ArticleBMC public health2015
Do discrimination, residential school attendance and cultural disruption add to individual-level diabetes risk among Aboriginal people in Canada?
Article in BMC public health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Prevalence of type 2 diabetes among global Indigenous adult populations: a systematic review.Diabetologia · 2026Pooled it
- Educating for Equity Care Framework: Addressing social barriers of Indigenous patients with type 2 diabetes.Canadian family physician Medecin de famille canadien · 2019Pooled it
- Impact of remote prenatal education on program participation and breastfeeding of women in rural and remote Indigenous communities.EClinicalMedicine · 2021Article
- Diabetes prevalence, incidence and mortality in First Nations and other people in Ontario, 1995-2014: a population-based study using linked administrative data.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Article
- Review
- Ethnic differences in vascular function and factors contributing to blood pressure.Canadian journal of public health = Revue canadienne de sante publique · 2018Article
- Migration and cognitive function: a conceptual framework for Global Health Research.Global health research and policy · 2018Review
- Residential schools and the effects on Indigenous health and well-being in Canada-a scoping review.Public health reviewsArticle
- Article
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAboriginal peoples in Canada (First Nations, Metis and Inuit) are experiencing an epidemic of diabetes and its complications but little is known about the influence of factors attributed to colonization. The purpose of this study was to investigate the possible role of discrimination, residential school attendance and cultural disruption on diabetes occurrence among First Nations adults.
methodsThis 2012/13 cross sectional survey was conducted in two Saskatchewan First Nations communities comprising 580 households and 1570 adults. In addition to self-reported diabetes, interviewer-administered questionnaires collected information on possible diabetes determinants including widely recognized (e.g. age, sex, lifestyle, social determinants) and colonization-related factors. Clustering effect within households was adjusted using Generalized Estimating Equations.
resultsResponses were obtained from 874 (55.7 %) men and women aged 18 and older living in 406 (70.0 %) households. Diabetes prevalence was 15.8 % among women and 9.7 % among men. In the final models, increasing age and adiposity were significant risk factors for diabetes (e.g. OR 8.72 [95 % CI 4.62; 16.46] for those 50+, and OR 8.97 [95 % CI 3.58; 22.52] for BMI 30+) as was spending most time on-reserve. Residential school attendance and cultural disruption were not predictive of diabetes at an individual level but those experiencing the most discrimination had a lower prevalence of diabetes compared to those who experienced little discrimination (2.4 % versus 13.6 %; OR 0.11 [95 % CI 0.02; 0.50]). Those experiencing the most discrimination were significantly more likely to be married and to have higher incomes.
conclusionsKnown diabetes risk factors were important determinants of diabetes among First Nations people, but residential school attendance and cultural disruption were not predictive of diabetes on an individual level. In contrast, those experiencing the highest levels of discrimination had a low prevalence of diabetes. Although the reasons underlying this latter finding are unclear, it appears to relate to increased engagement with society off-reserve which may lead to an improvement in the social determinants of health. While this may have physical health benefits for First Nations people due to improved socio-economic status and other undefined influences, our findings suggest that this comes at a high emotional price.
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