Indigenous Peoples and Type 2 Diabetes: A Discussion of Colonial Wounds and Epistemic Racism

Racism is rooted in historic and ongoing colonial strategies designed to erase, silence, and dismiss Indigenous peoples' voices, personhood, and worldview. Although within health care today interpersonal racism (discriminatory treatment) is commonly reported on, racism also influences our understanding of health conditions and related treatments. Epistemic racism, the discrimination of how we know, operates through the questions we ask to advance our evidence, and whose knowledge is sought and deemed valid. Epistemic racism is a colonial mechanism that marginalizes and diminishes the power of Indigenous peoples' voices and knowledge bases. In this work, we begin by sharing 2 stories of Indigenous peoples and type 2 diabetes (T2D) from an Indigenous knowledge base and a biomedical knowledge base. Our discussion of epistemic racism, which underlies reported T2D health disparities among Indigenous peoples, includes providing examples of knowledge emerging when the dominance of the biomedical knowledge base is disrupted through centring Indigenous knowledge and peoples. Indigenous-led research, in respectful relations with biomedical worldviews, is imperative. Unsilencing Indigenous peoples' voices and knowledge is necessary when addressing identified T2D health disparities and is truly a health priority. Indigenous revitalization, that is, acceptance of Indigenous knowledge bases, is valid and vital to health and well-being-it is time for ReconciliACTION. & COPY; 2023 The Author(s). Published by Elsevier Inc. on behalf of Canadian Diabetes Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).