For over 30 years, there have been reports in the published literature that point to the relatively greater burden of morbidity and mortality of diabetes in indigenous Australian populations. Local and international data that show the epidemic of diabetes in indigenous communities are generally interpreted in the context of rapid lifestyle transition following colonization, despite some interest in the role of birthweight and prenatal factors. The most immediate, drastic and discernible changes have been observed in contexts where ‘hunter-gatherer’ modes of living have been relatively recently replaced by sedentary lifestyles in centralized settlements.
This focus on the effect of diabetes on the health of indigenous people who live in those areas of Australia that are usually classified as remote is not without justification, given the effect of this disease on the physical and social well-being of such communities. However, there has been a lack of attention paid to those relatively more urbanized indigenous Australians who have a longer history of colonization and live in less discrete and easily discernable communities. This bias may reflect an assumption that the health disadvantage of indigenous peoples in urban areas is lessened by better access to primary, secondary and tertiary health services. It also possibly reflects some of the challenges of undertaking research in these contexts.