Type 2 Diabetes and Children in Aboriginal Communities: The Array of Factors that Shape Health and Access to Health Care

Abstract

In recent years, Canada's federal government has begun to consider Aboriginal claims regarding land, resources, health, social welfare, education, and employment. Although section 88 of the Indian Act provides that general provincial laws are applicable to Aboriginal persons, this is subject to Aboriginal treaty provisions, and to Parliament's overarching constitutional jurisdiction over "Indians, and lands reserved for the Indians". As such, Aboriginal affairs in Canada are governed primarily by Parliament, subject always to Aboriginal rights. At the same time, provincial legislation of general application, that is not inconsistent with Aboriginal rights or federal laws, also extends to Aboriginal peoples.

The impact on the health of Aboriginal adults is not the sole legacy of their historical marginalization. Aboriginal children suffer from excessive rates of meningitis, otitis media, respiratory illnesses and iron deficiency anaemia. The most striking disparity between Aboriginal and non-Aboriginal pediatric health is found in the increased rates of Aboriginal children with type 2 diabetes. Arguably, the psychosocial health of Aboriginal youth is an equal or greater cause for concern: depression, suicide and substance abuse rates among Aboriginal teens are alarming. Like psychosocial illness, diabetes is cyclical, bearing the potential to pass from one generation to the next. Both diseases also have their roots in the effects of colonialism, and both are gravely exacerbated by poverty and social marginalization. Yet, while a study of mental health in Aboriginal communities would lend itself to a similar discussion, the focus here will be on the prevalence of diabetes among Indigenous children and youth in Canada.

In Canadian politics, calls for government attention to particular matters of concern frequently are responded to with an injection of finances into agencies responsible for administering the issue in question, or into research programs designed to study and improve the situation. Where the concern is perceived to merit public assistance, a cash contribution is understood to be the most effective means for reaching a solution. Government responses to health care dilemmas within Canada's Aboriginal communities have followed along these lines. This is exemplified by strategies employed to deal with rising diabetes rates. In 1994, the Health Ministry of the Province of Ontario committed $450,000 to fund Aboriginal diabetes programs. By 1999, the Ministry offered another $3.3 million to sustain additional diabetes programs, primarily for Aboriginal communities. Similarly, the Federal budget announcement in 1999 provided $55 million over the following three years to combat diabetes. In so doing, the government indicated that this would lead to a greater understanding of why diabetes has been so prevalent in Aboriginal communities, and what must be done to ameliorate the situation.