Abstract
Cardiovascular and renal disease are highly prevalent in Canada's Aboriginal population
even though rates of cardiovascular disease are falling in the rest of the country.
High and rising prevalence rates of diabetes must be addressed to impact significantly
on global cardiovascular and renal risk. Type 2 diabetes is occurring in Aboriginal
youth, putting them at greater risk of long-term complications. The reasons for the
sudden upswing in diabetes rates in the past 60 years are a result in large part to
social determinants of health, which for Aboriginal people include the multigenerational
effects of colonization and consequences of the residential school system. Addressing
cardiovascular and renal risk therefore requires the knowledge and skills to implement
clinical practice guideline–based interventions, the ability to create culturally
safe chronic disease management programs in partnership with Aboriginal communities,
and advocacy across sectors for improvements in the social determinants of health.
Résumé
Les maladies cardiovasculaires et rénales ont une prévalence élevée dans la population
autochtone du Canada, malgré des taux de maladies cardiovasculaires en baisse dans
le reste du pays. Les taux élevés et de hausse de la prévalence du diabète doivent
être considérés pour leur impact significatif sur le risque cardiovasculaire global
et rénal. Le diabète de type 2 touche les jeunes autochtones, les mettant plus à risque
de complications à long terme. Les raisons de la soudaine hausse des taux de diabète
des 60 dernières années sont dues en grande partie à des déterminants sociaux de la
santé qui, concernant les peuples autochtones, comprennent les effets multigénérationnels
de la colonisation et les conséquences du système des pensionnats. Aborder le risque
cardiovasculaire et rénal nécessite donc les connaissances et les compétences pour
mettre en œuvre des interventions basées sur un guide de pratique clinique, la capacité
à créer des programmes de gestion des maladies chroniques culturellement sûrs en partenariat
avec les communautés autochtones, et de plaider dans tous les secteurs pour des améliorations
dans les déterminants sociaux de la santé.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Canadian Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
National Household Survey, Aboriginal Peoples in Canada: First Nations people, Metis and Inuit. Canada: Statistics Canada, 2011. Available at: http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-011-x/99-011-x2011001-eng.pdf. Accessed August 11, 2015.
- Prevalence, determinants and co-morbidities of chronic kidney disease among First Nations adults with diabetes: results from the CIRCLE study.BMC Nephrol. 2012; 13: 57
- Association of temporal trends in risk factors and treatment uptake with coronary heart disease mortality, 1994-2005.JAMA. 2010; : 1841-1847
- Cardiovascular health among Canada's aboriginal populations: a review.Heart Lung Circ. 2012; 21: 618-622
- A review of the cardiometabolic risk experience among Canadian Metis populations.Can J Cardiol. 2013; 29: 1006-1013
- Risk factors, atherosclerosis, and cardiovascular disease among Aboriginal people in Canada: the Study of Health Assessment and Risk Evaluation in Aboriginal Peoples SHARE-AP.Lancet. 2001; 358: 1147-1153
Reading CL, Wien F. Health inequalities and the social determinants of Aboriginal peoples' health. National Collaborating Centre for Aboriginal Health. Prince, George, BC; 2009. Available at: http://www.nccah-ccnsa.ca/docs/social%20determinates/nccah-loppie-wien_report.pdf. Accessed August 11, 2015.
- The experience of living with diabetes for low-income Canadians.Can J Diabetes. 2010; 34: 119-126
- Indigenous health part 2: the underlying causes of the health gap.Lancet. 2009; 374: 76-85
- First Nations wholistic policy and planning model: discussion paper for the World Health Organization Commission on Social Determinants of Health.Assembly of First Nations, Ottawa2007
- Serious complications for patients, care providers and policy makers: tackling the structural violence of First Nations people living with diabetes in Canada.Int Indigenous Policy J. 2011; 2: 6
- Coping with colonization: aboriginal diabetes on Manitoulin Island.in: Tillett R. Fear-Segal J. Indigenous Bodies: Reviewing, Relocating, Reclaiming. SUNY Press, New York2013
- Type 2 diabetes in vulnerable populations: community healthcare providers' perspectives on health service needs and policy implications.Can J Diabetes. 2011; 35: 503-511
- Geographical distribution of diabetes among the native population of Canada: a national survey.Soc Sci Med. 1990; 31: 129-139
Public Health Agency of Canada. Diabetes in Canada: Facts and figures from a public health perspective. Ottawa, Canada, 2011. Available at: http://www.phac-aspc.gc.ca/cd-mc/publications/diabetes-diabete/facts-figures-faits-chiffres-2011/index-eng.php. Accessed August 11, 2015.
- Diabetes mellitus: a “thrifty” genotype rendered detrimental by “progress”?.Am J Hum Genet. 1962; 14: 353-362
- Type II diabetes, essential hypertension, and obesity as “syndromes of impaired genetic homeostasis”: the “thrifty genotype” hypothesis enters the 21st century.Perspect Biol Med. 1998; 42: 44-74
- HNF1A G319S variant, active cigarette smoking and incident type 2 diabetes in Aboriginal Canadians: a population-based epidemiological study.BMC Med Genet. 2011; 12: 1
- Racializing narratives: obesity, diabetes and the “Aboriginal” thrifty genotype.Soc Sci Med. 2006; 62: 2988-2997
- ‘Race’ matters: racialization and egalitarian discourses involving Aboriginal people in the Canadian health care context.Ethn Health. 2008; 13: 109-127
- The relationship between hypertension and obesity across different ethnicities.J Hypertens. 2012; 30: 359-367
- First Nations Regional Health Survey RHS. Phase 2 2008/2010. National Report on Adults, Youth and Children Living in First Nations Communities.FNIGC, Ottawa2012
- Feasibility of treating prehypertension with an angiotensin-receptor blocker.N Engl J Med. 2006; 354: 1685-1697
- Incidence and precursors of hypertension in young adults: the Framingham Offspring Study.Prev Med. 1987; 16: 235-251
- Type 2 diabetes mellitus in Canada's first nations: status of an epidemic in progress.CMAJ. 2000; 163: 561-566
- Childhood obesity in a population at high risk for type 2 diabetes.J Pediatr. 2000; 136: 365-369
- A systematic review of physical activity levels in Native American populations in Canada and the United States in the last 50 years.Obes Rev. 2013; 14: 593-603
- The Canadian Diabetes Association 2013 Clinical Practice Guidelines.Can J Diabetes. 2013; 37: 137-138
- Increasing rates of diabetes and cardiovascular risk in Métis settlements in northern Alberta.Int J Circumpolar Health. 2009; 68: 5
- Recent epidemiologic trends of diabetes mellitus among status Aboriginal adults.Can Med Assoc J. 2011; 183: E803-E808
- Modelling preventive effectiveness to estimate the equity tipping point: at what coverage can individual preventive interventions reduce socioeconomic disparities in diabetes risk?.Chronic Dis Inj Can. 2014; 34: 94-102
- A comparison of rates, risk factors, and outcomes of gestational diabetes between aboriginal and non-aboriginal women in the Saskatoon health district.Diabetes Care. 2002; 25: 487-493
- Increased risk of cardiovascular disease in young women following gestational diabetes mellitus.Diabetes Care. 2008; 31: 1668-1669
- Increased rates of adverse outcomes for gestational diabetes and pre-pregnancy diabetes in on-reserve First Nations Women in Ontario, Canada.Diabet Med. 2012; 29: e180-e183
- The inter- and intragenerational impact of gestational diabetes on the epidemic of type 2 diabetes.Am J Public Health. 2011; 101: 173-179
- Mortality outcomes among status Aboriginals and whites with heart failure.Can J Cardiol. 2014; 30: 619-626
- Differential mortality and the excess burden of end-stage renal disease among First Nations people with diabetes mellitus: a competing-risks analysis.Can Med Assoc J. 2014; 186: 103-109
- Type 2 diabetes in Aboriginal peoples.Can J Diabetes. 2013; 37: S191-S196
- Diabetes risk evaluation and microalbuminuria DREAM. studies: ten years of participatory research with a First Nation's home and community model for type 2 diabetes care in Northern Saskatchewan.Int J Circumpolar Health. 2008; 67: 190-202
- Effectiveness and safety of medication adjustments by nurse case managers to control hyperglycemia.Diabetes Educ. 2009; 35: 851-856
- Diabetes care and health status of First Nations individuals with type 2 diabetes in Alberta.Can Fam Physician. 2009; 55: 386-393
- Diabetes epidemiology as a tool to trigger diabetes research and care.Diabetologia. 1999; 42: 499-518
- A community-based model of care improves blood pressure control and delays progression of proteinuria, left ventricular hypertrophy and diastolic dysfunction in Maori and Pacific patients with type 2 diabetes and chronic kidney disease: a randomized controlled trial.Nephrol Dial Transplant. 2010; 25: 3260-3266
- Globalization, coca-colonization and the chronic disease epidemic: can the Doomsday scenario be averted?.J Intern Med. 2000; 247: 301-310
- Healthy food procurement policies and their impact.Int J Environ Res Public Health. 2014; 11: 2608-2627
- Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program.JAMA. 2002; 288: 1882-1888
- Economic analysis of Heart and Stroke Foundation of Ontario's Hypertension Management Initiative.Clinicoecon Outcomes Res. 2012; 4: 323-336
- The importance of habits in eating behaviour. An overview and recommendations for future research.Appetite. 2011; 57: 585-596
- Effectiveness of community-directed diabetes prevention and control in a rural Aboriginal population in British Columbia, Canada.Soc Sci Med. 1999; 48: 815-832
- A successful diabetes prevention study in Eskimos: the Alaska Siberia project.Int J Circumpolar Health. 2005; 64: 409-424
- An integrated multi-institutional diabetes prevention program improves knowledge and healthy food acquisition in northwestern Ontario First Nations.Health Educ Behav. 2008; 35: 561-573
- Incidence and prevalence of type 2 diabetes in the First Nation community of Kahnawá:ke, Quebec, Canada, 1986-2003.Can J Public Health. 2007; 98: 438-443
- Impact of a diabetes prevention program on body size, physical activity, and diet among Kanien'keha:ka Mohawk. children 6 to 11 years old: 8-year results from the Kahnawake Schools Diabetes Prevention Project.Pediatrics. 2005; 115: 333-339
- A pilot school-based healthy eating and physical activity intervention improves diet, food knowledge, and self-efficacy for native Canadian children.J Nutr. 2005; 135: 2392-2398
- Health benefits of physical activity: the evidence.CMAJ. 2006; 174: 801-809
- The effectiveness of community based physical activity interventions with Aboriginal peoples.Prev Med. 2011; 53: 411-416
- Promising strategies for obesity prevention and treatment within American Indian communities.J Transcult Nurs. 2006; 17: 224-229
- Primary prevention of hypertension by nutritional-hygienic means. Final report of a randomized, controlled trial.JAMA. 1989; 262: 1801-1807
Guide to Community Preventive Services. Diabetes prevention and control: combined diet and physical activity promotion programs to prevent type 2 diabetes among people at increased risk. Available at: http://www.thecommunityguide.org/diabetes/combineddietandpa.html. Accessed August 11, 2015.
- A systematic review of interventions to improve diabetes care in socially disadvantaged populations.Diabetes Care. 2006; 29: 1675-1688
- Finding strength(s): insights on Aboriginal physical cultural practices in Canada.Sport in Society. 2014; 17: 1046-1060
- Bridging the implementation gap between knowledge and action for health.Bull World Health Org. 2004; 82: 724-731
- Pragmatic controlled clinical trials in primary care: the struggle between external and internal validity.BMC Med Res Methodol. 2003; 3: 28
- Indigenous health part 1: determinants and disease patterns.Lancet. 2009; 374: 65-75
- Have investments in on-reserve health services and initiatives promoting community control improved First Nations' health in Manitoba?.Soc Sci Med. 2010; 71: 717-724
- Effect of nurse-directed hypertension treatment among First Nations people with existing hypertension and diabetes mellitus: the Diabetes Risk Evaluation and Microalbuminuria DREAM 3. randomized controlled trial.CMAJ. 2006; 174: 1267-1271
- Blood pressure 2 years after a chronic disease management intervention study.Int J Circumpolar Health. 2010; 69: 50-60
- Sandy lake health and diabetes project: a community-based intervention targeting type 2 diabetes and its risk factors in a first nations community.Front Endocrinol Lausanne. 2013; 4: 170
- Specific patterns of food consumption and preparation are associated with diabetes and obesity in a Native Canadian community.J Nutr. 1998; 128: 541-547
- Can the democratic ideal of participatory research be achieved? An inside look at an academic-indigenous community partnership.Health Educ Res. 2008; 23: 904-914
- Effect of a multifactorial intervention on mortality in type 2 diabetes.N Engl J Med. 2008; 358: 580-591
- I-RREACH: An engagement and assessment tool for improving implementation readiness of researchers, organizations and communities in complex interventions.Implement Sci. 2015; 10: 64
Article info
Publication history
Published online: June 04, 2015
Accepted:
May 29,
2015
Received:
April 14,
2015
Footnotes
See page 1127 for disclosure information.
Identification
Copyright
© 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
