The Breakdown of Indigenous Culture and the Rise of Diabetes

Patient Expert

The basic reason why you and I have type 2 diabetes may be because we have broken ties to our culture. Another way of saying this is that our Western culture is itself broken.

This is still an hypothesis, but it's one that follows from research into the root cause of diabetes among First Nations people of Canada, Aboriginal Australians, the Pima Indians of Arizona. Studies have found a link between cultural collapse and diabetes among indigenous peoples around the world.

  • The direct link among First Nations People of Canada

A two-year research project  published in the October 2014 issue of International Journal for Equity in Health is the first study establishing a direct link between cultural loss and diabetes. Led by Richard Oster, senior research coordinator with the University of Alberta's Faculty of Medicine and Dentistry, the study examined the degree of cultural breakdown among 31 First Nations communities in Alberta, Canada.

"We found that those communities that have more people speaking and knowing their language, and who are presumably more connected to their culture, have significantly less diabetes," Dr. Oster says. "In fact, some of those communities had diabetes rates that were lower than the general rate." He told me that collective and intra-generational trauma is certainly at the heart of the diabetes epidemics seen in indigenous populations around the world.

  • The example of Australia's Aborigines

In fact, David Forbes, who studied cultural barriers and diabetes for his Ph.D. dissertation from Perth's Curtin University, found the same forces at work among Australia's Aborigines.

"Socio-culturally disadvantaged people globally endure significant health and health care disparities compared with the mainstream population," Dr. Forbes told me. "Rural and remote Australian Aboriginal communities suffer seriously adverse life expectancy rates, lifestyle disease complications, and hospital treatment needs due to type 2 diabetes."

  • The evidence from the Pima Indians of Arizona

The United States also offers a prime example showing that cultural collapse can lead to a high rate of diabetes. In one group it is in fact clearly a dominant factor leading to the world's highest recorded prevalence and incidence of type 2 diabetes. That group is the Pima Indians of Arizona.

A major study in Diabetes Care, "Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S.," concludes that "Given the similar genetic background of the Mexican and U.S. Pima-Indian populations, it is most likely that the fivefold difference in diabetes prevalence can be attributed only to differences in lifestyles and environments."

The development of diabetes among the Pima Indians of Arizona shows that it "is determined mostly by environmental circumstances, thereby suggesting that type 2 diabetes is largely preventable. This study provides compelling evidence that changes in lifestyle associated with Westernization play a major role in the global epidemic of type 2 diabetes."

One First Nations participant  cogently makes the connection, talking about the universal need to belong and how it is linked to culture:

"Everybody has to have a sense of belonging. Everybody has to feel like they're part of something. And if you don't, where are you going to end up? Probably on the street and homeless because you think nobody cares. And that's not just Aboriginal people, that's all people."

A subsequent article will explore how these examples from indigenous peoples in Canada, Australia, and the United States are relevant to all of us living in Western cultures.

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