Case Synopsis

Marie is a nurse and a member of the Bull Rapids First Nation. She is frustrated that there are no resources to help Indigenous people cope with the issue of chronic diseases such as type 2 diabetes, which is a major health issue in this community. Marie knows something needs to be done, so she undertakes research to determine whether there are any interventions that can help her community prevent, treat, and manage type 2 diabetes. During her research, she discovers Diabetes Alliance and the quality improvement strategy they have developed to empower Indigenous communities to create their own plans to combat diabetes. The purpose of this case is to give a brief overview of the colonial practices and the proximal, intermediate and distal determinants of health that have caused many of the health issues that occur today in Indigenous communities. It will also provide an opportunity for students to think critically about how chronic diseases can be addressed and what can be done to help improve the situation in Indigenous communities in Canada. This case gives students a chance to explore the concept of traditional knowledge, its importance to Indigenous communities, and how it can and should be incorporated into interventions. After reading this case, students will understand the historical events that have created the current health predicament in these communities. If students understand the issues that have caused the problem, it can help dispel any negative preconceptions that students may have of Indigenous people. This case provides an avenue for Indigenous students to discuss issues that actually impact them, their families and communities.

Case Objectives

  1. Identify the proximal, intermediate, and distal determinants of health and the vast impact that they have on the health and well-being of Indigenous people and their communities in Canada.
  2. Understand the impact that colonialism has had on Indigenous communities and how it has played a role in creating health disparities.
  3. Explain the guiding ethical research principles that have been created for working with Indigenous people and why these principles are needed.
  4. Examine interventions that can help alleviate health disparities experienced by Indigenous communities.

Case Study Questions

  1. Why do the social determinants of health play such a large role in determining the health and well-being of Indigenous people and their communities?
  2. What is community-based participatory research and why is it an important concept to adopt when working with Indigenous people?


Community-based participatory research, two-eyed seeing, health disparities, health intervention, Indigenous communities, Indigenous people, social determinants of health, type 2 diabetes



Recommended Citation

Bragg, S., Zaran, H., & Darnell, R. (2020). Coming Together to Promote Change: Best Practices to Prevent, Treat, and Manage Type 2 Diabetes in Indigenous Communities in Canada in: McKinley, G. & Speechley, M. [eds] Western Public Health Casebook 2020. London, ON: Public Health Casebook Publishing.