Study from NOSM Researcher Explains Poorer Health Outcomes in Indigenous Patients with Diabetes
In Canada, rates of type 2 diabetes are three to five percent higher in
Indigenous peoples when compared to non-Indigenous peoples. Not only
this, but Indigenous Canadians typically have poorer health outcomes
during treatment of diabetes.
A study published today in the Canadian Medical Association Journal
(CMAJ) states that Indigenous peoples in Canada with type 2 diabetes
experience culturally unsafe health care—a factor that may cause poorer
health outcomes. Dr. Kristen Jacklin,
Associate Professor at the Northern Ontario School of Medicine (NOSM)
and five of her colleagues conducted a national study that investigated
Indigenous Peoples experiences with diabetes care.
Participants in the study reported that both past and present negative
experiences with the health-care system that affected their care, such
as: having the health system experience trigger traumatic childhood
memories at residential schools, interactions that patients felt were
racially motivated, limited access to care due to physician shortages
and geographic isolation, and negative interactions with health-care
professionals. A key finding of the study was that health-care
relationships can be repaired when health care providers demonstrate
empathy, humility, and patience.
The research suggests that the answer to better health care for
Indigenous Peoples should be a two-pronged approach. First, Dr. Jacklin
and her colleagues recommend a stronger focus on cultural safety
training and antiracism education for health-care workers including a
stronger emphasis on relationship development and advocacy. Second,
enhancing patient-centered approaches to care to respond to the cultural
and social needs of Indigenous patients.
“This study found that many Indigenous patients avoided or disengaged
from their diabetes care because of negative experiences such as
derogatory or judgmental comments by health-care providers, or visual
triggers in health-care settings,” says Dr. Kristen Jacklin, NOSM
Associate Professor of Medical Anthropology and first author of the
study. “However, in my view, an equally important outcome of the
research was learning directly from Indigenous patients with diabetes
about what could be done to rebuild or improve health-care
relationships. We now have a much better sense of what patients feel
their health-care providers should know about them to improve
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The Northern Ontario School of Medicine is committed to the education of high quality physicians and health professionals, and to international recognition as a leader in distributed, learning-centered, community-engaged education and research.