The primary objective of the Canadian Health Act “…is to protect, promote and restore physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers” (Government of Canada, 2019). The Canadian Constitution recognizes three indigenous groups; the First Nations, the Inuit, and the Metis people constitute 4.9 percent of the population (Batal, 2019). These indigenous communities conceptualize well-being holistically; well-being includes the whole person and their spiritual, emotional and physical health (Gall et al.,2021).
Health Issues Faced by Indigenous Peoples
The indigenous peoples face a spectrum of chronic diseases. According to Bethune et al. (2019), the Canadian Aboriginal population is experiencing increasing instances of cancer. They are also heavily affected by obesity, cardiovascular disease, and diabetes (Batal, 2019; Liu, King & King, 2022). In 2015, 28.1 percent of Canadians aged 18 and 79 were obese. However, obesity levels are much higher among the indigenous peoples (Batal, 2019). In Alberta, hospital admission for chronic diseases, including chronic kidney disease, substance abuse disorders, depression, bronchitis, chronic obstructive pulmonary disease, pneumonia and other respiratory diseases, are significantly higher among indigenous peoples (Nader, Kolahdooz & Sharma, 2017).
Figure 1: Rate of Self-Reported cardiovascular Disease among First Nations, 2007- 2014
Source: Data from Canadian Community Health Survey, Statistics Canada. 73
Figure 2: Health Issues Affecting Aboriginal Canadians
The Canadian indigenous peoples experience a multitude of health disparities as compared to their non-indigenous European counterparts (Bethune et al., 2019). For instance, the lifetime risks of diabetes and cardiovascular diseases among the Aboriginal population are estimated at 57 percent and 7.1 percent compared to the non-indigenous European population at 44.5 percent and 5 percent, respectively (Liu et al., 2022). Cancer among Aboriginal Canadians is characterized by rising incidence, later diagnosis, and relatively poorer survival rates than non-indigenous. The prevalence of at least one chronic illness like obesity, arthritis or diabetes among the indigenous communities is 60 percent among adults (Nguyen, Subhan, Williams & Chan, 2020).
Healthcare Disparities between Indigenous Peoples and Non-Indigenous Populations
European population (Bethune et al., 2019). Only 44 percent of Aboriginal communities living on-reserve state that they receive very good/excellent health care compared to 60 percent of non-indigenous European communities. These health disparities are historically linked to colonialization and the attempt at dismantling the indigenous population's economic, socio-cultural, educational and health foundation percent. Thus, a confluence of policy and structural factors exacerbates the health disadvantages experienced by the Canadian Aboriginal communities. For instance, they have a much lower secondary school attendance rate of 62 percent compared to the Canadian average of 79.9 percent; their mean income is 27 percent below the national average. These factors have health implications as they affect an individual’s dietary patterns, physical activity, and health access (Batal, 2019). These policies generated forced transition of indigenous communities to western diets, limited access to health care and uptake of sedentary lifestyles. In Alberta, the indigenous people suffering from chronic conditions are less likely to visit specialists such as nephrologists, respirologists, allergists, pediatricians and general internists (Nader et al., 2017).
Barriers to Health Care for Indigenous Peoples
Three kinds of barriers to health access for the indigenous peoples in Canada can be identified. These barriers are; location and accessibility, lack of cultural competence and community coverage barriers. The location and accessibility barriers for indigenous peoples relate to the fact that most of these groups live on reserves and are thus isolated from urban health facilities. Access to urban-located health facilities can be difficult and costly (Nader et al., 2017). The lack of cultural competence relates to fewer people self-identifying as indigenous people working in health care. This hurts the acceptance of modern health care among the indigenous peoples. A recent report in Alberta found that out of 110,865 healthcare workers in the state, only 3,230 were from the indigenous peoples (Nader et al., 2017). The third barrier is that associated with community coverage. This is somewhat linked to the problem of access and implies the difficulty related to physically accessing hospitals, health care services, the lack of coverage by NIHB for specific health services, direct costs of some care, long waiting list and cultural barriers.
Reference
Batal, M. (2019). A Scoping Review of Obesity among Indigenous Peoples in Canada. Journal of Obesity, https://doi.org/10.1155/2019/9741090
Bethune, R., Absher, N., Obiagwu, O., Qarmout, T., Steeves, M., Yaghoubi, M., Tikoo, R., Szafron, M., Dell, C. & Farag, M. (2019). Social determinants of self-reported health for Canada's indigenous peoples: a public health approach. Public Health, 176; 172-180, https://doi.org/10.1016/j.puhe.2018.03.007.
Gall, A., Anderson, K., Howard, K. et al., (2021). The wellbeing of Indigenous Peoples in Canada, Aotearoa (New Zealand) and the United States: A Systematic Review. International Journal of Environmental Research and Public Health, 18; 5832. https://doi.org/10.3390/ijerph18115832
Government of Canada. (2019). Canada Health Act. [Online], available at: https://laws-Iois.justic.gc.ca/eng/acts/c-6/fulltext.html
Liu, P. P., King, M., King, A. (2022). Achieving Health Equities in Indigenous Peoples in Canada: Learnings Adaptable for Diverse Populations. Circulation, 146; 153 – 155 https://doi.org/10.1161/CIRCULATIONAHA.122.060773
Nader, F., Kolahdooz, F. & Sharma, S. (2017). Assessing Health Care Access and Use among Indigenous Peoples in Alberta: A Systematic Review. Journal of Health Care for the Poor and Underserved, 28; 1286 – 1303. https://doi.org/10.1353/hpu.2017.0114
Nguyen, N. H., Subhan, F. B., Williams, K., & Chan, C. B. (2020). Barriers and Mitigating Strategies to Healthcare Access in Indigenous Communities of Canada: A Narrative Review. Healthcare, 8(2), 112; https://doi.org/10.3390/healthcare8020112
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