Health Disparity Amongst Indigenous People In Canada

INTRODUCTION

The term Indigenous people (or aboriginal people) refers to the diverse group of original inhabitants of Canada, these include the First Nations, Métis and Inuit people. The early dwellers of Canada are called the First Nations people, the inhabitants of the arctic region are called Inuit and the Métis peoples are of the mixed European and Indigenous ancestry.

According to the census conducted in 2016 approximately 1,673,785 people identified themselves as Indigenous people making up about 4.9% of the total population of Canada.

Prior to colonization the traditional Indigenous people lived in harmony with nature, and had deep respect for all aspects of the land and its creatures. They embraced a rich, and spiritual healing system and their concept of wellness and wellbeing was deeply rooted in the Holistic concept of healthy balance. The 4 basic elements of wellness were: physical, emotional, mental, and spiritual.

These 4 elements are represented by image below called the Medicine Wheel. This is the most well-known and sacred Canadian Aboriginal healing model dating back to pre-historic ages.

Fig 1: The Medicine Wheel- All 4 quadrants of the wheel are equal, emphasizing the holistic approach. They also represent the four directions, the four seasons, & the four different stages of human life. It also encompasses their strong believe in honouring and respecting all living things.

(Ontario’s Aboriginal Health Access Centres, 2015)

HEALTH DETERMINANATS OF INDEGINOUS PEOPLE

The advent of colonization by the European fur traders brought diseases, conflicts, loss of traditional values, and loss of land, leading to serious disruption of the physical, emotional, mental, and spiritual health of the Aboriginal people. This changed the Indigenous ways of life forever and the ongoing impact is on generations to follow. Over a period of centuries the aboriginal populations have experienced high levels of racism, acts of segregation, poverty, abuse, intergenerational violence, discrimination, and unequal access to food resources that has had devastating consequences on the health and well being of the Indigenous people. This is leading to increased suicide rates, increase incidence of mental illnesses, homelessness, and other social issues.

The colonial policies, practices, and persistent inequalities for generations caused major disparities in the socioeconomic status leading to major health disparities in this now marginalized population. These disparities include higher levels of substandard and crowded housing conditions, poverty, unemployment, lower levels of education, and disproportionately poorer health outcomes together with limited access to quality health-care services.

Fig 2: The below chart highlights the Aboriginal health determinants

(Morley, 2009)

HEALTH DISPARITY

Canada prides on its universal healthcare, but Canada’s aboriginal population face an unnecessary healthcare inequity compared to the non-aboriginal population. Lower life expectancy and the prevalence of chronic conditions such as diabetes, hypertension, ischemic heart diseases (IHD), obesity, and arthritis disproportionately burden the Indigenous population.

DIABETES MELLITUS

Diabetes and its complications are the most widespread chronic illnesses affecting the Indigenous people. There are many contributing factors like genetics, sedentary lifestyle, obesity, socio-cultural, environmental, and biological factors, but there is a bigger picture to consider like the delayed and limited access to quality healthcare services, high rates of food insecurity, and aboriginal females experiencing a higher rates of gestational diabetes disproportionately affect Indigenous people.

Age-standardized rates show the prevalence of diabetes was 17.2% among First Nations individuals living on-reserve, 10.3% among First Nations individuals living off-reserve, and 7.3% among Métis, compared to 5.0% in the non-Aboriginal population.

(Government of Canada, 2011)

ISCHEMIC HEART DISEASE

Indigenous people are more likely to develop heart diseases and stroke. Some of the contributing factors are smoking of tobacco, improper diet, lack of exercise, late diagnosis, lack of preventive services, and management programs specifically to address their needs.

The Heart & Stroke Foundation of Canada identified risks for CVD and stroke that are profoundly greater for Aboriginal people compared with other Canadians and a risk profile that forecasted much higher CVD and stroke rates in the near future.

(Reading, 2015)

SUICIDE

The most tragic of all disparities facing the Indigenous population is the higher rate of suicide and self-inflicted injuries among their youth. Systemic dismantling of Aboriginal culture, tradition, and language during the colonization led the people alienated, displaced, oppressed and marginalized, further aggravating the mental health of this vulnerable group.

First Nations youth die by suicide about 5 to 6 times more often than non-Aboriginal youth. Suicide rates for Inuit youth are among the highest in the world, at 11 times the national average.

(Centre for Addiction and Mental Health, 2020)

RACISM IN HEALTH CARE THAT EFFECT INDIGENOUS PEOPLE

Cultural deprivation and systemic isolation created by the colonial practices and residential schools gave rise to a vicious cycle of health injustice among Indigenous people.

82% of Inuit living in Inuit Nunangat reported that they did not have a family doctor.

(Statistic Canada, 2020)

The video below is prepared by the Canadian Patient Safety Institute. Samaria Cardinal of the Metis heritage reflects back on her story of how drug addiction and domestic violence left her homeless on the streets of Calgary. She narrates her story of how the systemic racism by the Health Care system affected her life. To watch this video please click on the image.

https://www.youtube.com/watch?v=JYBVM3DjW7Y

(Patientsafetycanada, 2019)

ABORIGINAL HEALTH ACCESS CENTRES

All across Ontario, Aboriginal Health Access Centers (AHACs) are playing an important role in restoring, as well as providing health and well-being of the Aboriginal people. The programs and services are designed especially catering to the spiritual needs of the aboriginal people. Some of the services they provide are: traditional healing, primary healthcare, health promotion services, and community development initiatives.

Aboriginal Health Access Centres (AHACs) are Aboriginal community-led, primary health care organizations. They provide a combination of traditional healing, primary care, cultural programs, health promotion programs, community development initiatives, and social support services to First Nations, Métis and Inuit communities. There are currently ten AHACs in Ontario, providing services both on and off-reserve, in urban, rural and northern locations.

(Alliances for Healthier Communities, n. d.)

CONCLUSION

It is evident that the Indigenous communities have been exposed to centuries of injustice which has been brought about by cultural deprivation, spiritual, emotional, and mental disconnectedness, and systemic isolation. In order to serve them better we must as a society collectively acknowledge the deep loss this group has undergone for such a long period of time. As policy makers we need to create a more culturally aware environment and be respectful of their belief system and cultural practices. Respect goes a long way, it will help break political road blocks and ensure equity in access to healthcare programs and services.

A seat at the table for the Indigenous communities is mandatory when creating policy and developing programs in order to bridge the inequity gap. Involving the leaders and community members to take local control of health services and to come up with their own solutions for health challenges will create a sense of collective pride, and help elevate Aboriginal mental health.

REFERANCES

Alliances for Healthier Communities. (n. d.). Aboriginal Health Access Centres

Centre for Addiction and Mental Health. (2020). Mental Illness and Addiction: Facts and Statistics

FEMNORTHNET. (n. d.). Colonialism and its Impacts

Government of Canada. (2020). The Residential School System

Government of Canada. (2011). Highlights: Diabetes in Canada: Facts and figures from a public health perspective. Chapter 6: Diabetes among First Nations, Inuit, and Métis populations.

King, M., Smith, A., & Gracey, M. (2009). Indigenous Health Part 2: The underlying causes of the Health Gap. The Lancet, 374(9683), 76–85.

Morley, M. (2009). Aboriginal Health Determinants & Stroke/Chronic Disease. Health Nexus/Prevent Stroke Webinar Series-Part 2.

Murphy, T., Richardson, L. (2018). Bringing Reconciliation to Healthcare in Canada: Wise Practices for Healthcare Leaders. HealthCare Can.

Ontario’s Aboriginal Health Access Centres. (2015). Our-Health-Our-Future.

Patientsafetycanada. (2019). Breaking down the barriers indigenous people face in Canada’s health-care system. [Video]

Reading, J. (2015). Confronting the Growing Crisis of Cardiovascular Disease and Heart Health Among Aboriginal Peoples in Canada. Canadian Journal of Cardiology, 31(9), 1077–1080.

Statistic Canada. (2020). First Nations people, Métis and Inuit and COVID-19: Health and social characteristics