Introduction
Health and illness are complex issues that different forms of the health care systems across the world are grappling to comprehend with a view of improving public health. Since humans interact constantly, sociological factors that are present in their environment have a significant impact on their conditions of health and illness. Specifically, food and nutrition that people eat in a given community or social environment is subject to cultural beliefs and practices.
While some beliefs and practices have health benefits, others are harmful. In this view, Nayak, Sharada, and Geroge (2012) recommend healthcare providers to consider the influence of beliefs and practices on healthy lifestyles that people adopt in various social settings. Epidemiologists have expanded the approach of studying the occurrence of diseases in the society to include social forces such as beliefs and practices.
According to Thompson and Gifford (2000), ethno-epidemiological approach is effective in understanding sociological determinants of health that are present in family, community, and society. Therefore, this essay analyses the article, Trying to Keep a Balance: The Meaning of Health and Diabetes in Urban Aboriginal Community, with a view of describing the relationship between sociology and nutrition in causing diabetes among Aborigines in Australia.
Perspectives of Sugar and Causes of Diabetes
The perspective of sugar as the cause of diabetes originate from the influence of the Whites on food and nutritional habits of the Aborigines. Among Australian Aborigines, the perspective of diabetes is quite different from the conventional perceptive. Thompson and Gifford (2000) hold that “the sugar’ that causes diabetes is seen as coming into the community, introduced from the outside, typically by the white man’, in ways that, in the past, were seen as intentionally used to upset the balance of these connections” (p. 1462). The first aspect of this perspective is that the Aborigines identify sugar as the cause of diabetes.
The second aspect is that their experience at the hands of the colonialists disturbed the balance of sugar in their families, communities, and society, and thus, leading to unfavourable imbalance. Essentially, the belief of diabetes as a racial disease is not unique to the Aborigines. In the early part of the 19th century, the dominant belief was that diabetes was the disease of the coloured race, particularly the Jews (Tuchman 2010). As the Whites colonised the Aborigines, they brought diabetes into Australia and spread among the community members. Hence, such assertion, which is a lay perspective, explains the origin and cause of diabetes among the Aborigines in Australia.
The aborigines also hold the perceptive that sweet and bitter sugars exist depending on their origin. In essence, sweet sugar originates from the Aboriginal world, while bitter sugar originates from the non-Aboriginal world. The Aborigines believe that the Whites brought bitter sugar into their region and enticed their children to consume them as chocolates and lollies. Thompson and Gifford (2000) argue that the Aborigines believe that bitter sugar comprise of chemicals, food additives, and pollutants that predispose people to diabetes.
From such perspective, it is evident that the Aborigines identify diabetes as a disease that emanate from the consumption of foreign sugars in food and nutrition. Gollust, Lantz, and Ubel (2012) state that stereotypes of food and nutrition among different races have significant influence on the eating habits of people. In this view, the Aborigines believe that foreigners and their foodstuffs have contributed to the occurrence and high incidences of diabetes in Australia.
As foreign sugars are bitter, the Aborigines believe that these sugars do not instantly cause diabetes, but they accumulate with time in the body and ultimately results in diabetes. Evidently, the Aborigines perceive that the Whites enticed their children to consume bitter sugar, which accumulate in their bodies during their childhood and consequently lead to diabetes as they approach adulthood.
Thompson and Gifford (2000) notes that the Aborigines believe that the foreign sugars that children consume accumulate for a period of 20-30 years and predispose adults to diabetes. Hence, the perception of Aborigines is that the diabetes originate from childhood eating habits, which cumulatively affect the health conditions of the adults. Furthermore, the Aborigines hold that the accumulated sugars do not only affect individuals, but also pass from parents to children, and thus, causing diabetes among people, who have never taken them in their lives (Thompson & Gifford 2000).
Such a belief makes the Aborigines to attribute their eating habits to their parents. Gollust, Lantz, and Ubel (2012) argue that cultural beliefs make people to attribute their current state of illness to their experiences and inheritance. In this case, the Aborigines associate diabetes with accumulated sugars they have eaten throughout their lifetime and the amount they inherited from their parents because sugars run through families.
The Aborigines hold that an imbalance of sugars in the body originates from the traumatic experiences that they have endured across the ages. The history of the Aborigines shows that colonialists subjected them to traumatic experiences, which greatly influenced their way of life. The introduction of new lifestyles, eating habits, and foodstuffs disconnect individuals from their families, community, and society.
Thompson and Gifford (2000) state that, “the increasing isolation and disconnection from the family occurring in the younger generations of Melbourne Aborigines is symbolised by their greater intake of fast-food and absence of the young during the family gathering for home-cooked meals” (p. 1463). Such a belief offers an explanation as to why there are increased incidences of diabetes among the young people in Australia. Krishnan, Coognan, Boggs, Rosenberg, and Palmer (2010) concur with the beliefs of the Aborigines that associate the consumption of fast food, which are available in restaurants, with the occurrence of diabetes.
Fundamentally, fast food causes overweight and obesity among consumers and consequently predispose them to diabetes (Zaidi 2007). However, obese people among the Aborigines have to overcome pressure from family when preparing diet recommended by doctors. Hence, healthcare providers need to expound on the nature of food and nutrition that cause overweight, obesity, and consequently diabetes.
Late Diagnosis, Treatment, and Management of Diabetes
Although diabetes is a chronic metabolic disorder, the Aborigines perceive it as an acute disorder, which only presents itself suddenly without giving any signs and symptoms. According to Thompson and Gifford (2000), the Aborigines overlook the signs and symptoms of diabetes because they consider them normal, and thus, they only seek diagnosis very late when diabetes has become chronic. In this view, the Aborigines undertake late diagnosis of diabetes.
Brooks, Darroch, and Giles (2013) studied Canadian Aborigines and noted that late diagnosis of diabetes is the major issue that complicates treatment and management of diabetes among diabetics. Moreover, the treatment and management of diabetes is poor because diet and nutrition of diabetics are subject to the dictates of the beliefs and preferences of the family. Since diet and nutrition are critical in the treatment and management of diabetes, diabetics and their respective families do not utilise them early enough when their conditions are still at the nascent stages (Sizer & Whitney 2013). In this view, healthcare providers need to understand that the Aborigines overlook the signs and symptoms of diabetes, and therefore, diagnosis method should be sensitive to the perspectives that mask the existence of diabetes.
Treatment and management of diabetes among the Aborigines present major challenges to the health care system because of poor adherence to available interventions. Although the Aborigines know that diet, oral drugs, and injection are three applicable methods of treating and managing diabetes, they perceive that the use of injection is more severe and deadly than the diabetes. Thompson and Gifford (2000) state that diabetic patients prefer to die than tolerate regular injections.
From the sentiments of the Aborigines, it is evident that they do not understand the treatment and management interventions of diabetes appropriately, as they ascribe injection as an intervention for the most severe diabetes and diet as the intervention for the least severe diabetes. Sharma, Kalra, Dhasmana, and Basera (2014) note the ignorance as one of the causes of poor adherence to interventions, and hence, recommend education of diabetic patients to improve their adherence to medication. Therefore, health promotion is central in leveraging diabetic patients to embrace an appropriate diet and nutrition as long-term interventions for treating and managing diabetes.
Ultimately, the social life of the Aborigines dictates the nature of food and nutrition that they take, whether diabetic or not. For instance, family ties are very important as they override the prescriptions that doctors offer in terms of food and nutrition. Family members often meet during meal times and connect each other with a view of maintaining balance of sugars (Thompson & Gifford 2000).
The association of food and family ties implies that individuals have to consume similar diet and nutrition irrespective of their predisposition to diabetes. Lutz, Mazur, and Litch (2014) argue that families hold on beliefs, which dictate eating habits of family members in terms of frequency of meals and nature of nutrition. In this view, it is important for healthcare providers to consider social forces within the families and communities that determine the nature of food and diet that people consume.
Conclusion
The perspectives of Aborigines have marked influence on their health status because they dictate their food and nutrition, and consequently their predisposition to diabetes. From the perspectives of the Aborigines, the Whites caused diabetes as they brought bitter sugar and convinced them to consume. Accumulation of sugars in the body and the imbalances caused by traumatic experiences trigger the occurrence of diabetes among the Aborigines.
Late diagnosis and poor adherence to medication contribute to deprived treatment and management of diabetes among the Aborigines. Overall, family ties compel individuals to value social connections rather than recommendations that they receive from doctors regarding their medication and nutrition. Therefore, understanding of the perspectives of the Aborigines or other cultural groups is very important in customising treatment and management interventions of various diseases.
References
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Krishnan, S, Coognan, P, Boggs, D, Rosenberg, L & Palmer, J 2010, ‘Consumption of restaurant foods and incidence of type 2 diabetes in African American women’, American Nutrition of Clinical Nutrition, vol. 91, no. 1, pp. 465-471. Web.
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Sizer, F & Whitney, E 2013, Nutrition: Concepts and Controversies, Cengage Learning, New York.
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Tuchman, A 2010, ‘Diabetes and race: A historical perspective’, American Journal of Public Health, vol. 101, no. 1, pp. 24-33. Web.
Zaidi, S 2007, Take Charge of Your Diabetes: A Revolutionary Plan for Treating Your Diabetes and Preventing Its Complications, Da Capo Press, London.