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Article Excerpt
THE THRIFTY GENE THEORY is currently a captivating explanation for the high prevalence of non-insulin dependent diabetes mellitus (NIDDM) among Indigenous peoples globally. Originally proposed in 1962 by population geneticist James V. Neel, the thrifty gene theory is based upon the evolutionary notion that hunter/gatherer populations survived feast and famine living conditions because they possessed a thrifty genetic predisposition to accumulate and store fat. Neel (1962) argued that under recent conditions of rapid "Westernization" and related lifestyle and dietary changes, this naturally selected genetic predisposition, which sustained populations during times of famine, has led to the onset of obesity and NIDDM among contemporary populations. In subsequent publications in 1982 and 1999, confronted with evidence showing significant flaws in the original hypothesis, Neel modified its specifics and argued that, while it has never been proven, the thrifty gene does indeed exist.
Presently, the precise etiology of NIDDM is not known. However, NIDDM and obesity have long been associated with environmental and lifestyle factors such as age, stress, poor nutrition, sedentary lifestyles, as well as low socio-economic status, and social marginalization (Abonyi, 2001; Chaufan, 2004; Ozanne and Hales, 1998; McDermott, 1998). While there is a 30-year span of research that has attempted to delineate the genetic factors that cause NIDDM, typically, studies show inconclusive epigenetic and gene-gene relationships. There is no identifiable or isolated genetic component proven to be directly responsible for NIDDM (Fee, 2006; McDermott, 1998). There are, no doubt, genetic elements involved in the onset of obesity and diabetes for all populations; however, the seemingly absolute linkages between Aboriginal peoples and the thrifty gene ought to be opened to further dialogue.
The thrifty gene theory remains a hypothesis. Its existence is tentative at best and the multi-factorial aetiology of NIDDM is not solved (Abonyi, 2001). Surprisingly however, the thrifty gene is very much alive in the current Aboriginal health literature as a powerful explanation for NIDDM. Recently, the theory has received renewed scientific and popular attention in the Canadian context. In March of 1999, a clinical geneticist and a group of medical colleagues announced that they had found a genetic link between NIDDM and the Oji-Cree people of Sandy Lake, Ontario (Hegele, Cao, Harris, Hanley and Zinman, 1999). They claimed that they had discovered the exact gene variant, namely HNF1A G319S, related to the onset of NIDDM. In a later publication, Hegele (1999: S48) describes the research and concludes by stating that "[n]one of these findings ... would be inconsistent with the thrifty gene hypothesis of Dr. James Neel." Shortly thereafter, and with much more certainty, David Spurgeon (1999), a news writer for the British Medical Journal, reported the finding with the headline: "Thrifty Gene identified in Manitoba Indians." (1) In January of 2005, CBC's The Nature of Things aired a documentary about the obesity epidemic entitled "The Weight of the World," which reported that this same community of Sandy Lake was overcoming the thrifty genetic predisposition to obesity and NIDDM through remarkable and inspiring culturally appropriate and community-based programs geared toward diet and lifestyle. I conclude by suggesting that the full story of the thrifty gene thus far has not included Aboriginal perspectives and should be "decolonized."
This paper explores the role of the thrifty gene theory as a part of a story in the construction of health knowledge about Aboriginal peoples. (2) I argue that the full story of the thrifty gene thus far has not included Aboriginal perspectives and should be "decolonized." As such, the thrifty gene theory should be de-naturalized as a biological or genetic entity and should be thought of as part of an ongoing and transforming story about race, genetics and disease. Currently, the thrifty gene draws significantly on problematic and intersecting binaries, notably: civilized/primitive, Aboriginal/non-Aboriginal and science/culture. It is important, therefore, to open up dialogue that would highlight and value the perspectives of Aboriginal peoples in this story.
A new tale of the thrifty gene theory could begin with the mythical trickster--the paradoxical, the harmful/helpful, the spirit/body and the transformer--the Raven. A story of the Raven may be used to show how genetic science can be (un)defined as helpful and harmful, as powerful and weak, but certainly deceptive. Like Donna Haraway's (1999) call to converse with the Coyote trickster, who is the manifestation of continually problematized binary distinctions, the Raven tale seeks to denaturalize to demystify the binaries by telling another part of the tale.
Raven Trickster is the communicator and the mischievous transformer who performs important cultural tasks. Raven is smart, mischievous, unpredictable and fulfilled through trickery and transformation. Sometimes Raven's trickery becomes instructive. Raven is helpful/harmful but only helpful when the people pay attention. In the story Raven Steals the Light written by Haida author Bill Reid (Reid and Bringhurst, 1984), Raven is dismayed that the world is dark. He decides to steal the sun for light, which is hidden inside several boxes in the village. By turning himself into a seed, Raven is unknowingly swallowed by a young woman who becomes pregnant and Raven is re-born as Raven-Child. Raven infiltrates the village and tricks the people into giving him the sun to play with. Raven intends to keep the sun, but is pursued by Eagle who wants the light for everyone. While attempting to escape the pursuit of Eagle, Raven spills pieces of light that become stars and moon and then drops the sun, bringing light for everyone (Reid and Bringhurst, 1984). In this story, because of Raven's trickery and transformative potential combined with the participation of other characters with different perspectives, new worlds become visible.
Envisioning the thrifty gene story as a trickster tale brings into visibility the importance of perspective and valuing Aboriginal knowledges about health, healing and diabetes. More emancipatory and empowering iterations of the thrifty gene may be carried forward here by beginning a new dialogue that is inclusive of indigenous perspectives. The story of the thrifty gene is a powerful example of the complex interplay between genes, race and society, and a provocative reason why it is essential to look back at seemingly finished knowledge, to challenge it, and to produce emancipatory and valid knowledge for the future--indeed, for the purposes of looking back on the future.
Decolonizing Genetic Science, Geneticization and Racialization
This work emerges out of a larger decolonizing post-colonial science study and has strong linkages to literature in the social studies of science and knowledge (Biagioli, 1999; Burfoot and Poudrier, 2005; Harding, 1998: Haraway, 1999; Nader 1996; Skinner and Rosen, 2001) as well as the social construction of biological, genetic and health sciences (Duster, 1996; Goodman, Heath and Lindee, 2003; Lippman, 1991; Rabinow, 1994; 1999). It is based on the teachings of indigenous knowledges (Awang, 2000; Battiste and Henderson, 2000; Harry, 2001; Smith, 1999; Whitt, 1999) and draws conceptually on Linda Tuhwai Smith's (1999) ideas surrounding decolonizing methodologies as well as Laurie Anne Whitt's (1999) "indigenist" critiques of science.
In 1991, Abby Lippman (1991) developed the term "geneticization" to describe the condition under which cultures of individuals and groups become defined by scientific and genetic categories through a complex interplay between techniques of prenatal screening and contemporary discourses in genetic prediction. Adam Hedgecoe (2002) further complicates the concept of geneticization by capturing the historical shifts in diabetes classification system plus a role in the relationship between genetics and diabetes. In their recent edited collection, Genetic Nature/Culture, Goodman, Heath and Lindee (2003) capture several critical perspectives that aim to shed light upon the nature/culture split. Paul Rabinow's (1999) provocative conception of "biosociality" refers to a transformative condition under which both nature and scientific work in the life science become increasingly revealed as artificial and as cultural practice. In this new era of artificiality, the nature/culture divide will cease to exist and both culture and science will be increasingly understood through ethics.
Focussing specifically on ethnicity and race in genetics and medicine, Troy Duster (1996: 123) argues "it is not genetic evidence that drives the engine of scientific inquiry, but the social concerns that drives the engine of the 'scientific' attempt to portray and explain these social concerns genetically." Moreover, where ethnic populations are epidemiologically at-risk and are considered a financial drain on health care resources, and where medical science is increasingly entrenched (through large investments) in genetics, the hunt for genetic racial susceptibility proceeds. This hunt, as well as related techniques of screening through outpourings of funding, research and policy, is all too familiar.
The issues surrounding surveillance and population health are particularly salient for Aboriginal peoples as targeted populations. Though their critique does not focus upon racialization and genetics, John O'Neil, Jeff Reading and Audrey Leader (1998) address epidemiological knowledge about Aboriginal peoples and describe the way that it operates as a powerful mechanism of regulatory surveillance. Where epidemiological research is a "response to the political problem of regulating potentially dangerous behaviours," epidemiological discourse becomes a tool of disciplinary power over problematic populations and perilous lifestyles (O'Neil, Reading and Leader, 1998: 230). Contemporary portraits of Aboriginal communities reflect images of misery, disease and poverty that play a commanding role in the construction of Aboriginal identity (O'Neil, Reading and Leader, 1998). Health discourse about Aboriginal peoples reflects sick, disorganized, uncontrolled and dependent peoples (O'Neil, Reading and Leader, 1998; Waldram, Herring and Young, 1995). According to O'Neil and others (1998), this image legitimates paternalistic and regulatory management over Aboriginal health in communities and further marginalizes overarching efforts geared toward self-determination and development. Arguing that biomedicine is "a cultural system itself, and an appendage of the colonial state structure," James Waldram and colleagues (2000: 37) warn that current medicine must address cultural knowledge, lest it turn into "another form of assimilative pressure."
Robyn McDermott (1998) offers a most compelling critique of the thrifty gene theory from an epidemiological standpoint. She argues that it is an historical and narrative construct of genetic epidemiology. The logic that makes a scientific case for genetic predisposition to disease...
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