by Shawna Ritchie, Policy Analyst
In a recent article in the Calgary Herald, the Canadian Diabetes Association (CDA) warned that the cases, and the costs, of diabetes will balloon in Alberta if the government doesn’t take aggressive action.
Michael Cloutier, president and CEO of the CDA, cautions that the burden of diabetes is rising sharply in Alberta. He attributes this to “a growing population and because many immigrants are from Asian or South Asian background and others born with a higher predisposition to the disease.”
Diabetes is a growing problem in Canada and I commend them for speaking out. I was struck, however, by a surprising omission. Nowhere did they mention or discuss the prevalence of diabetes in the Canadian Aboriginal population (unless that is what is meant by, “others born with a higher predisposition?”), which seems like a very large oversight. Here’s why:
- Diabetes has become so prevalent in Canadian Aboriginal communities, particularly in First Nations communities, that the National Aboriginal Diabetes Association says it has “reached epidemic levels.”
- The rates of diabetes diagnosis are three to five times higher in Aboriginal populations than in the general population.
- In a study published in the Canadian Medical Association Journal in 2010, Dr. Roland Dyck of the University of Saskatchewan revealed that by the age of 60 almost half of First Nations women and more than 40 per cent of First Nations men have diabetes!
- The rates of Aboriginal diabetes are expected to continue to increase as Aboriginal peoples typically develop the disease at much younger ages, and as children and teenagers—who make up almost half the Aboriginal population—become adults.
This is a particularly acute issue for western Canada, which is home to the majority Canada’s Aboriginals, both in absolute terms and in terms of population percentages.
For example, in 2009 Manitoba released the results of a 20-year study on diabetes in the province, with an emphasis on diabetes in the First Nations population. Based on what they learned, they forecast that the number of First Nations diabetes cases will increase three-fold in the next 20 years resulting in a prevalence rate of 27% in the province—more than one in four of the population.
Because diabetes is a disease with many side effects, this same study estimates that over the next 20 years, as rates of diabetes increase, there will be “a 10-fold increase in the rate of cardiovascular disease; a 5-fold increase in strokes; 10 times as many dialysis starts; 10 times the rate of lower extremity amputations; and 5 times the rate of blindness” in the province.
Rising diabetes rates will have tremendous impacts on the economy and health care requirements of Manitoba. This is also ominous for Saskatchewan and Alberta, which have similar proportions of Aboriginal peoples.
The reality is, you can’t talk about diabetes in western Canada and ignore diabetes in the Aboriginal population. Not only because the rates are so high and the complications so severe. But also because effective solutions for diabetes in Aboriginal communities must take into account their unique cultural and geographical situation.
In many developed countries, Aboriginal peoples fall behind the rest of the population in a host of health, education and prosperity indicators. Diabetes rates amongst Aboriginal peoples in Canada are a symptom of these broader and deeply entrenched set of issues. As such, diabetes must be tackled as part of an integrated public policy strategy for Aboriginal Canadians.
It isn’t enough to launch an education campaign about the importance of following the Canada Food Guide, when many of those foods are not part of traditional Aboriginal diets and when many Aboriginal communities are in isolated areas that don’t have access to fresh fruits and vegetables for most of the year. The first step to solving a complex problem is admitting that there is a problem to solve, and that’s why we need to tell the whole story of diabetes in western Canada.