LEC 11: Indigenous Health

Question 1

Indigenous Health

Answer 1

Structural impacts of colonization and bad government policy have left a legacy of negative health/ social issues

Question 2

What are significant policies and practices that have impacted Indigenous health?

Answer 2

1. Residential schools (1883-1996)
   - 150, 000 children
2. Sixties Scoop
   - 40x increase in children care in 1 decade

Question 3

How is the legacy of intergenerational trauma still impacting Ingenuous people?

Answer 3

1. Individual: personal impacts on abuse and cultural disconnect
2. Family: negative actions, abuse passed on in families
3. Community: group cultural norms disrupted. altered, lost

Question 4

What are the 8 main SDH found within Indigenous communities?

Answer 4

1. Stress, bodies & illness
2. Income and education
3. Un/employment
4. Early childhood development
5. Food insecurity/ housing
6. Social exclusion/ safety net
7. Health services and disability
8. Indigenous status, gender, and racism

Question 5

SDH: Stress & Physical/ Mental Effects

Answer 5

1. Stress: SDH challenges, systemic racism, PTSD, negative coping
2. Physical Effects: Illness, delayed recovery from illness
3. Mental Effects: Negative psychological impacts/ coping

Question 6

SDH: Illness

Answer 6

Past health may be linked to present health

1. Nutrition: Poor nutrition may be linked to illness such as diabetes
2. Stress effects linked to illness. exacerbation of chronic disease such as:
   - Cardiovascular
   - Immune system
   - Obesity etc.

Question 7

SDH: Income

Answer 7

Linked to education and employment
1. Average income varies greatly between on-reserve ($18,586) and off-reserve ($29,780)

2. Non-indigenous average income in Canada is $41,052

Question 8

SDH: Education

Answer 8

On-reserve education funding capped (INAC)

1. High school completion rate 72% vs 89% non-indigenous
2. 31% of students attend off-reserve schools )esp. high school) away from home-support and home access issues
3. University degree attainment 10.9% vs 26.5% non-indigenous

Question 9

SDH: Employment

Answer 9

Employment and working conditions

1. Employment rate 52.1% vs 61.2% non-indigenous
2. Differences between on-reserve (35.4%) vs off-reserve (52.6%) linked to job opportunities and local economy
3. Barriers include geography, education, structural racism

Question 10

SDH: Unemployment & Job Security

Answer 10

1. Unemployment rates 15% vs 7.5% non-indigenous
2. Again differences between on-reserve (25.2%) and off (15.3%)
3. Rates 25% grater if no high school diploma or training

Question 11

SDH: Early Childhood Development

Answer 11

1. Early childhood programming (below 5) can be of great benefit to all children
   - Start of literacy. numeracy, socialization, skills development
   - Early childhood experiences impact on later life outcomes
2. Early learning/ child care programs available
   - 67% of FN communities have them- but only 22% of children have access due to wait lists
   - Increasing on-reserve child welfare programming and interventions, but provincial social services still the norm

Question 12

SDH: Food Insecurity

Answer 12

Risks linked to income and housing

• 14-33% of FN households have experienced food insecurity
• Food insecurity rates 4X non-indigenous households

Question 13

SDH: Housing

Answer 13

Issues related to shortage of good quality housing
1. Inuit Nunangat: 10x the crowding (39%) vs indigenous houses (4%(- links to stress/illness, high TB rates (400X)

2. On-reserve: Funding/income/legal issues impact on new housing and upkeep/repairs to older housing stock
3. Homelessness: Indigenous rates 10X grater than non-indigenous, ranges from 38% (YVR) to 71% (YWG)

Question 14

SDH: Social Exclusion

Answer 14

Connection to broader society

• Indigenous Canadians more likely to be excluded from social participation- economic civil affairs, access to social goods, social production (social/ cultural activities)
• First Nations people in Canada did not have right to vote in Federal elections until 1960 (laws changed by Diefenbaker)

Question 15

SDH: Safety Net

Answer 15

Access to social benefits

• Accessing benefits difficult- service fragmented
• Jurisdiction issues between Federal and Provincial and Local
• Internet often needed- but may not be available on-reserve

Question 16

SDH: Health Services

Answer 16

Vary with barriers to care

• Direct Federal provision of health care in about 500 communities (FNIHB)- health centers with varying services
• FNIHB also runs two hospitals and 50 drug treatment centers
• Barriers in accessing health care include: health services not available in area, transport, costs, NIHB coverage issues

Question 17

SDH: Disability

Answer 17

Jurisdiction and funding issues are barriers

• Adults: split between INAC and NIHB for funding issues
• Children: “Jordans Principle” to provide Federal funding for on-reserve services, but legal issues over who receives what

Question 18

SDH; Indigenous Status

Answer 18

SDH and health outcomes seen here

- Indigenous BUT many cultures and traditions and languages

Question 19

SDH: Gender

Answer 19

Gender issues impact on women and on men

• Indigenous women 2x as likely to experience intimate partner violence as non-indigenous women
• Indigenous men experience 2x more violence

Question 20

SDH: Racism

Answer 20

Structural and interpersonal racism impacts

• Structural systems that can cause harm, isolate, prevent health
• Interpersonal: stereotypes (anti) (social) media, day-today

Question 21

How are things changing?

Answer 21

1. EducationL Efforts to indigenize curricula by including indigenous perspective and knowledge
2. Health Services: Increasing work on implementing cultural competence and cultural safety
3. Health Services/ Disability: Changes to departments at Federal level may make funding/programming better
4. Increasing understanding of colonization history and its impacts on Indigenous Canadians but still much more work to be done by all of us