Obesity in Aboriginal Population
A continued increase in prevalence rates of overweight and obesity is being witnessed around the world with the latter becoming a major health concern in Canada. Obesity is seen as a major problem in the Aboriginal population where the prevalence rates are reported to be higher than the national average. According to the 2004 Canadian Community Health Surveys (CCHS) report, obesity prevalence rates among the off-reserve aboriginal population were estimated at 37.8 percent and 23.1 percent for the Canadian population. The prevalence rate among the First Nations people living on-reserve was estimated to be 36 percent by the 2002-2003 First Nations Regional Health Survey (FNRHS) report. The focus is thus on obesity prevalence and sex differences, the prevalence of obesity among Aboriginal children and youth, obesity-related health risks, and some of the research areas explored by most studies on the same.
Obesity Prevalence and Sex Differences
According to a report by the FNRHS, the rate of obesity is higher among First Nations women than non-Aboriginal women. As the body mass index increases, the differences between the two populations get more pronounced. Aboriginal women are less likely to be overweight as compared to their male counterparts. It is estimated that Aboriginal women’s likelihood to be overweight is 31.1 percent and 41.8 percent for men (Batal & Decelles, 2019). However, Aboriginal women are more likely to be obese (34.3 percent) as compared to men (28.6 percent).
Prevalence Among Aboriginal Children and Youth
The rate of obesity prevalence is disproportionately higher amongst Aboriginal children and youth as compared to Aboriginal adults. In comparison to their non-Aboriginal peers, Cree children and adolescents in Quebec are five times more likely to overweight. Mohawk children found in Quebec and Ontario are believed to slightly heavier than their non-Aboriginal peers. Presumably, as children from the two mentioned populations reach the age of nine, the differences became more pronounced (Hajizadeh, Hu, Bombay & Asada, 2018). It is further estimated that Aboriginal children aged 12-17 years among the First Nations are obese. This translates to 36 percent of the youth population across Canada. Surveys indicate that Aboriginal girls are more likely to be obese compared to boys. For instance, in the James Bay region of northern Quebec, it was found out that the rate of obesity among the Cree girls’ population was 24 percent and 9 percent for boys. Another study at northern Manitoba showed that the rate of obesity amongst Ojibwa-Cree girls was at 40 percent and 30 percent for boys (Russell et al., 2016). The body mass index (BMI) between the Aboriginal girls and boys is similar as they continue to grow although the differences become more pronounced as they reach the age of 13. At 13, BMI tends to be higher in Aboriginal girls as compared to their male counterparts. The likelihood of girls aged 13 to 17 years becoming obese is 7.4 percent whereas that of their male counterparts is 9.2 percent.
Obesity-Related Health Risks
Considering the high rates of obesity among the Aboriginal population, this population is often at a high risk of developing a wide range of health risks related to the health problem. In association with the BMI, Aboriginals have more body fat percent and face higher risks of obesity health-related diseases as compared to their non-Aboriginal counterparts (Chen et al., 2015). Moreover, the impact of obesity on both women and men differs with the condition having more severe implications on women than men. The distribution of body among the Aboriginal population is more centralized and they have a greater percentage of subcutaneous fat, which associated with some obesity-health related problems such as diabetes and cardiovascular disease.
The risk factors of diabetes are overweight and obesity. Diabetes results from the various body complications that trigger the production of insulin thereby leading to an increase in glucose levels in an individual’s blood. Various health problems such as kidney and heart failures are associated with this disease as it shuts the functions of several body organs when left untreated. In the Aboriginal population, people living with diabetes experience certain health challenges such as circulatory problems and heart disease. The Aboriginal population experiences three types of diabetes including Type 1, Type 2, and gestational diabetes. Type 1 rare among the Aboriginal population although it occurs in childhood and early adolescence. Type 2 and gestational diabetes are significant in the Aboriginal population. Gestational diabetes relevant to Aboriginal women occurs when hormone secretions prompt an elevation in glucose level during pregnancy (Leung, 2016). When women are unable to produce sufficient insulin to regulate these high glucose levels, they may experience some problems with their pregnancy and even experience miscarriage.
In the Aboriginal population, prevalence rates of diabetes are considerably higher as compared to the non-Aboriginal population across Canada. Based on the 2002-2003 FNRHS report, the prevalence rate of diabetes in the First Nations population is five times greater than that in Canada’s general population. According to studies conducted in Ontario and Manitoba, the prevalence rate of type 2 diabetes is more significant in girls as compared to their male peers. Besides, the rates of diabetes are disproportionately high in adults and Aboriginal women are believed to be more diabetic than men (Staniferet al., 2017). On the other hand, non-Aboriginal men tend to be more diabetic than women.
Cardiovascular diseases refer to conditions that involve damage to the circulation system including blood vessels and the heart. Symptoms of the cardiovascular disease manifest differently in both men and women. For example, men and women experience chest pain although women are likely to exhibit additional symptoms such as sweating and heartburn (Chu et al., 2019). High blood pressure, excessive alcohol consumption, and high cholesterol are some of the risk factors for cardiovascular disease.
There is little research that demonstrates the prevalence of heart disease in the Aboriginal population including the First Nations and Inuit peoples. Some studies show that the disease is slightly prevalent in First Nations adults in comparison to Canada’s general population. The rate of heart disease in First Nations adults is at 7.2 percent whereas that of the general population is 5.6 percent. The variations between these rates become more pronounced with age. For example, 11.5 percent of Aboriginal adults aged between 50-59 years reported having the condition while 5.5 percent of non-Aboriginal adults of the same age reported having such a health condition. In the First Nations women population, the rate of heart disease prevalence is 8.0 percent while in the non-Aboriginal women population it is at 5.1 percent (Chu et al., 2019). This health problem is also more prevalent in Aboriginal adults (14.5 percent) with diabetes type as compared to those without diabetes whose figure stands at 3.3 percent.
Most research studies concerned with obesity in Aboriginal communities explore various interrelated theories such as behavioral or lifestyle and environmental theories. The argument in each of these approaches is as follows.
Behavioral or Lifestyle Factors
Most of the research studies explore obesity in the Aboriginal population including the First Nations, Inuit, and Metis populations focus on health-related behaviors of an individual. According to the FNRHS report, it is argued that the obesity epidemic facing the Aboriginal population in Canada is associated with the population’s adoption of diets that consist of high fat and sugar levels. The health condition is also associated with the population’s rapid transition to a sedentary lifestyle. The rise in obesity in Canada can also be attributed to decreased physical activity among the Aboriginal population. Despite the mentioned causes of the health problem, obesity and lifestyle trends of the Aboriginal population account for many cases of obesity among the population. Physical activity levels and consumption of foods that contain high fats are some of the most commonly researched obesity-related behaviors in the Aboriginal population.
In the Aboriginal population, physical inactivity contributes to rising overweight and obesity prevalence rates. Physical inactivity can be linked to sedentary behaviors such as continuous and lengthy television viewing. Ethnicity notwithstanding, at least 56 percent of Canada’s general population including Aboriginals and non-Aboriginals aged 19 to 50 were obese as a result of physical inactivity. 50 percent of the population was the Aboriginal population and 23 percent were individuals from the non-Aboriginal population (Bruner et al., 2016). However, the CCHS report indicates that there are no ethnic differences in the prevalence of physical inactivity between Aboriginal and non-Aboriginal populations.
According to the CCHS report, Aboriginal women consume larger quantities of high-calorie foods compared to non-Aboriginal women. For example, the report found that Aboriginal women aged between 19 and 30 consume high-calorie foods and snacks at a higher rate as compared to non-Aboriginal women (Macniven et al., 2016). The differences have contributed to the higher rates of obesity among Aboriginal women.
Environmental degradation affects the availability of traditional food sources hence dietary choices of the Aboriginal population are affected. The Aboriginal population is also exposed to environmental contaminants through contact and consumption of contaminated food (Rosol, Powell-Hellyer & Chan, 2016). Lack of sufficient traditional foods, exposure to environmental contaminants, and industrialization force the Aboriginal population to access high-calorie foods leading to an increase in overweight, obesity, and other health problems associated with the conditions.
Despite the variance in obesity prevalence rates between the Aboriginal population and Canada’s general population, the rate of obesity is higher among Aboriginal women compared to men and non-Aboriginal women. In the Aboriginal population, the prevalence rate of obesity is also higher as compared to their non-Aboriginal counterparts. Various health risks such as diabetes and cardiovascular disease are associated with obesity. These mentioned health risks cause the loss of lives in the Aboriginal population. Diabetes is the most prevalent health-related obesity risk factor in the indigenous population in Canada, particularly type 2 and gestational diabetes. There are several studies that explore obesity-related theories some of which are behavioral and environmental theories.
Batal, M., & Decelles, S. (2019). A scoping review of obesity among indigenous peoples in Canada. Journal of obesity, 2019. Retrieved from http://downloads.hindawi.com/journals/jobe/2019/9741090.pdf
Bruner, M. W., Hillier, S., Baillie, C. P., Lavallee, L. F., Bruner, B. G., Hare, K., & Lévesque, L. (2016). Positive youth development in Aboriginal physical activity and sport: A systematic review. Adolescent Research Review, 1(3), 257-269. Retrieved from https://link.springer.com/article/10.1007/s40894-015-0021-9
Chen, Y., Rennie, D. C., Karunanayake, C. P., Janzen, B., Hagel, L., Pickett, W., & Saskatchewan Rural Health Study Group. (2015). Income adequacy and education associated with the prevalence of obesity in rural Saskatchewan, Canada. BMC Public Health, 15(1), 700. Retrieved from https://link.springer.com/article/10.1186/s12889-015-2006-9
Chu, A., Han, L., Roifman, I., Lee, D. S., Green, M. E., Jacklin, K., & Tu, J. V. (2019). Trends in cardiovascular care and event rates among First Nations and other people with diabetes in Ontario, Canada, 1996–2015. CMAJ, 191(47), E1291-E1298. Retrieved from https://www.cmaj.ca/content/191/47/E1291.short
Hajizadeh, M., Hu, M., Bombay, A., & Asada, Y. (2018). Socioeconomic inequalities in health among Indigenous Peoples living off-reserve in Canada: trends and determinants. Health Policy, 122(8), 854-865. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0168851018301969
Leung, L. (2016). Diabetes mellitus and the Aboriginal diabetic initiative in Canada: An update review. Journal of family medicine and primary care, 5(2), 259. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084544/
Macniven, R., Richards, J., Gubhaju, L., Joshy, G., Bauman, A., Banks, E., & Eades, S. (2016). Physical activity, healthy lifestyle behaviors, neighborhood environment characteristics and social support among Australian Aboriginal and non-Aboriginal adults. Preventive medicine reports, 3, 203-210. Retrieved from https://www.sciencedirect.com/science/article/pii/S2211335516000097
Rosol, R., Powell-Hellyer, S., & Chan, H. M. (2016). Impacts of decline harvest of country food on nutrient intake among Inuit in Arctic Canada: impact of climate change and possible adaptation plan. International journal of circumpolar health, 75(1), 31127. Retrieved from https://www.tandfonline.com/doi/full/10.3402/ijch.v75.31127
Russell, C. G., Taki, S., Laws, R., Azadi, L., Campbell, K. J., Elliott, R., & Denney-Wilson, E. (2016). Effects of parent and child behaviours on overweight and obesity in infants and young children from disadvantaged backgrounds: systematic review with narrative synthesis. BMC public health, 16(1), 151. Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-2801-y
Stanifer, J. W., Mathew, A., Kilonzo, K. G., & Yeates, K. (2017). Prevalence of Predialysis Kidney Disease in Disadvantaged Populations in Developed Countries: Canada. In Chronic Kidney Disease in Disadvantaged Populations (pp. 7-14). Academic Press. Retrieved from https://www.sciencedirect.com/science/article/pii/B9780128043110000029