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Background: Aboriginal peoples in Canada (First Nations, Metis and Inuit) are experiencing an epidemic of diabetes and its complications but little is known about the influence of factors attributed to colonization. The purpose of this study was to investigate the possible role of discrimination, residential school attendance and cultural disruption on diabetes occurrence among First Nations adults.Methods: This 2012/13 cross sectional survey was conducted in two Saskatchewan First Nations communities comprising 580 households and 1570 adults. In addition to self-reported diabetes, interviewer-administered questionnaires collected information on possible diabetes determinants including widely recognized (e.g. age, sex, lifestyle, social determinants) and colonization-related factors. Clustering effect within households was adjusted using Generalized Estimating Equations.Results: Responses were obtained from 874 (55.7 %) men and women aged 18 and older living in 406 (70.0 %) households. Diabetes prevalence was 15.8 % among women and 9.7 % among men. In the final models, increasing age and adiposity were significant risk factors for diabetes (e.g. OR 8.72 [95 % CI 4.62; 16.46] for those 50+, and OR 8.97 [95 % CI 3.58; 22.52] for BMI 30+) as was spending most time on-reserve. Residential school attendance and cultural disruption were not predictive of diabetes at an individual level but those experiencing the most discrimination had a lower prevalence of diabetes compared to those who experienced little discrimination (2.4 % versus 13.6 %; OR 0.11 [95 % CI 0.02; 0.50]). Those experiencing the most discrimination were significantly more likely to be married and to have higher incomes.Conclusions: Known diabetes risk factors were important determinants of diabetes among First Nations people, but residential school attendance and cultural disruption were not predictive of diabetes on an individual level. In contrast, those experiencing the highest levels of discrimination had a low prevalence of diabetes. Although the reasons underlying this latter finding are unclear, it appears to relate to increased engagement with society off-reserve which may lead to an improvement in the social determinants of health. While this may have physical health benefits for First Nations people due to improved socio-economic status and other undefined influences, our findings suggest that this comes at a high emotional price. [ABSTRACT FROM AUTHOR]

Background: Obesity is prevalent in rural communities in Canada, however little is known about the social determinants of health and obesity in rural populations. Socioeconomic status has been found to be inversely associated with the risk of obesity in developed countries. This study investigated the relationship between income adequacy, education and obesity in a rural setting. Methods: The study used data from 5391 adults aged 18-69 who participated in the Saskatchewan Rural Health Study in 2010. Participants completed a survey that included questions about location of residence, body weight, height, and socio-demographic and behavioral factors. Obesity was defined as body mass index being ≥ 30 kg/m2. Logistic regression using generalized estimating equation was conducted to assess the associations of income adequacy and education level with the prevalence of obesity taking covariates into consideration. Results: Approximately a third of the participants were obese and the prevalence of obesity was similar for men and women. The prevalence of obesity was significantly higher for rural residents not living on farm compared with those living on farm (p < 0.05). After adjustment for potential confounders, the risk of obesity was increased for those with ≤ 12 years of education compared with those with > 12 years of education (aOR: 1.18; 95 % CI: 1.05 - 1.34). Low income adequacy was significantly associated with an increased risk of obesity but only among those not living on farm (aOR: 1.80; 95 % CI: 1.16 - 2.79). Conclusions: Home location was associated with obesity prevalence in rural Saskatchewan and modified the influence of income adequacy, but not the influence of education, on obesity. Adults not living on farm had an increased risk of obesity and showed a significant impact of income adequacy on obesity. [ABSTRACT FROM AUTHOR]

Background: Obesity is prevalent in rural communities in Canada, however little is known about the social determinants of health and obesity in rural populations. Socioeconomic status has been found to be inversely associated with the risk of obesity in developed countries. This study investigated the relationship between income adequacy, education and obesity in a rural setting. Methods: The study used data from 5391 adults aged 18–69 who participated in the Saskatchewan Rural Health Study in 2010. Participants completed a survey that included questions about location of residence, body weight, height, and socio-demographic and behavioral factors. Obesity was defined as body mass index being ≥ 30 kg/m2. Logistic regression using generalized estimating equation was conducted to assess the associations of income adequacy and education level with the prevalence of obesity taking covariates into consideration. Results: Approximately a third of the participants were obese and the prevalence of obesity was similar for men and women. The prevalence of obesity was significantly higher for rural residents not living on farm compared with those living on farm (p < 0.05). After adjustment for potential confounders, the risk of obesity was increased for those with ≤ 12 years of education compared with those with > 12 years of education (aOR: 1.18; 95 % CI: 1.05 - 1.34). Low income adequacy was significantly associated with an increased risk of obesity but only among those not living on farm (aOR: 1.80; 95 % CI: 1.16 – 2.79). Conclusions: Home location was associated with obesity prevalence in rural Saskatchewan and modified the influence of income adequacy, but not the influence of education, on obesity. Adults not living on farm had an increased risk of obesity and showed a significant impact of income adequacy on obesity. [ABSTRACT FROM AUTHOR]