BY HEIDI ULRICHSEN
Date Published | Sept. 20, 2007

Ethically-conducted research is helping aboriginal people receive better health care, according to the scientific director of the Canadian Institute of Health Research (CIHR) - Institute of Aboriginal Peoples’ Health.

Jeff Reading has written a set of guidelines that researchers working in aboriginal communities must adhere to if they receive funding from CIHR.

“There have been some bad experiences with research in the past in aboriginal communities,” he said.

“People in communities don’t often see the connection between the research being done and the conditions in the communities. A lot of research gets done, but they fail to see the improvements filtered down to their lives.”

Reading, who has a Mohawk father, grew up in Toronto and earned a PhD in public health science at the University of Toronto.

When not working with CIHR, Reading is a professor in the faculty of Human and Social Development at the University of Victoria.

He is a health researcher himself, having conducted studies on tobacco use, diabetes and other subjects affecting aboriginal health.

As part of his job with CIHR, Reading finds aboriginal health issues that need to be explored and invites researchers to apply for grant money to conduct ethical studies in those areas.

Research must be done in partnership with the priorities of aboriginal communities, integrating indigenous “ways of knowing” with innovative ideas derived from ancient traditional practices of aboriginal healers, he said.

“There’s all kinds of research being done,” said Reading.

“Food security, environmental contaminants in wild food, diabetes, child obesity, management of chronic diseases, prevention of suicide and other mental health problems are some examples.

“There are also areas like genetics and research involving disorders that could be prevented if proper therapies are developed. It’s everything from molecules to community-based research.”

Type 2 diabetes is a huge problem in aboriginal communities, with about 20 per cent of the population suffering from the disorder. In comparison, about five per cent of the general population in Canada has Type 2 diabetes.

Reading figures the incidence of Type 2 diabetes is high partly because those living in aboriginal communities tend to be poor and can’t afford nutritious food. Food also costs more in remote, northern communities, he said.

Type 2 diabetes causes all kinds of other health problems, from hypertension to blindness to kidney disease, he said.

A recent Sunnybrook and Women’s College Health Science Centre-led project, the Diabetes Risk Evaluation and Microalbuminuria (DREAM 3) controlled trial, looked into the best way to control hypertension among aboriginal people in Saskatchewan.
All participants had their blood pressure monitored, were given drugs to reduce hypertension and underwent laboratory tests over one year.

The only difference was that one group of participants was monitored by a doctor, and the other by a home care nurse. There was no significant difference between the two study groups; both experienced reductions in their blood pressure by the final visit.
“The idea was to show that you can get the same effect by having a program that is administered by a nurse rather than a physician. Both programs had positive effects. Sometimes, in remote areas, it is hard to get physicians.”

Although it may be cheaper to conduct health research in urban areas, it’s not sufficient to translate outcomes from other populations to aboriginal populations, he said.
Treatment plans need to be adapted to the realities of the north because large hospitals and specialists are sometimes hundreds of kilometres away, he added.

If poverty could somehow be eradicated in aboriginal communities, a lot of health problems would disappear as well, said Reading. But because poverty still exists in these communities, good health research is needed.

“There are a lot of factors that determine health, including housing, quality of water, access to education and income,” he said.

“When there’s a disparity in the things that determine health, poor health is a consequence. Eradicating poverty would go a long way to improving the health of aboriginal people, but that hasn’t happened yet.”

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