endobj 11 0 obj How do you feel self-determination and health are related (if at all) in your community? /CropBox [0 0 595.2760009766 793.7009887695]
Also, we wish to thank Davida Reingold for her assistance. /Parent 15 0 R 2009, 374 (9683): 65-75. They made these little guys bury their brothers, and tell `em, "ok, get back to the fields and work". One participant described how traditional culture is increasingly limited, and sedentary behaviours consequently heightened, due to this western influence: There´s so much at play with the dominant society because you have TV, you got media, and people are constantly in the midst of the dominant society.
One participant remarked "the older generation seemed more self-determined than the new generation, `cause this generation seems more dependant". We achieved strength and rigor during the qualitative research process by adhering to the strategies for qualitative description set out by Whittemore, Chase, and Mandle [13] and Milne and Oberle [14] of authenticity, credibility, criticality and integrity. /B [208 0 R 209 0 R] Crude diabetes prevalence by Aboriginal language knowledge for the year 2005. Most Indigenous adults (72.3%) experienced racial discrimination some or most of the time in childhood. >> /D [29 0 R /FitR 0 794 596 794] endobj The participants felt that traditional culture, and having their culture continue into future generations, is inextricably linked to their health. Innovation with Tradition. endobj /T 7 0 R
115 0 obj /ColorTransform 0 /Type /Pages People don´t want us to make reference to the Nazis and of the concentration camps, but they were here. Cultural continuity was measured using the Vancouver Index Enculturation Scale.
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How do you feel self-determination and health are related (if at all) in your community?
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Chapter 9: Research Involving the First Nations, Inuit and Mètis Peoples of Canada. endobj Our findings go beyond, and suggest that one of the key underlying determinants of these disparities is cultural continuity. /Rotate 0 uuid:aea91655-cb22-4db1-811e-8e35a91ffb65 << endobj /D [29 0 R /FitR 0 481 596 481] >> <<
/CA 1 /D [27 0 R /FitR 0 794 596 794] International Journal for Equity in Health, http://www.ethics.gc.ca/pdf/eng/tcps2/TCPS_2_FINAL_Web.pdf, http://www.hc-sc.gc.ca/fniah-spnia/pubs/finance/_agree-accord/10_years_ans_trans/index-eng.php, http://www.aadnc-aandc.gc.ca/eng/1307458586498/1307458751962, http://creativecommons.org/licenses/by/4.0, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s12939-014-0092-4.
/Subtype /Image Google Scholar, Mayan MJ: Essentials of Qualitative Inquiry. Some participants spoke of other factors that might contribute to self-determination in First Nations such as economic development, increased employment, increased number of educated people, increased local autonomy, reclaiming traditional lands, and engaging the mainstream society with reciprocity in mind. 10.1016/0277-9536(94)00125-D. Bruyere J, Garro LC: "He travels in the body": Nehinaw (Cree) understandings of diabetes. A kid is brought in" Shave your head" You´re given a number. 2010, 71 (4): 717-724. 111 0 obj Therefore, in the second phase of our mixed methods approach, we aimed to determine whether diabetes prevalence rates in First Nations in Alberta were related to cultural continuity.
21 0 obj Criticality, or being questioning of one´s work, was attained through reflection on the critical appraisal of decisions made throughout the research process. They were finding skeleton bones in the incinerators of fetuses. << 2009, 5 (2): 88-101. endobj /D [37 0 R /FitR 0 794 596 0] /Prev 295 0 R /ColorTransform 0 << The Canadian Diabetes Association did not have a role in the study design, the collection, analysis, or interpretation of the data, the writing of the manuscript, or the decision to submit.
Some participants explained how western society continues to encroach on and influence First Nations, and that the erosion of Indigenous languages was a direct result of this "outside influence". The most recent age-adjusted data for Alberta shows 13.5% of adult First Nations people have diabetes compared to only 6.0% of adults of the general population [7]. >> /LW 1
This is in line with our qualitative findings which revealed the importance of traditional culture and its relevance to health and diabetes, as well as the unyielding connection between culture and traditional language. >> >>
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We purposefully sampled 10 adult (20years or older) First Nations participants that were currently, or had recently been (within three years), an elected community official (Band Councilor or Chief) in a First Nation within Alberta. We´re expected to function on shrinking budgets´ There´s no revenue sharing agreement.
Some of the participants described how the Indian Act disallows Indigenous people from borrowing or having collateral which puts extreme limits on getting a mortgage, starting a business, or economic development. << You´re given a uniform´ You´re four years old, you´re put in an institution, and you´re institutionalized for fourteen years of your life. We show that generalizing obscures the differences in prevalence that exist among different First Nations. The negative impacts of residential school are profound and ongoing, resulting in "diabetes", "broken communities", "loss of parenting skills", "addictions, suicides, and marital breakups", "apprehended children", "lifeline (culture) severed", "shame", loss of "a voice", "mental health problems", "contaminated families", "disarray and chaos", and "pain". My grandpa seen his brother thrown in a hole. Participants also linked cultural continuity to increased physical activity and consumption of traditional foods resulting from hunting, trapping, and fishing. /Next 129 0 R Briefly, authenticity refers to paying close attention to the voices of participants, and was attained by purposeful sampling, participant-driven data collection and accurate transcription. /Keywords ( Indigenous population; Diabetes mellitus; North America; Language; Qualitative research; Cross sectional analysis) ; licensee BioMed Central Ltd. endobj /Type /Pages Despite the influence of Chandler and Lalonde [1],[2], to our knowledge their work has not been repeated in their own or other contexts, or in relation to other major Indigenous health problems, such as type 2 diabetes.
Adrian Jo Milang, cultural practitioner & community manager. << One such story was so poignant we felt it was necessary to include it in full: Residential schools were concentration camps. You have to feed them, you have to water them, and you have to house them locally. 114 0 R 115 0 R 116 0 R 117 0 R 118 0 R Int J Equity Health 13, 92 (2014). 134 0 obj 51 0 obj Article 93 0 obj Another participant went on to clarify: Self sustaining is tied right back to our culture, our source of life. Every participant had their own personal family story of residential schools and its impacts. The national average of eligible First Nations that had signed these agreements was 41% in 1999, with rates as high as 70% in Saskatchewan [26]. endobj
/Parent 11 0 R They NEED to have a sense of belonging... You have a sense of pride because you have a sense of belonging. >>
endobj © 2019 The Authors. >> 59 0 obj /D [33 0 R /FitR 0 181 596 181] << /First 292 0 R /Parent 15 0 R /D [28 0 R /FitR 0 601 596 601] /D [37 0 R /FitR 0 794 596 0] Diabetes Care. /Resources 199 0 R endobj
83 0 obj 70 0 obj The findings were verified by the participants as an accurate portrayal of their collective experiences. /First 22 0 R It was also decided at this stage, since it was agreed that further interviews were not likely to reveal new information or insight, that data saturation had been reached and data collection should be concluded. /CropBox [0 0 595.2760009766 793.7009887695] /Limits [ ] In many instances participants viewed western society and its values as a barrier to cultural continuity and self-determination. endobj <<
The qualitative findings were used as the basis for designing the second phase of our mixed methods approach. All analyses were conducted using STATA statistical software. /Contents 219 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R << >> Through use of government mortality data on First Nations communities, it was found that youth suicide incidence rates varied markedly in British Columbia First Nations [2],[3]. Analysts from Alberta Health applied the National Diabetes Surveillance System algorithm to identify diabetes cases, which requires an individual to have either two physician visits within two years or one hospitalization for diabetes (International Classification of Diseases - 9 codes 250 or International Classification of Diseases - 10 codes E10-E14) [15]. <<
45 0 R 46 0 R 47 0 R 48 0 R 49 0 R << /Contents 155 0 R Caution is needed when interpreting the cross-sectional results, which were from 2005. Med J Aust. /Contents 256 0 R << 1995, 16 (1): 24-26. Permissions team, https://doi.org/10.1186/s12939-014-0092-4. Acrobat Distiller 10.1.5 (Windows) Table11 shows the average values and simple linear regression results (as a predictor of diabetes) for median household income, unemployment rate, high school completion rate, and Indigenous language knowledge rate. First Nations crude prevalence rates for 585 Alberta communities were obtained from Alberta Health. Some participants explained how western society continues to encroach on and influence First Nations, and that the erosion of Indigenous languages was a direct result of this "outside influence".
The advisory group assisted in identifying 31 of the 585 communities as First Nations that we could collect publically available data for. /D [37 0 R /FitR 0 794 596 0] endobj /Parent 15 0 R endobj
<< Some of the participants explained how a First Nation cannot endure and "know where it is going" without first understanding "who we are and where we come from". endstream