Diabetes is often framed as a purely medical condition, managed through medications, blood sugar monitoring, and lifestyle changes. For many Indigenous youth in Canada, however, history and culture shape how they experience the condition. The enduring impacts of colonialism, intergenerational trauma, and the healthcare system’s failure to provide culturally sensitive and adequate care have contributed to diabetes being disproportionately prevalent in Indigenous communities across Canada.
These realities have influenced Jonathan Linton—a First Nations young adult living with diabetes in the Eeyou 1st-chee (EI) territory in Quebec, home to nine separate Cree communities—to develop a peer mentorship program to address the diabetes epidemic specifically in this region.
“Even before the [peer mentor program], I wanted to help my fellow Crees with their diabetes, because diabetes is a big thing around here, and a lot of people [used to think] it was the end when they were first diagnosed,” Linton said in an interview with The Tribune.
The program employs a community-based approach, featuring activities based on promoting wellness practices, maintaining a healthy lifestyle, and reconnecting with the land to improve health and psychosocial outcomes for individuals with diabetes. Linton chose this approach because clinical environments often create barriers, including long wait times, feelings of stigma, and challenges navigating medical information that is delivered in ways that do not align with Indigenous values and beliefs.
“When I, myself, as a diabetic, went to the clinic, it was hard to understand [the medical professionals] […] and the [clients] would go through the same thing I went through. By the time I left the doctor’s office, I would forget most of the things that they told me,” Linton said. “But then, I started asking my clients if they wanted to go out on the land because it is our medicine and freedom […] and so [the program] took off.”
‘Going out onto the land’ refers to engaging in land-based activities, such as hunting, fishing, and preparing traditional foods. Linton explains that participation in these activities promotes physical exercise, which supports diabetes management, while also benefiting mental health.
Romina Pace, an assistant professor in McGill’s Department of Medicine, also shared her experiences working alongside Cree communities to improve healthcare delivery and outcomes in an interview with The Tribune.
“As a physician working with people with diabetes, and especially within the Cree community, I think that the lifestyle changes and the reconnecting with the land aspects [of the program] help with a lot of stuff besides diabetes,” Pace said. “Having those lifestyle changes for mental health, or the self-esteem that the program actually builds for people […] helps to deal with drugs, alcohol, and other stressors that are going on a lot with the youth and young adults in the community.”
Pace also emphasized the recurring complications First Nations youth with diabetes continue to endure, explaining that many people in the community are on dialysis from kidney failure. However, she is hopeful that negative health outcomes can be prevented through the implementation of peer-mentorship programs such as Linton’s.
“Stepping into the [regular] clinic has a negative stigma, particularly for Cree youth and young adults, who are at higher risk of having renal complications from diabetes,” Pace said.
Finally, Sahar Fazeli, a postdoctoral fellow at the McGill University Health Centre, highlighted some specialized methods used in the peer mentorship program to approach difficult discussions regarding individuals’ health.
“When people are talking about their lived experiences, it is usually very hard and challenging, especially for the youth,” Fazeli said in an interview with The Tribune. “So that’s why we try to [approach discussions] through arts-based methods, which have deep roots in the Indigenous culture.”
The project uses a decolonizing approach by working alongside EI young adults and the Cree Board of Health and Social Services of James Bay, fostering respect, reciprocity, and peer mentorship to optimize psychosocial support for diabetes care.Given the high prevalence of diabetes in Indigenous populations, with specifically one in five adults in Cree communities living with diabetes, expanding programs like Linton’s to other Indigenous communities across Canada is essential to reconciliation and progression towards health equity.
