Leading Our Way: Urban and Rural Indigenous Diabetes and Obesity Wellness Programs

Urban living Indigenous Peoples in Canada experience diabetes 3-6 times and obesity 1.5 times more than the general population. Indigenous children are being diagnosed with type 2 diabetes, and complications are more severe for all ages. These disparities are directly related to racism, discrimination and colonization. Western (mainstream) health systems have had limited success in effective health-care provision for Indigenous people, however, culturally-safe Traditional and Western partnership programs have demonstrated better outcomes. This Indigenous-led community responsive research collective of six urban/rural Friendship and Métis Center communities, university and health authority members, use Indigenous methodologies and Two-Eyed Seeing. We are guided by Elders and site-specific community advisory teams. Talking circles and community gatherings shape programs and pre-post clinical measures/surveys, and evaluation surveys/tools, map success and actions for change. Knowledge Keepers and Healers teach gathering, preparation and use of Traditional medicines/foods, healthy life balance (physical, mental, emotional, spiritual); nurses, dietitians, and other health providers teach nutrition, mindfulness, glucose/weight management; and community gardens and cooking classes have also been offered. The Collective has: 1) Co-developed/delivered/evaluated 12 site-specific, culturally safe, 8-week diabetes/obesity wellness programs; 2) Increased access and capacity for Traditional and Western education and service delivery; 3) Initiated/sustained partnerships with the regional health authority, Indigenous and non-Indigenous health and wellness providers; and 4) Co-developed culturally safe Indigenous tele-diabetes/obesity clinics and accredited diabetes/obesity management workshops. We share insights of how Indigenous-led, community-driven, culturally safe Traditional and Western approaches to research and wellness programs can promote health equity and improve diabetes/obesity health outcomes.