discourages community-based screening
  • 5. Why not? Potential poor patient follow-up Uncertain health impact Fear of  Labeling  Stigmatization  Feelings of loss of control Cultural barriers
  • 6. Reasons to screen Cost effectiveness of prevention Current and projected costs of extant diabetes Socio-cultural benefit  Empowerment  Capacity building  Collaboration  Cultural renewal
  • 7. My Own Diagnosis
  • 8. “Your mother has it. You have it. You are Aboriginal. You are genetically pre-disposed.”
  • 9. “The White Man did this to you.”
  • 10. Lifestyle change. Active lifestyle  Hunting  Fishing  Nomadic life  Horticulture  Natural harvesting
  • 11. Change of DietFROM TO Lean wild meats  White fat Fish  White flour Fruits and vegetables  White sugar  White salt  Caffeine
  • 12. Disempowerment Colonialism Treaty breaking Indian Act Residential Schools Racism Poverty
  • 13. “We did this to you.”
  • 14. Colonialism Another people’s agenda Another people’s values Another people’s norm  Creation of a norm makes all others deviant  This leads to marginalization  The end result is stigmatization – the ultimate disempowerment
  • 15. “I take responsibility for this.”
  • 16. Blame-deflecting I was not there. We did not make these decisions. That happened so long ago, you just need to get over it.
  • 17. Healthy immigrant effect Immigrants to Canada are healthier than Canadians when they arrive After being here a number of years they are less healthy than Canadians  European immigrants decline less  People of colour of non-European origin decline the most
  • 18. Who is making them sick? Western culture?  European immigrants suffer less  Non-European immigrants suffer more As an Aboriginal I can say, “Perhaps it is making you sick like it made us sick.”
  • 19. What is making them sick? Western medicine’s “norm making?”  What happens if you use a northern European as “the norm?”  What about a southern European?  What about an English Canadian or French Canadian? As an Aboriginal I can say, “It doesn’t matter, they are all Western, we will never correspond.”
  • 20. Aboriginal Diabetes Pre-Disposition I lamented  My grandmother’s diabetes  My mother’s diabetes  My diabetes  My Aboriginal heritage I hoped my children would not be cursed by my Aboriginal genetics
  • 21. “No (not bad genetics)! Good genetics – bad diet and lifestyle!” This turned everything completely around in me  My heritage is not the problem  My genetics is not the problem  I have a great heritage  I have great genetics
  • 22. Decolonized Thinking I am Ongwehohweh and I am not a deviation! Our Aboriginal heritage is our asset. We are how the Creator made US. We don’t have to change to become “normal.” We are the “norm” for US. Give us the tools and we will find our way through to health for US.
  • 23. Decolonization Prime Minister Harper apologized for the “policy of assimilation” as expressed in the Residential School system What does “not assimilating” Aboriginal people look like?
  • 24. RCAP (Royal Commission on Aboriginal Peoples) A return to the treaty relationship  Nation to Nation  Respect Dealing honestly with the past  Treaty violations  Residential Schools Reconciliation
  • 25. Ruppert Ross“while western psychology’s discussions about thingslike Complex PTSD might help non-aboriginal peopleunderstand the impact of residential schools, theyremain western discussions, coming out of a westernworld-view. A different world-view, however, wouldresult in a different vision of what a healthy person is,a different description of ill-health, and differentprescriptions for returning to good-health.” Heartsong:Exploring Emotional Suppression and Disconnection inAboriginal Canada, Nov. 2009
  • 26. Empowerment The locus of control for Aboriginal Health needs to be in the Aboriginal community not outside.  Health Policy  Health Budget  Health Programming  Health Accountability
  • 27. Colonialism in Health
  • 28. Aboriginal Control
  • 29. To Screen or Not To Screen MDSi produces a data resource for Aboriginal control Community Based Research and Education NAHO’s OCAP (Ownership Control Access Possession) Decolonizing Aboriginal Health requires it. “YES, as long as it is an act of empowerment, resourcing the Aboriginal community to make health agenda decisions.”
  • 30. Adrian Jacobs – ajacobs@ualberta.ca www.braiddm.ca“Restoring Aboriginal culture through community-based type 2 diabetes screening” by Richard Oster, Ellen Toth International Journal of Circumpolar Health 2010 http://www.braiddm.ca/69_3_oster.pdf
  • 31. Nia:wen Gowa

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