Diabetes, in particular, non-insulin-dependent diabetes, is prevalent in the Aboriginal and Torres Strait Islander populations of Australia. As many as 1 in 20 Australians are said to suffer from diabetes. Aboriginal people are three times as likely to become diabetic in comparison to non-Aboriginal people. In contrast with type 1 diabetes, which is a predisposed autoimmune condition, type 2 diabetes or insulin-resistant diabetes, is a preventable disease, heavily influenced by a multitude of socioeconomic factors. Sufferers of the disease are consequently more susceptible to chronic health issues, including heart disease and kidney failure. Conclusively, this has contributed to the 17 year life expectancy gap between Aboriginal people and non-Aboriginal people and has led to health inequities between Aboriginal people and non-Aboriginal people.
History
The history of Aboriginal Australians is said to have spanned some 60,000 years prior to colonization, yet they were first cited by Europeans in 1606. Further investigations of the land over the years leading to James Cook's arrival in 1769-70, suggested that the Aboriginal people were hunter-gatherers, who were described as "beasts who roamed the land". Fully utilising the resources at their disposal, the diet of the early Aboriginal people was predominantly made up of land animals, fish and shellfish, as well as birds and plant foods. (Note that some historians dispute this, such as Bill Gammage and Bruce Pascoe (in his Dark Emu).)
Post-colonisation, the Aboriginal people experienced excessive disruptions to their socioeconomic circumstances, leading to a rapid decline in their health status. Forced to assimilate into a Eurocentric society, Aboriginal people abandoned their traditional way of living and reluctantly adopted those of the colony. Over time, this has seen the introduction of sugar and refined foods into the diet of Aboriginal Australians, initially to sever existing connections to the land. Aboriginal people have since viewed sugar as an important cultural food, associated with family identities and reinforcing connections. Subsequently, Aboriginal people have since become highly vulnerable to suffering from conditions such as diabetes.
Causes
European influence
The prevalence of type 2 diabetes, obesity, and the corresponding diseases that are associated with these conditions, are often attributed to European influences at the time of colonisation. Sugar and refined foods were used at this time as a means of detaching Aboriginal people from the land and assimilating them into white society. Consequently, Aboriginal Australians have likened certain traditions and memories to the use of sugar. Thus, the ‘Westernisation’ of Aboriginal communities forced the neglect of a nutrient-dense diet and cemented a foundation for the development of type 2 diabetes.
Remoteness
The remoteness of Aboriginal communities and socioeconomic disparity have contributed to the prevalence of diabetes in Aboriginal Australians. Consequently, refined foods have seemingly replaced healthy alternatives, as communities are denied access to fresh and healthy foods due to limited resources. Many Aboriginal people live in poverty, with unemployment and dependence on welfare being common in many communities. Energy dense, filling foods, which are often high in fats and sugar, are more common in the diets of people living in poverty. There are direct correlations between the disparity of wealth, obesity, and subsequent morbidity. This is a main contributor to Aboriginal people and Torres Strait Islanders being 2-4 more times likely to suffer from this condition.
Health inequalities
Health inequalities in society and lack of education can also contribute to the higher diagnosis of diabetes among Aboriginal and Torres Strait Islanders.
Unutilised resources
Similarly, Aboriginal people are recognised as not utilising the health resources at their disposal. Bush tucker, a dietary staple prior to European settlement that is low in natural sugars and free of refined sugars, is not being utilised even in remote communities due to the high dependence on Western diets. Australian Aboriginal people are said to be lacking in diabetes education, including proper monitoring of glucose levels, making them more susceptible to diabetes-related problems.
Low birth weights
Aboriginal infants are also said to have relatively lower birth weights than normal, which can also contribute to early incidences of type 2 diabetes.