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The inequitable population prevalence rates of obesity and diabetes being experienced by First Nations peoples in British Columbia require public health protection practitioners to deepen their inquiry into the social determinants of these chronic conditions. These attempts need to be placed within the context of food insecurity that is garnering growing attention from public health at large and, more specifically, within the emerging Indigenous consensus understanding of the relationship between the ongoing nutrition transition and the inequitable prevalence rates of these conditions. We suggest that these reflections are productively theorized from a Political Economy of Health standpoint and supported by representative findings from the First Nations Regional Longitudinal Health Survey. This theoretical perspective supports the viewpoint that the inequitable expression of these chronic conditions can be attributed to the nutrition transition that populations experienced as they were shifted from a traditional subsistence diet to a commoditized, industrialized food production system. This analysis also supports the structural recommendations of the British Columbia Food Systems Network Working Group on Indigenous Food Sovereignty that would remove barriers and threats to traditional food acquisition. These include making environmental protection and conservation of biological diversity a priority in all land use planning; setting aside adequate tracts of land for the protection, conservation, and restoration of Indigenous food systems; giving priority to traditional food and cultural values in contemporary forestry, fisheries, rangeland, and agrarian management policies and practice; and giving priority to Indigenous food and cultural harvesting over commoditized, export-oriented commercial harvesting. Public health protection practitioners will be progressively challenged to support these recommendations by the communities they serve. Although there is no guarantee that implementation of these recommendations will reverse the trend of decreasing participation rates in traditional food harvesting in British Columbia, we suggest that unless many of the systemic irrationalities, vested interests, and historically unjust rationales for maintaining the status quo with respect to Indigenous food sovereignty are interrogated and challenged, an ancient lifeway grounded in demonstrably sustainable traditional food harvesting practices will remain threatened.

environmental health review

Applying a Political Economy of Health standpoint to traditional food acquisition practices and the inequitable prevalence of obesity and diabetes amongst First Nations peoples in British Columbia