The need for diabetes interventions to have a life course perspective rooted in critical decolonizing Indigenous theory

Abstract

Diabetes is a multifaceted disease, with a myriad of causes. Diabetes has been linked to reducing lifespan 5-15 years, contributing to: cardiovascular disease, renal failure, amputation, stroke, heart attack and blindness. Diabetes currently affects 3.4 million Canadians, with that number projected to increase to 5 million in 2025 (CNIB, 2015). Diabetes has been shown to affect Indigenous populations disproportionately from the rest of the Canadian populations, with those living on First Nation reserves having a diagnosis rate 3-5 times higher (PHAC, 2011). The purpose of this review is to critically analyze diabetes interventions that have been initiated on First Nation reserves in Canada and evaluate their effectiveness, while advocating for interventions to use ideas derived from life course theory and critical decolonizing Indigenous theory to target children. Life course theory posits that development occurs over the lifespan within social and historical constraints, and with respect to diabetes, can begin to manifest through key events stemming from as early as gestation (Elder, Johnson and Crosnoe, 2003; Hertzman and Power, 2006). Critical decolonizing theory, in part, looks to identify the ways colonization has impacted the health of Indigenous peoples, while advocating for an understanding of traditional Indigenous health views (Smylie, Kaplan-Myrth and McShane, 2009). This review will consist of a comprehensive search of ProQuest, Google Scholar and Pubmed, in order to identify what initiatives are being implemented in First Nation communities across Canada. Using a life course approach to create initiatives that target children will enable maximum effectiveness in reducing the likelihood of diabetes diagnosis in later years. In addition, employing decolonized culturally and socially relevant methodology will allow for diabetes interventions to resonate with First Nations populations in ways that will have lasting impacts.