Final Exam Flashcards

1
Q

What is cultural safety?

A

“Requires the explicit and detailed recognition of the cultural identity of the Indigenous people and the historical legacy of power relations and repression”

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2
Q

What is reflective learning?

A

Students take a step back to analyze and reflect on their responses to the course materials

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3
Q

What is insurgent education?

A

Engage in “decolonizing and discomforting moments of Indigenous truth-telling that challenge the colonial status quo”

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4
Q

What is Indigenous Ways of Knowing?

A

We respect that Indigenous Peoples have our/their own ways of knowing and interpreting the world that are not required to conform to Western paradigms

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5
Q

Define Aboriginal.

A

-Defined as “Indian, Inuit and Métis People of Canada”

-Very Diverse

-Identities have been shaped, and continue to be shaped by colonial and neo-colonial policy

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6
Q

Define Indigenous.

A

Considered more acceptable as a generalizing term, because it signifies that people have inhabited a particular territory for millennia, and because it connects common experience across the globe.

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7
Q

Define First Nations.

A

-Refers to people who are members of and retain connections to one or more of the First Nation communities in Canada, and who may be Status or Non-Status Indians

-More than 50% of First Nations people no longer live in the lands that were reserved for their Nation

-This term became widely used in the 1980’s in place of ‘Indian’ or ‘Band’

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8
Q

Define Metis.

A

-A complex identity that is legally defined within Canadian law and refers to the ‘mixed blood’ descendants of European and Indigenous people

-This identity developed from the recognition of the unique culture, language (Michif) and people of mixed ancestry descent from the French and Cree families living in the Red River Valley

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9
Q

Define Inuit.

A

Legally defined identity embedded within Canadian law and refers to the culturally and linguistically similar people living in the Arctic regions

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10
Q

What is self identification?

A

-Many Indigenous populations have their own Indigenous language-based names for themselves, their Indigenous nations, Tribal organizations, alliances, landmarks, life-ways and people.

-The terms ‘Indian’ and ‘Native’ are NOT preferable terms in this course

-By institutionalizing categories, terms and definitions of Indigenous groups/people, the colonial state has directly contributed to the breaking of family bonds, loss of identity and undermining of traditional Indigenous conceptions of identity and community

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11
Q

Why does Terminology matter?

A

-It is dehumanizing not to use them appropriately and respectfully

-When you refer to someone as Indian, First Nations, Inui, etc. you are referring to them by an ‘assigned’ descriptor. When appropriate, add the Term Peoples, Persons or populations

-When speaking about race, ethnicity, sexuality, ability, or gender, the term is always explained by adding the subject

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12
Q

Define race.

A

Socially constructed phenomenon that is not supported by scientific evidence - there is no ‘racial hierarchy’ - but nonetheless, ideas about racial categories and traits persist and continue to shape conversations

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13
Q

What is critical race theory (CRT)

A

Examines how race is implicated in all aspects of society and how certain racial groups with power govern other racial groups

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14
Q

Criticism of CRT

A

Does not name and examine the role of colonialism

Does not include the voices of Indigenous scholars/discussions around sovereignty

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15
Q

Anti-racism education includes:

A

-Naming the visible and invisible powers and privileges that have been normalized by White people

-Examining the construction of race in relation to power

-Expands on anti-racism education and CRT by examining the links between colonialism and racism

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16
Q

Define Racism.

A

Is the marginalization and/or oppression of people of colour based on socially constructed racial hierarchy that privileges white people

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17
Q

What are the 8 Components of Racism

A
  1. Prejudice
  2. Ethnocentrism
  3. Stereotypes
  4. Discrimination
  5. Harassment
  6. Racial Harassment
  7. Microaggressions
  8. Colour Blindness
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18
Q

What does “Unpacking the White Knapsack” define white privilege as?

A

an invisible package of unearned assets, that could be relied upon, but weren’t supposed to be recognized as assets

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19
Q

sum up “unpacking the white knapsack”

A
  • denial protects male privilege and same cane be see in white privilege
  • whites are not taught to recognize their privilege
  • “whites are taught to think their lives are morally neutral, normative, and average”
  • their needs to be realization of this privilege
  • list of extensive statements to ask when thinking about privilege (i.e. I can, if I wish, arrange to be in the company of my race most of the time, etc)
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20
Q

different types of advantages associated with privilege. From the white knapsack article.

A

Earned strength vs. Unearned power

Positive advantages vs. Negative advantages

Unearned Entitlement vs. unearned advantage

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21
Q

Where does advantage come from?

A

Race
Sex
Age
Ethnicity
Physical ability
Nationality
Religion
Sexual orientation
Social class
Economic class

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22
Q

What are determinants of health?

A

Simply something that can impact an individual’s, a family’s or a community’s health

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23
Q

What are social determinants of health?

A

Resulting from social constructions and situations

Provide us with a framework for understanding health and what influences it

Ex. where a person lives may impact their health status (lack of access to food and medical services)

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24
Q

What does the World Health Organization say about social determinants of health?

A

States that social determinants of health are the conditions in which people are born, grow, live, work, and age, including health systems

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25
Q

What are the Public Health Agency of Canada’s 12 key DoH?

A

Income and social status
Social support networks
Education and literacy
Employment/working conditions
Social environments
Physical environments
Personal health practices and coping skills
Healthy child development
Biology and genetic endowment
Health services
Gender
culture

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26
Q

What are the 3 levels of determinants of health?

A

Proximal
Intermediate
Distal

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27
Q

Describe Proximal when it comes to determinants of health?

A

“Conditions that have a direct impact on physical, emotional, mental, or spiritual health” such as overcrowding, family violence and substance use

These conditions create stress, which can promote learning difficulties, mental health issues, and exacerbated health problems

Broken down into subcategories:
Health behaviours
Physical environments
Employment and income
Education
Food insecurity

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28
Q

Describe Intermediate when it comes to determinants of health?

A

The origin of proximal determinants

This interaction between determinants is evident in the following areas:
-Health care systems
-Education systems
-Community infrastructure, resources, and capacities
-Environmental stewardship
-Cultural continuity

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29
Q

Describe Distal when it comes to determinants of health?

A

Refer to “political, economic, and social contexts that construct both intermediate and proximal determinants”

These overarching frameworks include:
Colonialism
Racism
Social exclusion
self -determination or lack thereof

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30
Q

Describe the River Parable

A

Tells a story of people walking alongside a river and seeing children in the water. They keep jumping in to save the children over and over again.
Then one of the people decides to go upstream to see how all these children are getting in the water and finds a man up there throwing children into the river.
Basically looking to the root of the problem instead of just trying to solve the temporary solution in front of us.

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31
Q

Disparity and Inequity

A

Often used interchangeably to signify that something is not equal

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32
Q

What is equality?

A

treating everyone the same, regardless of their individual circumstances or needs

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33
Q

What is equity?

A

is about fairness through adjusting resource opportunities based on individual needs and circumstances

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34
Q

Indigenous people are more likely….

A
  • to have lower median after-tax income
  • to experience unemployment
  • to live in a house needing repairs
  • to experience physical, emotional or sexual abuse
  • to be victims of violent crimes
  • to be incarcerated and less likely to be granted parole
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35
Q

How do Indigenous people rate the emergency department?

A

44% rated quality care in emergency departments as either fair or poor

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36
Q

How do Indigenous people access healthcare?

A

43% reported receiving poor treatment due to racism and discrimination

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37
Q

How are health services for Indigenous people funded?

A
  • provincial systems provide acute and intensive services for ALL populations
  • Federal government provides health services for on-reserve status First Nations and Inuit communities
  • funding is not provided for non status or Metis populations
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38
Q

What is health transfer?

A

refers to the process by which control over health services and programs is transferred from federal/provincial governments to Indigenous communities or organizations

aims to give Indigenous people more control over their own health care systems

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39
Q

What is the broad goal of health transfer?

A

to move toward self-determination and reconciliation with Indigenous communities

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40
Q

How is Indigenous healthcare access different?

A

they are less likely to seek help when symptoms arise

more likely to be diagnosed at a later stage of disease than non-Indigenous people

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41
Q

What does the Health Council of Canada Report?

A

Doctors would not prescribe painkillers to Indigenous people

Emergency room patients were assumed to be under the influence of drugs and alcohol

Code words to signify dismissively to colleagues that the next patient is an Indigenous person

Keeping mothers and newborn babies longer than necessary to ‘access’ whether she will be a good parent

Indigenous woman was told she would not be included in the planning process for her family member’s care because she ‘wouldn’t understand’

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42
Q

Describe the Chandler and Lalonde study.

A

-demonstrates the important role of cultural contninuity and self-determination in health status, particularly that of social/mental health and suicide rates

  • examined rate of Indigenous suicide rates compared to non-Indigenous
  • Longitudinal study
  • conducted in BC and finalized in 2008
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43
Q

What were some of the statistics found from the Chandler and Lalonde study?

A

Indigenous people account for 3% of the total population in BC but account for 9% of all suicides in BC

Indigenous youth account for 23% of all youth suicides in BC

The province wide rate of Indigenous youth suicide is 5x higher than the national average

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44
Q

What are the 6 factors associated with cultural continuity?

A

land claims
self government
self-determination
education services
police and fire services
health services
cultural facilities

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45
Q

What is the rational that supports Indigenous people having control over their own health services?

A

Communities with more of the 6 factors related to cultural continuity had either no suicides or reduced rates

Increased cultural continuity = reduced suicide rates

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46
Q

Describe creation stories.

A

we all have creation stories. An origin or conception story is used to explain how people and the world came into existence

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47
Q

What are some of the common ailments of Indigenous people, pre-contact?

A

pyorrhea (disease of the gums), arthritis, venereal disease and broken bones

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48
Q

What did Indigenous people use to help aid ailments?

A

they used plants and herbs as medicine (many modern drugs are derived from these)

Had healers

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49
Q

What are some of the practices Indigenous people used pre-contact?

A
  • women were valued and held leadership roles
  • children were raised according to the values of the sacred circle
  • used to the resource-rich environment to provide abundant healthy food
  • believes everything is interconnected (physical, mental, emotional, & spiritual)
  • adapted to environment and migrated when needed
  • in harmony with the environment and other species
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50
Q

What was special about healers?

A

they were specialized and trained from a young age

knew much more than the general healing practices

diverse knowledge in plant medicine, spiritual or ceremonial healing, physical, mental or emotional therapies and treatments, and minor surgeries

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51
Q

Define Colonization

A

mainly refers to the establishment of a colony in an area, or the spreading of a species into a new habitat, there are a number of practices associated with the act

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52
Q

What was the settlers goal in colonization?

A
  • intended to permanently occupy and assert their control over, Indigenous lands
  • This invasion is structural rather than a single event
  • the goal is to eliminate colonial difference by eliminating Indigenous peoples, thereby establishing settler right to Indigenous lands
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53
Q

Colonial practices include..

A

war, displacement, forced labour, removal of children, relocation, massacres, genocide, banning of languages

acts as a structure of domination

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54
Q

What new Europeans values were forced onto the Indigenous population?

A
  • patriarchy
  • male-dominated power structures

this influenced their existing social/family relations

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55
Q

Prior to colonization, Indigenous people believe what about the land?

A

belief that the land belonged to everyone

land displacement/ownership was the first step towards European colonization

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56
Q

What are the 4 major contributors to the spread of infectious disease?

A

-Large, sedentary population
-Overcrowding and poor hygiene
-Poor nutrition
-Close contact with animals (they are reservoirs for microorganisms)

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57
Q

How did contact affect the Indigenous diet?

A
  • Increase in saturated fats, sugars, starches, refined salts, alcohol, and caffeine have contributed to health and social problems
  • Also loss of cultural knowledge about foods and medicines.
  • After colonization, residential schools and reserves interrupted this pattern and changed their diets
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58
Q

during ________ years of contact, disease such as ______, ________, _______, _______ & ______ reduced population

A

200-300

smallpox, tuberculosis, influenza, scarlet fever, and measles

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59
Q

What is the estimated size of Indigenous population in Canada in 1871?

A

102,000

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60
Q

How many years did it take to increase the Indigenous population to 500,000?

A

over 100 years
in the early 1980’s

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61
Q

almost ___% of off-reserve Indigenous children under the age of __ live in low income families, compared to ___% of non-Indigenous

A

50%
6 years
18%

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62
Q

____% of Indigenous children that live in large urban centers are living in low income families

A

57

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63
Q

Assimilation definition

A

“The policy of assimilation did not mean the physical annihilation of Indian people, rather it referred to the cultural and behavioural change of Indians such that when they would be culturally indistinguishable from other Canadians.”

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64
Q

Some of the ways the Indian Act achieves its goal…

A

controls Indigenous status
Land displacement
limits trade
oppresses cultural practices

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65
Q

When was the Indian Act adopted? and what was its goal?

A

1876
“explicit goal to control every facet of life on reserves”

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66
Q

Defining “Indianness” from the Indian Act

A

Between 1876 and 1985 ‘Indianness’ was traced through the male line

Indian women who married non-Indians ceased to be Indians under the Act. They weren’t considered Canadian Citizens ether between 1876 and 1960

Indian men could not lose status through marriage

If they married a non-Indian women, she gained status under the Act

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67
Q

The revision of the Indian Act

A
  • In 1985, a revision to the Indian Act was made as this policy conflicted with the Charter of Rights and Freedom

-The revision, Bill C-31, allowed for Indigenous women who married Non-Indigneous men to reapply for status

-Although this step did not mean that women/families were welcomed back to their communities (many were unknown since they had lived off reserves for so long)

-Bill C-31 was developed to ensure that eligible children/grandchildren of women who lost their status become entitled to registration (status)

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68
Q

How did the Indian Act effect careers?

A

Section 86(1), sought to take away the access of any Indian who had a degree, or became a doctor, lawyer, or clergy member

Any Indian person wishing to pursue higher education risked losing his/her status as an Indian, including all benefits of living on reserve

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69
Q

What was the Blood Quantum Formula?

A
  • Indigenous was also determined through this formula located in the act
  • labels Indigenous as 6(1) or 6(2) and defines what level their children are recognized at, or if their children lose status based on the level of their parents
  • tried to determine who was ‘real’ Indians
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70
Q

Define the purpose, and conditions of Residential schools

A

Used to destroy cultural values, beliefs and languages (“Kill the Indian in the child”)

Underfunded, contained unsanitary conditions, caused health epidemics and hundreds of childrens deaths
Physical, emotional and sexual abuse

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71
Q

How were Residential schools come by in Canada?

A

in 1879, Sir John A. Macdonald assigned Nicholas Flood to report on the US’s industrial schools

looked into the feasibility of establishing similar institutions

were originally to teach arts, crafts and industrial skills of modern economy but were used to solve the “Indian Problem” (the crown had a treaty obligation to protect and act in the best interests of the First Nations people as long as the First Nations kept their culture/traditions, therefore they wanted to get rid of it)

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72
Q

What churches pressured the government to fulfill the educational clauses in the numbered treaties?

A

the Catholic, Anglican, Presbyterian and Methodist

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73
Q

What is pedagogy?

A

Change learning and education from holistic to western

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74
Q

What is paganism?

A

Needed to be Christianized

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75
Q

Purpose of the residential schools in regards to culture, appearance and education?

A

Needed to take on ‘white-western’ values

Needed to ‘look’ more like white people

Needed to learn English or French; weren’t allowed to speak Indigenous languages

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76
Q

What year approximately did resident schools start?

A

During the 1870s

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77
Q

What happened in 1894?

A

a compulsory attendance policy was brought into the schools and they introduced removal policies

78
Q

The government worked alongside the ____ tp ensure children went to the schools

A

church (until 1969)

79
Q

In the early 1900s about ___/___ of children between the ages of ___ and ____ attended these schools

A

1/6 of children
the ages of 6-15

80
Q

By the 1940s about ______ children were enrolled in ___ schools across the country

A

8000 children
76 schools

81
Q

In 1992, how many former students were alive?

A

93,000

82
Q

between the 1800s and 1900s hw many boarding/residential schools were there?

A

over 130

83
Q

What was the sixties scoop?

A

in the 1960s, Canadian government extended assimilation from education into child welfare

This meant that through the Indian Act, social workers had a legal mandate to enter reserves and remove Indigenous children from their parents

Children were take and placed with white middle class families

removed if parents were not able to provide financially or if they did not have Christian beliefs

84
Q

Prior to the 1960s, Indigenous children made up ___% of children in the child welfare system, by the late 1960s, Indigenous children made up ___%

A

1%
40%

85
Q

Describe sterilization.

A

There was a number of Indigenous women who were sterilized so they could not have children.

Either coerced, forced or done without their permission

86
Q

What effect did Alberta and BC have on sterilization?

A

They both had legislation in favour of eugenics (belief to improve the genetic quality of a population)

Alberta also had a Sexual Sterilization Act that was passed in 1928 and lasted until 1972

87
Q

Patient consent was only given on ___% of sterilizations, in comparison to ___% for non-Indigenous women

A

17%
49%

88
Q

What are some health inequities as a result of colonization?

A
  • High infant and young child mortality
  • High maternal morbidity and mortality
  • Greater risk of infectious disease burdens
  • Malnutrition and stunted growth
  • Obesity, diabetes, hypertension, cardiovascular disease, and chronic renal disease
89
Q

What were some of the outcomes of colonization?

A
  • Devastating exposure to smallpox, measles, and tuberculosis
  • Dietary changes to foods that were nutritionally inferior
  • Long-term social, psychological, and emotional damage
  • Loss of traditional laws, languages, dress, religions, sacred ceremonies, rituals, healers, and health remedies
  • Poverty, undereducation, unemployment, and exploitation
  • Shortened lifespan
90
Q

Some of the health inequities faced by adolescents due to colonization

A

Little knowledge of determinants of health and disease risk

Increasing use of harmful substances such as tobacco, alcohol, and other drugs

High-risk sexual activities

High-risk of unplanned, and “poorly supervised” (unsupported) pregnancies

Violence and trauma in crowded communities and urban environments

Increasing rate of obesity in increasingly urban populations

High rate of mental and emotional disorders

91
Q

What were some of the inequities seen in mothers and children due to colonization?

A
  • unfavourable prenatal and neonatal health care
  • lower immunization numbers due to availability and feasibility
  • greater risk of pre-mature birth, low birthweight, etc
92
Q

What does cultural prohibition mean?

A

lack of opportunity for cultural expression

loss of traditional teachings and knowledge

loss of language

loss of identity

93
Q

what fraction of Indigenous people are able to converse in their Indigenous language regularly?

A

1/4

94
Q

What does residential instability look like?

A
  • land exploitation
  • high mobility weakens social cohesion
  • Instability positively correlates with single parent, low income families (divorce, crime, and suicide)
95
Q

In 2001, What faction of reserves had water supplies that were at risk?

A

2/3

96
Q

What are some persistent problems in the healthcare system?

A
  • poor understanding of the complexities of Indigenous health
  • widespread prejudice and racism
  • mishandling culturally sensitive matters
  • government indifference, ignorance, neglect, and denial about poor state of Indigenous health
  • false expectations that medical strategies can overcome Indigenous health problems
  • not enough surveillance of Indigenous healthcare and striving to improve
97
Q

What are some areas with improvement in Indigenous healthcare?

A
  • Suppression of some vaccine-preventable diseases
  • Improved pregnancy outcomes, including birthweight
  • Lower rates of some infections and related deaths
  • Some reduced maternal, infant, and young child mortality
  • Increased life expectancy in some populations
  • Improved education in some Indigenous groups and their employment in health-related fields
  • Introduction of Indigenous components to education and training in health professionals
  • Training of Indigenous peoples for careers in healthcare
  • Increased participation of Indigenous people in policy-making
  • Awareness of seriousness of health issues in Indigenous peoples
  • Formal recognition of some national governments of Indigenous peoples’ rights
98
Q

What are some areas in Indigenous healthcare that have deteriorated?

A
  • illness associated with overcrowding/environmental contamination
  • rapid upsurge of lifestyle diseases (obesity, hypertension, cardiovascular disease, diabetes)
  • respiratory disease from smoking
  • emotional, mental, and psychiatric illnesses
  • STI’s
  • interpersonal and family violence
99
Q

Canada is the 6th most developed country in the world. If First Nations were evaluated using the same data, they would be _____

A

63rd

100
Q

First Nations are ___% of Canada’s Indigenous population; Inuit & Metis;

A

61% (900,000 people)

101
Q

What fraction of First Nations living on reserves are high school dropouts?

A

6/10 (vs 3/10 for off-reserve and 1/10 for other Canadians)

102
Q

A teen on a reserve is more likely to go to ____ than end up graduating high school

A

jail

103
Q

what percentage of status First Nations live in poverty?

A

50% compared to 17% of other Canadians

104
Q

What is the median income for First Nations?

A

19k (vs 33k for other Canadians)

105
Q

What is the infant mortality rate for Indigenous populations?

A

8 in 1000 (vs 5.5 in 1000 for other Canadians)

106
Q

What is the average life expectancy for Indigenous?

A

Man: 69 years (other Canadian average is 77)
women: 77 years (other Canadian average is 82)

107
Q

Suicide rates for Indigenous people are ______x higher

A

5-6 times

108
Q

What is the diabetes percentage for First nations over the age of 45?

A

19% (compared to 11% for other Canadians)

109
Q

In May 2018, how many water drinking advisories were there in over 100 reserves?

A

174

110
Q

what percentage of First Nations adults report depression in Canada?

A

18%

111
Q

What are some of the social factors that affect PTSD

A

o Gender
o Lower income & education
o Life events
o Ethnic minority

112
Q

What are some environmental factors that affect PTSD?

A

o Exposure to trauma
o Family instability
o Childhood adversity
-Separation from parents
-Poverty
-Family dysfunction
o Individual factors include:
-Personality
-Mental health
-Anxiety or depression
-Emotional or behavioural
problems before the age of
6

113
Q

What are some signs of PTSD in children?

A

o Lose interest in play activities
o Recurrent nightmares
o Repetitive play with trauma-related themes
o Substance abuse
o Mental health issues
o Problems with personal and family relationships

114
Q

What is complex PTSD?

A

layers of trauma experienced over a significant period of time

115
Q

What is the connection between residential schools and PTSD?

A

Clinicians linked the symptoms of former residential school students to PTSD, but this diagnosis falls short due to the complex and intergenerational nature of their trauma.

116
Q

what are the 5 Influential characteristics that perpetuate intergenerational transmission of trauma?

A

Traumatic Bonding
Trauma Re-enactment
Anxiety
Hyper-vigilance
Depression

117
Q

How is historical trauma different from PTSD?

A
  1. HT is more complex
  2. HT is a collective phenomenon
  3. HT is described as cumulative in its impacts over time
  4. HT is intergenerational
118
Q

What is the intergenerational outcome of Historical transmission?

A

Social disorders are not just caused by immediate trauma but by memories of past traumas passed down through generations, disrupting behavior and weakening social skills.

119
Q

historic trauma transmission was coined for what purpose?

A

to explain the origins of social malaise (discomfort, ilness or lack of wellbeing) in Indigenous communities and the dynamics of interventions particular to Indigenous contexts.

120
Q

what are some of the disadvantages that Indigenous people have faced due to historical trauma?

A
  • Lower levels of income and education
  • Poorer quality of housing
  • Reduced access to resources
  • Erosion of cultural identity
121
Q

What are some ways to heal from PSTD/Historical trauma?

A
  • re-engaging in positive social and cultural activities
  • revisiting their past, and making connections between the traumatic events from the past and disruptive social behaviours in the present.
  • becoming aware of their memories of suffering and understanding the meaning behind the images of loss and grief.
  • revitalizing their political, social, and economic spheres, and their participation in a collective enterprise of bringing wellness to their communities
  • Incorporating this cultural context honours the Indigenous ways of being prior colonization creating an stronger attachment to identity.
122
Q

what is culture?

A

worldviews, lifestyles, learned and shared beliefs and values, knowledge, symbols, and rules that guide behaviour and create meanings within a group of people

it is dynamic

123
Q

Culture can be influenced by:

A

race
gender
religion
ethnicity
socio-economics
sexual orientation
life experience

124
Q

what is cultural continuity?

A

is the intergenerational culture connectedness preserved through families, communities, and knowledge holders who pass traditions on to subsequent generations

cultural continuity= determinants of Indigenous health

125
Q

What is self determination?

A

the act of freely determining one’s political status and freely pursing economic, social, and cultural development; and, dispose of and benefits from their wealth and natural resources

(Treaty law–Canada is obligated to respect the First Nations right to self determination)

126
Q

What is cultural continuity as a spectrum?

A

cultural awareness
cultural sensitivity
cultural competence

127
Q

What is culture awareness?

A

Awareness of one’s own culture, as well as others

Continuous process of examining and understanding other cultures

128
Q

What is cultural sensitivity?

A

Focusing on being sensitive and respectful towards worldviews, principles, and practices of peoples from different cultures

129
Q

What is cultural competence?

A

A focus on acquiring an adequate and appropriate set of skills, knowledge, attitudes, protocols, approaches, language, and experiences for working with people from other cultures

130
Q

What is cultural safety?

A

Theory uphold political ideas of self-determination and de-colonization

Acts as a Person-Centered Model of care that situates overall health within the cultural, historical, economic, and political context of the service user

Aims to shift the power imbalance inherent in the relationship between healthcare providers and Indigenous health care recipients by empowering the recipient, and promoting their participation in decisions regarding their health

131
Q

what is Cultural responsiveness?

A

Cultural responsiveness is the ability to learn from and relate respectfully to people of our own culture as well as from other cultures. It is an awareness of one’s own cultural identity and views, and the ability to learn and on the culturally different norms of others

(cultural responsiveness is a 4 step process towards cultural safety–awareness, sensitivity, competence and then safety)

132
Q

How can you combat culturally unsafe care?

A
  • use questions to ask yourself if you are being culturally responsive
  • two-eyed seeing
133
Q

What are some questions to ask regarding culturally unsafe care?

A

How am I reinforcing certain norms (perhaps Eurocentric norms) within healthcare?

How am I seeing certain behaviours, beliefs and practices as “normal” and others as “cultural”?

How am I serving certain economic and political interests through my daily practices?

134
Q

What is 2 eyed seeing?

A

is the gift of multiple perspective treasured by many [Indigenous] peoples and explains that it refers to learning to see from one eye with the strengths of Indigenous knowledges and ways of knowing, and from the other eye with the strengths of Western knowledges and ways of knowing, and to using both these eyes together, for the benefit of all”

135
Q

What are some other things you can do to ensure you are providing culturally safe care?

A

Ensure diversity amongst your team

Seek out opportunities to learn about or expose yourself to other cultures

Ask for feedback when appropriate

Ensure your patients or clients have ways to express themselves

136
Q

What are some stats regarding the Alaska Nuka System of Care, an Indigenous lead model

A
  • Emergency department visits decreased by 42%.
    -Hospital stays were reduced by 36%.
    -Childhood vaccination rates increased by 25%.
    -Patient satisfaction in cultural safety reached 94%.
    -Staff turnover decreased by 75%​
137
Q

What is the RCAP?

A

the Royal Commission on Aboriginal Peoples

138
Q

What is TRC?

A

Truth and Reconciliation Commission

139
Q

What is MMIWG?

A

National Inquiry into Missing and Murdered Indigenous Women and Girls

140
Q

Describe the RCAP commission and year.

A

1991
a groundbreaking commission for its time, when Canadian society largely ignored issues of colonization and Indigenous experiences

residential schools were still operating when RCAP was formed, and colonization was not a focus in education

141
Q

What is the TRC and year.

A

2008
marked a pivotal moment by bringing survivor testimonies to public attention on a national scale

the Calls to Action prompted institutions across sectors to address reconciliation. For example, post secondary institutions began appointing leaders for Indigenous engagement, such as U of R creating its Associate Vice-President (Indigenous Engagement) position in 2021.

142
Q

What is the National Inquiry MMIWG and year.

A

2016
established nearly a decade after the TRC to address the unique challenges and risk faced by Indigenous women, girls, and 2-spirited individuals

highlights intersectionality, recognizing that the experiences of Indigenous women are shaped by both their identity as Indigenous peoples and their perceived gender

looks to research to discover the truth about violence to Indigenous women and girls.

143
Q

What is the RCAP composed of?

A

5 volumes and over 4000 pages
19 recommendations

144
Q

What are the RCAP 4 principles?

A
  1. Mutual recognition
  2. Mutual respect
  3. Mutual sharing
  4. Mutual responsibility
145
Q

What are some of the initiatives and apologies made?

A
  1. Gathering Strength Action Plan (Post RCAP)
  2. Office of Indian Residential Schools Resolution Canada (2001)
  3. Settlement Agreement (2007)
  4. Formal Apology (2008)
146
Q

Important info about the Gathering Strength Action Plan?

A

Included the Statement of Reconciliation, where the Canadian government acknowledged its role in the development and administration of Indian Residential Schools.

147
Q

Why was the Office of Indian Residential Schools Resolution Canada made?

A

Established to manage abuse claims filed by former students against the federal government.

148
Q

What are some of the measures addressed in the Settlement Agreement?

A
  • Common experience payout (compensation for former students)
  • Independent accessment process (focused on sexual/physical abuse claims)
  • Truth and Reconciliation Commision (to document the history and impacts of the schools)
  • Healing support Programs (funded for Aboriginal healing)
149
Q

More details about the Formal Apology.

A

On June 11, 2008, Prime Minister Stephen Harper issued a public apology in the House of Commons to former students, their families, and communities.

150
Q

What are the 5 sectors of the TRC?

A
  1. Education
  2. Child Welfare
  3. Health
  4. Culture and Language
  5. Justice
151
Q

What are the 2 main goals of the TRC?

A

Develop and teach curriculum on Indigenous spirituality, history of Residential schools, religious conflicts in families, and the churches responsibility to fix it

Establish funding for community-controlled healing/reconciliation projects, cultural/language projects and education/relationship projects

152
Q

According to the Native Womens Association of Canada (NWAC), between 2000-2008, ____% of all homicides in Canada were of Indigenous women and girls, while Indigenous women and girls only make up ____% of the female population.

A

10%
3%

153
Q

Out of 582 cases of missing/murdered Indigenous women/girls, stats show:

A
  • 67% are murder cases
  • 20% are cases of missing women or girls
  • 4% are cases of suspicious death (natural or accidential by police)
  • 9% are unknown
154
Q

____% of the cases involve women/girls under the age of 31; only ___% involve women 45 and older

A

55%
8%

155
Q

how many MMIWG are mothers?

A

88%

156
Q

What percentage of murder cases have led to charges (MMIWG)?

A

only 53%

157
Q

What is the Alaska Native Tribal Health Consortium?

A

is a non-profit organization that provides a wide range of health services to Alaska Native people. It is the primary health organization for Alaska Native and American Indian people in the state of Alaska, operating under the guidance of the Alaska Tribal Health System. ANTHC works in collaboration with the Indian Health Service (IHS) and other tribal health organizations.

158
Q

What is the IRSSA?

A

Indian Residential School Settlement Agreement

allocated 2 billion for nearly 86,000 survivors

included 60 million for the TRC to document over 6750 survivor testimonies

159
Q

How many Calls to Action are there?

A

94
covering areas such as education, health, justice, language preservation, and professional training

160
Q

There are approximately ______ Indigenous peoples in the world, belonging to ______ different groups, in ___ countries worldwide

A

370 million
5000 groups
90 countries

161
Q

Indigenous knowledge should be viewed as…

A

complex knowledge systems that have developed overtime by particular people in particular areas that have been transmitted from generation to generation

162
Q

Indigenous knowledge is considered (16 descriptive words)

A

adaptive
cumulative
dynamic
holistic
humble
intergenerational
invaluable
irreplaceable
moral
non-linear
observant
relative
responsible
spiritual
unique
valid

163
Q

describe each of the 5 circles in the knowledge wheel?

A

Center = Individual person. Indigenous wellness starts with the individual

Second Circle = Different aspects of health (physical, mental, emotional, spiritual)

Third Circle = Overarching values that support wellness (respect, wisdom, responsibility, and relationships)

Fourth Circle = The people that surround an individual (nation, family, community, and land)

Fifth Circle = Social, cultural, economic, and environmental determinants of our health and well-being

164
Q

The circle is ___________________________

A

primary to all life and life process

165
Q

what does the term Knowledge Holder mean?

A

“Elder” was originally used to describe individuals who practice, maintain, and teach the unique customs, beliefs, and practices pertaining to Indigenous knowledge; however, Knowledge Holder is more appropriate

166
Q

What is an appropriate gift to give a knowledge holder when seeking their knowledge?

A

Tobacco

167
Q

What is the term used for a knowledgeable person originally, instead of knowledge keeper?

A

Elder

168
Q

What is the medicine wheel?

A

Circular symbol broken into 4 quadrants of colours yellow, red, white, and black

Different nations have different medicine wheel teachings according to their stories, values, and beliefs

4 areas have attributes assigned to them (four directions, four states of being, four sacred medicines, four seasons, four elements, four stages of life)

169
Q

Why is this circle so important?

A

The circle represents the circle of life, the circle of self awareness, and the circle of knowledge

The Indigenous people look to this circle as a reminder that everything flows in a circle and that live continues on and on

Also represents our own awareness of ourselves and states: mental, physical, spiritual, and emotional. We need all four to be balanced

Use the circle of knowledge as a tool for passing on knowledge

170
Q

What does it mean that “all aspects of life are interconnected”?

A

All creation on mother earth was put here for a purpose

Spirit world connects to life on earth, water is connected to land, the sky connected to ground

Our connection to the land and mother earth can directly affect our spiritual well being (physical, emotional, mental health)

All nations of the earth are connected to the medicine wheel

171
Q

Discuss details about the health research done on Indigenous peoples.

A

In 1942 researchers (including Canada’s leading experts on nutrition) identified malnutrition/hunger in Indigenous communities

research done between 1942 and 1952

studies showed malnutrition was common, many health conditions would improve with provision of nourishment

172
Q

What was wrong about the health research done in these communities?

A

government did not respond humanely to nutritional deficiencies

less than half the members were provided with vitamin supplements, leaving remainder in the same nutritional condition

researchers exploited conditions of Indigenous people (unethical collection of information)

also done in residential schools: trying to determine if these supplements could mitigate nutrition (didn’t work)

children became more anemic, likely contributing to more deaths

173
Q

How were these research techniques on Indigenous people/children allowed?

A

Setting out with “best intentions”

Participants already marginalized/vulnerable

Participants had no voice, no one looking out for their best interest

174
Q

What are the types of research Indigenous communities desire?

A

Community driven
Self-determined
Action oriented
Culturally responsive
Upholds indigenous sovereignty of data/info

175
Q

What was established to help ensure no more unethical studies/research?

A

contemporary research ethics boards established, controlled protocols/standards to govern research involving humans

176
Q

What was flawed with the ethics boards for research?

A
  • indigenous communities critique institutions/protocols
  • claim standards/protocols are in place to protect universities/researchers, not participants
    -Government of Canada (2018) tri-council statement is put into place to ensure ethical treatment of participants
177
Q

Indigenous health research: types of research falls under 2 groups….

A
  1. seek to change research structure from within
  2. wish to create new path forward
178
Q

Important research/academic institutions increasingly take up these guidelines:

A

Tri-council policy (2018) for ethical conduct for research involving humans governs research involving humans, funded in Canada

University of Manitoba framework for research engagement with FN, Metis, Inuit developed in partnerships with Indigenous communities

179
Q

What is OCAP stand for?

A

Ownership
Control
Access
Possession

180
Q

Definition of Ownership in OCAP.

A

refers to collective right of FN to their cultural expertise, data, info

181
Q

Define Control in OCAP

A

affirms that FN, their communities are involved in research projects from start/finish

182
Q

Define Access in OCAP

A

FN have access to info/data about selves

183
Q

Define Possession in OCAP

A

raises point of physical control of data collected

184
Q

What are the additional policies that Indigenous people have established for research?

A

Go beyond merely acquiring approval from community leadership

Balance individual/collective rights

Uphold cultural norms/values

Integrate indigenous self-determination into research

185
Q

What came out of the research done on Indigenous children in residential schools?

A

The children were denied adequate nutrition to test the effects of dietary deficiencies and various supplements.

this data was used to inform national nutritional policies, including the development of Canada’s Food Guide

186
Q

What was expected to happen in the first wave of covid in regards to Indigenous populations?

A
  • Colonial history + government mistrust = vaccine hesitancy
  • Higher rates of infection/death
  • Outbreaks
  • Transmission between on/off reserve members
  • Fear mongering, pushback
187
Q

What did the first wave of covid actually look like for Indigenous people?

A
  • high rates of vaccinations
  • expanded delivery of vaccinations (lower ages, police, non-indigenous peoples)
  • low rates of vaccine hesitancy
188
Q

Case study between Regina and a Indigenous community 45 minutes away.

A

Regina, SK:
- Outbreaks
- High infection rates
- Increases hospitalizations
- COVID-19 benefits decreasing
(EI, CERB, support, etc.)
- Vaccine hesitancy, anti-vax
demonstrations

Example First Nations Community, SK:
- 0 active cases
- Social/health supports in place
- Vaccines available
- Borders restricted, now just
monitored
- Schools open, remote
available

189
Q

Covid 19 4th wave facts about vaccination and cases.

A

SK has lowest vax rates in Canada, some indigenous communities (southern framing communities) had lowest COVID-19 vaccine uptake. FN fighting uphill battle against virus, case rates twice as high as rest of province

Indigenous services Canada says 64% of eligible population are fully vaccinated in FN in SK

higher vaccinations rates among seniors in FN communities vs younger people

190
Q

What were some of the barriers for Indigenous people in Covid?

A

Mistrust of providers due to colonization/past practices (forced sterilization, medical experimentation)

Lack of access/regular use of healthcare

Lack of basic infrastructure (overcrowding, lack of services, poor housing, poor water supply, etc.)
- Ex.) intergenerational families:
overcrowding in home, less
change of proper isolation

Negative healthcare experiences, racial discrimination

191
Q

Strengths for Indigenous people during Covid

A
  • community beyond the individual (FN understood how to protect the vulnerable = more vaccinated)
  • value of life
  • value of health
  • importance of our Knowledge Keepers
  • Creative outreach ideas