Screening for Undiagnosed Type 2 Diabetes in Aboriginal Communities: Weighing the Advantages and Disadvantages




Many Aboriginal people worldwide share the experience of sociohistorical disempowerment. In Canada, the health system continues to build and rebuild subjugating structures that disenfranchise Aboriginal peoples. However, collaborative Aboriginal health research — research-related diabetes screening, in particular — has the potential to address Aboriginal disenfranchisement and create shared “ethical space” for Aboriginal communities and researchers. We describe Aboriginal disenfranchisement as it has been constructed via Canada’s health-care system. We discuss the advantages and disadvantages of conducting research-related screening for undiagnosed type 2 diabetes in Aboriginal communities, describing the potential for collaborative community-based participatory research (CBPR) to create trust relationships between community and researcher; define new ethical arrangements that emerge from community wisdom, tradition, practice, and commonsense; and take into account the sociohistorical realities experienced by Aboriginal peoples through generations. We assert that collaborative CBPR can be a blueprint for implementing new systemic structures, such as health care delivery, at a societal level, aimed at addressing Aboriginal disenfranchisement, and at creating shared ethical space to encourage the non-Aboriginal partner, situated in the dominant sphere, to relinquish power.

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