Week 8: Public policies and indigenous health Flashcards
Proper terminology
Indigenous or Aboriginal peoples
First Nations
Metis
Inuit
Avoid native
Indian terminology
Legal designation
Status Indian
On- reserve and off reserve
Access to government services
Non-status Indian
No access to government services
Colonialism definition 1
Policy or practice of acquiring full or partial control over another country, occupying it with settlers and exploiting it economically
Colonialism definition 2
Ongoing system of power that perpetuates the genocide and repression of indigenous peoples and cultures
Colonial policies and institutions in Canada
Constitution act
Indian act
Relocation of Inuit communities
Residential schools
Sixties scoop
Missing and murdered Indigenous women and girls
Constitution act
Federal government is responsible for Indians and lands reserved for Indians
Indian act (1876)
Gives control and management of reserve lands to the federal government
Defines who is legally recognized as Indigenous (status vs non-status)
Limits the right to vote
Loss of self governance
Limited economic and political participation of Indigenous people
Outlawed ceremonies and other cultural practices
Undermined role and status of women
Why did the Indian act cause a loss of self-governance?
Health and education under federal control
Indian agent given authority over food, goods, and travel for on-reserve First Nations
Relocation of Inuit communities
Federal program resulting in forced relocation to remote permanent settlements
What has relocation of Inuit communities resulted in?
Disparities in the social determinants of health
Increased government involvement
Residential schools
A system of institutionalized education and care that aimed to assimilate Indigenous children into European and Christian norms, beliefs and practices
“kill the Indian in the child”
Negative effect of residential schools
Trouble adopting to culture once they returned to their communities
Alcohol and drug abuse
Intergenerational trauma
What is the sixties scoop?
Mass apprehension of Indigenous children into the care of child welfare that began in the 1950s and peaked in the 60s
1/3 of Indigenous children taken from families
Results of sixties scoop
By 1970, 30-40% of children in care were indigenous and today 48% of children in care are indigenous
Vast majority of these children were adopted in to non-Indigenous homes
Underlying goal of both residential schools and the sixties scoop
Assimilate Indigenous children into European and Christian cultural norms, beliefs and practices.
Missing and murdered indigenous women and girls and politics
Lack of political and societal response
How do Indigenous people in Canada access health care?
- Provincial/territorial health care systems
- Federal government
- Self-governance and community-directed initiatives
Indigenous access to health care- Provincial/territorial systems
Physicians and hospitals
Non-indigenous specific community health centres
Indigenous programming at mainstream organizations
Indigenous access to health care- Federal government
Non-insured health benefits
Non-insured health benefits
Provides coverage for status indians
Covers dental and vision care, prescription meds, medical supplies, equipment and transportation, short-term crisis intervention and mental health programming
Indigenous access to health care- Self governance and community-directed initiatives
On-reserve services and programs
Urban Indigenous health centres (ie. Anishnawbe in toronto)
BC first nations health authority
Barriers to accessing care for indigenous people
- Geography/remoteness
- Federal/provincial lack of clarity and bureaucratic disagreements
- Individual and structural racism
- Lack of culturally safe care
Indian act vs constitution
Indian act gives federal government authority over health care of Indigenous individuals and constitution is responsibility over the reserves/land
Jordan’s principle
Legislation that requires that the government of first contact pay for the health care service to the child without delay or disruption
Why is it difficult to conduct research on racism?
Underreporting of experiences of racism and lack of self-identification of Indigenous
Research on the effects of racism
Spotty and cross sectional
Few standardized measurement instruments
Steps to achieving cultural safety
- Cultural awareness
- Cultural sensitivity
- Cultural competence
- Cultural safety
Cultural sensitivty
Attitude change
Respecting difference
Cultural competence
Skills, knowledge and attitudes
Cultural safety
Emphasizes colonial, historical and sociopolitical context
Health care providers examine own culture, history, lived experiences, beliefs and attitudes
Explicit attention and action to address power relations
Responses and interventions for racism, health and health care
- Individual, family and community strategies and resiliencies
- health care and service delivery
- Health professional education and training
- Policy responses specific to health and health care
- Policy responses affecting health
Individual, family and community strategies and resiliencies example
Community-based fundraisers held in rural Metis communities to raise funds to cover travel costs to receive specialized health services
Health care and service delivery example
First Nations Health authority in BC
Health professional education and training
Society of obstetricians and gynaecologists of Canada Policy statement: a guide for health care professionals working with aboriginal peoples
Policy responses specific to health and health care example
Jordan’s principle
Federal transfer of health services
Policy responses affecting health example
Affect social determinants of health such as truth and reconciliation commission
Bill C-31 under the Indian act
- Indigenous women who married non-Indigenous men lost their Indigenous status
- Indigenous status was conferred upon non-Indigenous women who married Indigenous men
- Indigenous men who married non-Indigenous women lost their Indigenous status
What did both residential schools and the sixties scoop aim to do?
Assimilate indigenous children into non-Indigenous society
Cultural safety and background info of a health care provider
Health care providers examine their own background and privileges and how they might influence the care they provide to indigenous people
What group tends to have the poorest health outcomes?
Indigenous women
Indian relocation outcome
Patronizing and unsuccessful
