Assignment 3: Health Inequities for Aboriginal Peoples in Canada

Introduction

The word 'Aboriginal" includes the original inhabitants in Canada, Inuit, Metis' and First

Nations peoples, along with their descendants, (NCCAH,2013).

Throughout this course, there have been several discussions regarding the Aboriginal 

populations and the inequality of the social determinants of health. Terms such as 

discrimination, racism, stigma, bias, marginalization, and assimilation into Western culture all 

point to the same issue.Our culture and society for generations, has treated Aboriginal people 

like second class citizens, and it doesn't appear to be going away anytime soon. The purpose 

of this paper is to bring to light this ongoing struggle, reveal health inequities imposed on 

these people,highlight current initiatives to draw attention to the issues, and hopefully educate 

others on the impact this treatment has had on them.

The Impact of Colonialization

According to NCCAH (2013), there are significant health inequalities in Canada. Before the

European colonization of the Aboriginal people, this population practiced traditional medicine

and "had fully functional systems of health knowledge" (NCCAH, 2013, p.3). Family and

community members looked after their own if they became ill and were a source of comfort 

and support. The spiritual leaders also called 'Sharman' were intimately connected to the

environment and had extensive knowledge of the healing abilities of plants and herbs. Children

were raised by the extending family including aunts, uncles, and the grandparents.

Arrival of the first settlers in the 1700's brought exposure to disease; epidemic disease followed

the explorers into the native communities, masses of Aboriginal people died, and many 

remained unburied (FNHA,2018).

"Colonization and government assimilation (i.e., into mainstream Western society) impacted all

aspects of Aboriginal life, including: health, traditional roles, culture, socio-economic conditions,

access to services, and equity among others. Consequently, many Canadian Aboriginal 

peoples today experience health inequities, loss of tradition and traditional practices, and 

breakdown of the family unit" (MacDonald, C, & Steenbeek, A., 2015).

"Colonial authorities were expanded to facilitate land and resource extraction, and to limit First

Nations rights. Indigenous spirituality, political authority, education, health care systems, land

and resource access, and cultural practices were all repressed. In some missionary writings 

there are explicit descriptions of attempts to eradicate traditional healing practices" (FNHA, 

2018).Now fast forward three hundred years. With the destruction of their culture, language, 

traditional medicine and healing, and attempted annihilation of their population through 

disease and residential schools, how far have we come as a nation?

Twenty-first Century Healthcare

As a country, Canada's healthcare system has taken notice of the tragedies suffered by the

Aboriginal people. Government policies have become more inclusive, apologies have been 

made as our Western society acknowledges their part in the destruction of Aboriginal culture 

and way of life. As a society, progress has been made, but there is still a long way to go. 

Prejudice, racism, and stigma still thrive in many healthcare settings across Canada creating 

health inequities. Examples of such include:

• Aboriginal peoples have higher rates of chronic disease and major illness than non-

aboriginal people (NCCAH, 2012).

• "Although substance use is common across BC and around the world, regardless of race or ethnicity, background, socioeconomic status or sexual orientation, the opioid public health emergency has disproportionately affected First Nations peoples and communities in BC due to the ongoing legacy of colonization" (FNHA, 2017, p.2).

• Racism and bias persist with chronic disease management. When treating Indigenous

people with end-stage renal disease, there is a lower survival rate among this population

due to lack of resources to travel for treatment (Collier, 2013). If the patient is Aboriginal

and diabetic, this affects their chance of getting a transplant due to added post operative

complications due to compliance issues based on location and supports (CIHI, 2013).

• Some of the government statistics for First Nations people in Alberta include: a lower life expectancy at birth and in general; First Nations women are three times more likely to be a mother between the ages of 15-24; 51.9% of Indigenous Albertan's have not completed high school; First Nations income is significantly less than non-Aboriginal Albertans; and 17.7% of First Nations live in crowded housing (Statistics Canada, 2016).

• Aboriginal peoples have a higher incidence of cardiovascular disease than non-

Aboriginals, have higher smoking rates, have a reduced 5-year cancer-survival rate than

other communities in Canada, a higher incidence of tuberculosis than the rest of Canada

according to Davidson (2016).

• Assumptions in the healthcare system where alcohol and drug-seeking behaviors are

part of their problem, Aboriginal people fear that this will influence their treatment in the

healthcare system (Allan & Smylie, 2015).

• Indigenous women 92% more likely to be diagnosed with cervical cancer with a poorer

survival rate according to CBC (2017). This is due to limited health care and racism.

Stereotyping of Indigenous women develops mistrust and makes them less likely to seek

help and earlier treatment (Black, 2010).

Numerous other examples are available to show the racial disparities still practiced today.

Amnesty International, a defender of human rights, has stated that "despite living in one of the

world's wealthiest countries, Indigenous families and communities continue to face widespread

impoverishment, inadequate housing, food insecurity, ill-health and unsafe drinking water"

(Amnesty International, 2018).

Actions to deal with Health Inequities

It's important to understand the reasons behind the inequities from the historical point of

colonialism and where we, as a nation can see where the start of mistreatment and

misunderstandings began. The Government of BC, First Nations Health Authority, and local

health authorities are working together to bridge the gap in healthcare, listed below are some 

of the provincial and national initiatives.

• The Provincial Health Services Authority (2018) with the Aboriginal Health Program and

other contributors have developed education and training mandatory for all health

authority employees to increase their cultural competency.

• The First Nations Health Authority (2013) states "Our vision is to transform the health

and well-being of BC's First Nations and Aboriginal people by dramatically changing

healthcare for the better" (FNHA, 2013).

• The BC Medical Association (2017) and the First Nations Health Authority have

partnered together to advance humility and cultural safety into medical practice. "The

Declaration contains the following guiding principles of cultural safety and humility:

Cultural humility builds mutual trust and respect and enables cultural safety. Cultural

safety is defined by each individual client's health service experience" (BCMA, 2017).

              The Health Council of Canada (2012) introduced education around cultural 

competency for care givers in urban care settings to assist them in creating safe, caring .

• In Hamilton, Ontario, there is an Aboriginal health centre and seven community health

centres with a team of health professionals that focus on primary health care, holistic

care, mental heath services, education for staff to provide culturally appropriate care, etc.,

(Community and Aboriginal, 2014).

• According to the NCCAH, (2012), there is very little accurate and complete

documentation of the health of the Aboriginal peoples, but a report called "The State of

Knowledge of Aboriginal Health", published by NCCAH, provides information

regarding Aboriginal Public Health in Canada (NCCAH, 2012).

Conclusion

Although progress has been made in reduce the impact of the healthcare inequities, it's 

evident that there is still plenty of work to be done with all levels of government to stop the 

racism and prejudgment of Aboriginal peoples. It's a problem that cannot be resolved quickly 

and perhaps never completely. I feel it's important to realize that we are all responsible for our 

own actions and how we treat each other. Small gestures of patience and kindness cannot be 

overlooked, change can begin with each one of us.

References

Allan, B. & Smylie, J. (2015). First Peoples, second class treatment: The role of racism in the health and well-being of Indigenous peoples in Canada. Toronto, ON: the Wellesley Institute. Retrieved fromhttps://www.wellesleyinstitute.com/wp- content/uploads/2015/02/Summary-First-Peoples-Second-Class-Treatment-Final.pdf

Black, A (2010). Cervical Cancer Screening Strategies for Aboriginal Women. Aboriginal Policy Research Consortium International (APRCi); retrieved from:https://ir.lib.uwo.ca/cgi/viewcontent.cgi?referer=https://www.google.com/url?sa=t& rct=j&q=&esrc=s&source=web&cd=6&ved=2ahUKEwj- jIe2ss_eAhXnYt8KHezYBKIQFjAFegQIAhAC&url=http%3A%2F%2Fir.lib.uwo.ca%2 Fcgi%2Fviewcontent.cgi%3Farticle%3D1392%26context%3Daprci&usg=AOvVaw3ml YMWYtqnVpWNUt5n-Ay2&httpsredir=1&article=1392&context=aprci

Canadian Institute for Health Information. (2013). End-Stage Renal Disease Among Aboriginal Peoples in Canada; Treatment and Outcomes. Retrieved from: https://secure.cihi.ca/free_products/EndStageRenalDiseaseAiB-ENweb.pdf

CBC (2017). First Nations in B.C. face lower cancer survival rates than non-First Nations; retrieved from: https://www.cbc.ca/news/canada/british-columbia/first-nations-in-b-c- face-lower-cancer-survival-rates-than-non-first-nations-1.4306514

Collier, R. (2013). Renal disease more prevalent and problematic for Aboriginal peoples. Canadian Medical Association Journal. 185(5), E214. Retrieved from https://www.cmaj.ca/content/cmaj/185/5/E214.full.pdf

Community and Aboriginal Health Centers. (2014). Retrieved fromhttps://www.hnhblhin.on.ca/en/aboutus/hsplist/CommunityHealthCentres.aspx

Davidson, M. (2016). 4 Diseases Impacting Health on First Nations in Canada | Aetonix Systems. Retrieved from https://aetonix.com/2016/12/22/4-diseases-impacting-health- first-nations-canada/

First Nations Health Authority. (2017). FNHA (n.d.). Overdose data and First Nations in BC. Retrieved from https://www.fnha.ca/newsContent/Documents/FNHA_OverdoseDataAndFirstNatio nsInBCPreliminaryFindings_FinalWeb.pdf

First Nations Health Authority. About the FNHA. (2018). Retrieved from https://www.fnha.ca/about/fnha-overview

Health Council of Canada. (2012). Empathy, Dignity, and Respect. Retrieved from: https://healthcouncilcanada.ca/files/Aboriginal_Report_EN_web_final.pdf

Health Equity [Health Equity for All Tool]. (n.d.). Retrieved from https://www.publichealthgreybruce.on.ca/Your-Environment/Healthy- Communities/Health-Equity

MacDonald, C & Steenbeek, A (2015) The Impact of Colonization and Western Assimilation on Health and Wellbeing of Canadian Aboriginal People, International Journal of Regional and Local History,10:1, 32-46, DOI: 10.1179/2051453015Z.00000000023

National Collaborating Centre for Aboriginal Health. (2012). The State of Knowledge of Aboriginal Health: A Review of Aboriginal Public Health in Canada. Retrieved from https://www.ccnsa-nccah.ca/docs/context/RPT-StateKnowledgeReview-EN.pdf

Our History, Our Health. (2018). Retrieved from https://www.fnha.ca/wellness/our-history-our- health

Our Work: Issues: Indigenous Peoples. Indigenous Peoples in Canada. (2018). Retrieved from https://www.amnesty.ca/our-work/issues/indigenous-peoples/indigenous-peoples-in- Canada

Provincial Health Services Authority (PHSA). San'yas Indigenous Cultural Safety Training. (2018). Retrieved from https://www.sanyas.ca/home

Setting the Context. An Overview of Aboriginal Health in Canada. (2013). Retrieved from https://www.ccnsa-nccah.ca/docs/context/FS-OverviewAbororiginalHealth-EN.pdf, p.1-3

Statistics Canada. (2016). Focus on Geography Series, 2016 Census. Retrieved from https://www.12.statcan.gc.ca/census-recensement/2016/as-sa/fogs-spg/Facts-PR- Eng.cfm?TOPIC=9&LANG=Eng&GK=PR&GC=48