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Trying to keep a balance: the meaning of health and diabetes in an urban Aboriginal community

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  • Thompson, Samantha J.
  • Gifford, Sandra M.

Abstract

Although the predominant paradigm of epidemiological investigation continues to focus narrowly on the individual and on individual risk factors, there is a growing body of work that calls for a rethinking of the current epidemiological models. In this paper we illustrate the need for a more comprehensive epidemiological approach towards understanding the risks for diabetes, by exploring the lived experiences of diabetes and lay meanings of risk among Aborigines living in Melbourne, Australia. Ethnographic fieldwork was conducted within the Melbourne Aboriginal community in the state of Victoria over a 22-month period (1994-1996). Melbourne Aborigines see non-insulin dependent diabetes mellitus (NIDDM) as the result of living a life out of balance, a life of lost or severed connections with land and kin and a life with little control over past, present or future. The lay model regarding diabetes that is derived from the narratives of Melbourne Aborigines, consists of three levels of connectedness important in determining an individual's susceptibility not only to diabetes but to all disease -- (1) family, (2) community and (3) society. This structure of interactive systems at successive levels from the individual to the population fits within the framework of an ecological paradigm. The strength of ethnography as applied to epidemiology is that it has the capacity to discover previously unknown components of a system at several different levels, and to build models to explain how these components interact. This framework, developed using an ethno-epidemiological approach, has application in other indigenous populations who have been dispossessed of their land, their pasts and their future. There is great potential to apply this approach to the major public health challenges presented by rapid global socio-cultural and environmental change that are impacting negatively on population health.

Suggested Citation

  • Thompson, Samantha J. & Gifford, Sandra M., 2000. "Trying to keep a balance: the meaning of health and diabetes in an urban Aboriginal community," Social Science & Medicine, Elsevier, vol. 51(10), pages 1457-1472, November.
  • Handle: RePEc:eee:socmed:v:51:y:2000:i:10:p:1457-1472
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    Citations

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    Cited by:

    1. Elisabeth Marks & Margaret Cargo & Mark Daniel, 2007. "Constructing A Health And Social Indicator Framework For Indigenous Community Health Research," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 82(1), pages 93-110, May.
    2. Giles, Brian G. & Findlay, C. Scott & Haas, George & LaFrance, Brenda & Laughing, Wesley & Pembleton, Sakakohe, 2007. "Integrating conventional science and aboriginal perspectives on diabetes using fuzzy cognitive maps," Social Science & Medicine, Elsevier, vol. 64(3), pages 562-576, February.
    3. Michelle Schmidt, 2022. "Cultivating health: diabetes resilience through neo-traditional farming in Mopan Maya communities of Belize," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 39(1), pages 269-279, March.
    4. Naemiratch, Bhensri & Manderson, Lenore, 2006. "Control and adherence: Living with diabetes in Bangkok, Thailand," Social Science & Medicine, Elsevier, vol. 63(5), pages 1147-1157, September.
    5. Finn, Mark & Sarangi, Srikant, 2008. "Quality of life as a mode of governance: NGO talk of HIV 'positive' health in India," Social Science & Medicine, Elsevier, vol. 66(7), pages 1568-1578, April.
    6. Joanne Nicole Luke & Alister Thorpe & Carlina Black & Lisa Thorpe & David Thomas & Sandra Eades & Kevin Rowley, 2021. "Collaborative Social-Epidemiology: A Co-analysis of the Cultural and Structural Determinants of Health for Aboriginal Youth in Victorian Schools," IJERPH, MDPI, vol. 18(16), pages 1-22, August.
    7. Yoshitaka Iwasaki, 2007. "Leisure and quality of life in an international and multicultural context: what are major pathways linking leisure to quality of life?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 82(2), pages 233-264, June.
    8. Marie Baron & Mylène Riva & Christopher Fletcher & Melody Lynch & Marie-Claude Lyonnais & Elhadji A. Laouan Sidi, 2021. "Conceptualisation and Operationalisation of a Holistic Indicator of Health for Older Inuit: Results of a Sequential Mixed-Methods Project," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 155(1), pages 47-72, May.
    9. Mark Daniel & Margaret Cargo & Elisabeth Marks & Catherine Paquet & David Simmons & Margaret Williams & Kevin Rowley & Kerin O’Dea, 2009. "Rating Health and Social Indicators for Use with Indigenous Communities: A Tool for Balancing Cultural and Scientific Utility," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 94(2), pages 241-256, November.

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