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 health-care encounters.”

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Highlights include NOSM’s Response to the TRC’s Calls to Action and an introduction to the School’s Indigenous Health Curriculum Co-Lead for Postgraduate Education

The Indigenous Reference Group (IRG) of the Northern Ontario School of Medicine (NOSM) held a face-to-face meeting on Tuesday, December 6, 2016. Members began their one-day meeting with an opening prayer from Elder Tom Chisel, Traditional Knowledge Keeper, followed by a welcome from Dot Beaucage-Kennedy, Chair of NOSM’s Indigenous Reference Group.

“Joining NOSM’s Indigenous Reference Group for the day was the School’s Circle of Elders and Knowledge Keepers who serve the School as the lead advisors of Indigenous knowledge and wisdom on the Indigenous Peoples’ rights, education, cultures, languages, worldview, values and traditions,” said Tina Armstrong, NOSM’s Director of Indigenous Affairs. “During the meeting, an Indigenous name for the Circle of Elders—Ogichidaang Gagiigatiziwin—was gifted to the group. Ogichidaang can be translated as a position of highest respect and honour with the overall translation of the two words meaning ‘Leaders of the Good Life.’”

Members of the IRG and Circle of Elders and Knowledge Keepers received updates from various areas of the School, including curriculum, research, and NOSM’s response to the 94 Calls to Action from the Truth and Reconciliation Commission of Canada.

Dr. Charles Branch discussed his new responsibility of Indigenous Health Curriculum Co-Lead for NOSM’s Postgraduate Education. Branch is Western Band Cherokee and is sharing the position with Dr. Shannon Wesley, an Anishinaabe woman, both of whom graduated from NOSM’s Family Medicine residency program. In addition to being husband and wife, they share a family practice in Thunder Bay and Wesley works in the remote First Nation community of Kitchenuhmaykoosig Inninuwug (also known as Big Trout Lake) one week a month.

Participants also heard from Dr. Sharon H. Venne (Notokwew Muskwa Manitokan), an Indigenous Treaty person (Cree) and by marriage a member of the Blood Tribe within Treaty 7. Venne spoke about the Truth and Reconciliation Commission of Canada from an Indigenous perspective and practice.

The Indigenous Reference Group was presented with reports following the Indigenous Research Gathering that took place in Sault Ste. Marie in June 2016.

Reporting to the NOSM Dean, the Indigenous Reference Group was established to provide advice to the Northern Ontario School of Medicine’s initiatives, including research, administration, and academic issues in the promotion of excellence in higher learning and accommodation of the Indigenous world view. The Indigenous Reference Group serves as a resource for the medical school in the fulfilment of its social accountability mandate as it relates to Indigenous health education.

The Northern Ontario School of Medicine’s next Indigenous Reference Group meeting is scheduled to occur in the spring of 2017.