Tony Abbott is a cold, gimlet-eyed pod person who seems to have learnt human empathy from a book. So his remark that poor Aboriginal kidney health is due to lack of exercise and bad food is caused by ‘poor personal choices’ — as reported by Graham Ring in Crikey on Friday — doesn’t surprise me in the least.

Nevertheless, even the dumbest pig finds a truffle now and then, and some of the complexities in the issue Abbott is discussing need to be disentangled.

As Ring notes, low-weight birth, poor fresh food supply, among other things are all major contributing factors to catastrophically high levels of renal disease in Aborigines.

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Yet it is also true that the major contributing factor to kidney disease — diabetes type 2 — is more amenable to lifestyle changes than is often suggested. Diabetes 2 is a threshold disease — it comes on after prolonged high levels of sugar intake and obesity make it impossible for the pancreas to pump out enough insulin. Eye, limb and kidney damage result from years of excess sugar in the blood more or less ‘shredding’ the nerves and cells.

But the thing about diabetes 2 (unlike type 1) is that diet and weight loss can reduce blood sugar so that the symptoms of diabetes type 2 are controlled, and further damage held at bay. Even a 5-10kg weight loss, diet changes and exercise can be sufficient to overcome this.

Abbott’s obtuseness centres around the idea that the whole rigmarole of modern urban life — the gym, aerobics, fresh food, calorie-counting and so on — is something that can just be easily transplanted willy-nilly to societies that live in substantially different ways. Abbott is by all accounts a fitness-freak in the hyperindividualised fashion, keeping his body honed like a machine for the further accumulation of power. He simply can’t or won’t understand societies where physical activity was, traditionally, part of working life — whether hunter-gathering, jackarooing, etc — and done collectively.

But that doesn’t mean that nothing can be done along these lines to improve Aboriginal health. Soaring diabetes rates are common not just to indigenous populations but to other groups blindsided by modernity — rustbelt populations in Midwest US and the English North among them. The middle classes look after themselves because they have a stake in society and their lives are individualised anyway. A lot of other people fairly reasonably tend to see the whole gym thing as a bit of a wank.

But really there isn’t much choice. Exercise and weight loss aren’t poor substitutes for diabetes 2 care — they are the best treatment for the condition. So campaigns of community organised programs, independent of the Government’s criminal negligence, are crucial. Yes, poverty and disempowerment are real. But to blunt about it, using them as ‘shazam’ words to explain away everything doesn’t really work, and ultimately leads to passivity.

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Peter Fray
Peter Fray
Editor-in-chief
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