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Claire Guatto
type 2 diabetes. Individuals that distrust—with good cause—the government and the health services and lessons it provides, are less likely to seek medical help or receive a diagnosis. The lack of culturally appropriate health care options and the dismissal of traditional Inuit medicinal knowledge bar Nunavummiut Inuit from accessing adequate health care. A mistrust in government healthcare policies and practices has been cultivated for years, and cultural differences between doctors and patients lead many Inuit people to avoid hospitals unless absolutely necessary. As Durie explains, “where doctor and patient are from different cultural backgrounds the likelihood of misdiagnosis and non-compliance is greater.”24 Doctors are more likely to misdiagnose and disregard patients’ concerns, and, as a result, patients are less likely to return. Cultural alienation, particularly between doctor and patient, is prevalent in healthcare interactions in Nunavut. Understanding cultural knowledge surrounding the health conditions in specific communities is crucial to maintaining effective healthcare.25 Existing health care options may not be sufficient. Moreover, historical failures of the government to provide for Inuit communities continue to foster mistrust within those communities.26 Health care is seen by some as a continuation of the colonial narrative. Traditional Indigenous knowledge and practices are not taken into account when treating Indigenous people, an approach which is often interpreted as a form of assimilation. The dismissal of Inuit knowledge in the health care field contributes to Inuit individuals being less likely to visit the doctor, and they are therefore more likely to suffer from poor health while being less likely to receive diagnoses. Not only are the social, economic, and cultural determinants of health necessary to analyze in their relation to the perpetuation of dysfunctional and potentially harmful health care systems, environmental determinants are also exceedingly relevant factors when it comes to Inuit health and well-being. The environment in Nunavut is cold, snowy, and dark for most of the year. Communities are isolated: even Iqaluit, the capital, has only around 6,700 people. Isolation, both from other towns and from much of the Canadian population, limits access to health care professionals. Driving in the dark, on icy roads, to go see a doctor is not an option for many Inuit people, particularly if type 2 diabetes is normalized and therefore not viewed as a serious health concern. Moreover, a cold climate with a lot of snow and very little sunlight in the winter makes going outside for regular, 24. Durie, “The Health of Indigenous Peoples,” 510. 25. Durie, 510. 26. O’Gorman and Pandey, “Explaining Low High School Attainment,” 300.