Diabetes in Aboriginal communities has a significant impact on morbidity and mortality rates.
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Type 2 diabetes is a major health issue for Australian Aboriginals.
It is estimated that:
- Aboriginal people are 3.4 times more likely than non-Aboriginal people to have diabetes or pre-diabetes
- The Kimberly population (Northern Western Australia) has the 4th highest prevalence or Type 2 diabetes in the world.
- Gestational diabetes is up to 20% higher in the Aboriginal population compared with the non-Aboriginal population.
- Kidney disease is a complication of diabetes and is 10 times more likely to occur in Aboriginal people when compared with non-Aboriginal people.
The trends are showing that the total incidence of diabetes is on the rise and Aboriginal people are presenting with the condition at a much younger age than non-Aboriginal people.
Research has shown that many Aboriginal people view diabetes as a low priority in their lives and therefore they often act too late in attempts to prevent or manage condition, resulting in adverse complications.
There are many reasons why there are high rates of morbidity and mortality from type 2 diabetes in Aboriginal Populations in Australia. These include:
The Impact of historical and political events
In the past, laws were enacted that had a negative impact on the social and cultural fabric of the Aboriginal community. The result of this has filtered down from generation to generation and has not been dealt with effectively. The consequence has been a build up of stress and trauma that is taking time to heal. The progress on the journey and the methods used in reconciliation varies greatly across the Aboriginal population.
Low socioeconomic status
Aboriginal people experience disadvantage through a lack of access to education, employment, income and housing which, puts them into a low socioeconomic category in society. Adults who have a low socioeconomic status are more likely to die prematurely from diabetes and have more chronic disease risk factors than those of high socioeconomic status. This is certainly the case for Aboriginal populations where life expectancy is lower than in non-Aboriginal populations.
A High Prevalence of Risk Factors for Diabetes
In comparison to non-Aboriginal populations, Aboriginal populations have higher rates of obesity, physical inactivity, smoking, gestational diabetes, heart disease and stroke. These are all risk factors for the development of type 2 diabetes.
More than half (57%) of Aboriginal people aged 15 years and over are overweight or obese.
Half of Aboriginal adults are regular smokers, which is twice the rate of non-Aboriginal adults.
A Lack of Access to Health Services
Many Aboriginal people live in rural and remote areas of Australia where health services are limited. In combination with this, access to transport is poor with little or no public transport and reliance on private vehicles which may not be available. Research has shown that the greater the distance from health services the lower the rate of access to those health services. A reduction in access to health services has a profound effect on the prevention, detection and management of diabetes.
In urban settings, where health services are more accessible. Many Aboriginal people don’t use them as they may not be culturally sensitive or meet all of their needs.
Issues of daily stress and its relationship to diabetes management
Aboriginal people with diabetes are constantly living with issues causing stress and dealing with these issues take precedence over one's own health. This results in the early onset of complications and adverse outcomes. Stressors include cultural, social, environmental, spiritual, emotional, economical or mental aspects, with themselves and family or extended family. Priority given to these stress factors has an influence on the urgency of seeking treatment for diabetes by an individual.
Research shows that Aboriginal adults are twice as likely as non-Aboriginal adults to report high to very high levels of psychological distress.
The prevention and management of diabetes is a challenge within the context of the environment described above. There is however stories of hope that are available and the road to developing diabetes for Aboriginal people is not one that every person has to take. For more information visit the Aboriginal Booklet of Hope and listen to Stories of Hope on this site.