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 health-care encounters.”

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