Health Watch - March 2015

Provinces with high Aboriginal population rank poorly in health

 The Conference Board of Canada report has given both Manitoba and Saskatchewan overall grades of ‘D’, ranking them 23rd and 24th respectively out of 29 high-income regions around the world.

Every province and 15 countries in Europe, Asia and North America were graded on 11 indicators of health—life expectancy, premature death, infant mortality, self-reported health status, deaths due to cancer, heart disease, stroke, respiratory illnesses, diabetes and the nervous system, as well as suicides and self-reported mental health.

The report notes Manitoba and Saskatchewan have the highest proportion of Aboriginal people. Manitoba Health Minister Sharon Blady said she believes a lot of the concerns for health in Manitoba stem from poor health outcomes for Aboriginal Manitobans and she blamed Ottawa.

“I know we’ve got a certain population that is operating at a disadvantage because the federal government is not living up to its obligations.”

Jo-Ann Episkenew is the director of the Indigenous Peoples’ Health Research Centre in Saskatchewan. “If we have a whole bunch of people in the province doing well and one group who makes up about 15 per cent of the population doing poorly, you’ve got to look at the structures that are maintaining that.”

Racism, access to health care linked

The report, First Peoples, Second Class Treatment, links racism experienced by Canada’s Indigenous people to the lack of equal access to health care.

“The historical and contemporary link between racism and poor Indigenous health outcomes is clear but we need better data to understanding the specific impacts of racism at both the individual and systems levels and identify the best strategies to address it,” said Metis physician Dr. Janet Smylie. He is co-author of the report, which was produced for the Wellesley Institute.

More reliable measures of the disproportionate burden of illness, poverty, and discrimination that challenge Indigenous people compared to the rest of Canadians will allow advocates to better engage Canadians in discussion on how to improve health and its determinants for Indigenous peoples.

The researchers wrote that racism in the Canadian health care system can be fatal, citing the death of Brian Sinclair, following a 34-hour wait in a Winnipeg emergency department in 2008. They also cite evidence describing the pervasiveness of racism within the health-care system and how Indigenous peoples strategize around anticipated racism before visiting the hospital or choose to avoid care altogether.

A primary focus of the report was the need to better measure the impact of racism on Indigenous peoples’ access to health care, but researchers also call for the evaluation of Indigenous health interventions that have already been implemented.

AFN launches mental health wellness framework

 The Assembly of First Nations has released a national framework addressing mental health wellness among First Nations. The framework is the result of extensive collaboration that began in 2012 among the AFN, Health Canada, and community mental health leaders, including the National Native Additions Partnership Foundation and the Native Mental Health Association.

The process included a comprehensive mapping of existing mental health and addictions programming that identified gaps and ways to address and avoid them. Culture is the heart of the framework, emphasizing First Nations strengths and capacities.

It identifies a continuum of services needed to promote mental wellness and provides advice on policy and program changes that will enhance First Nations mental wellness outcomes.

Service integration among federal, provincial and territorial programs is central to its success. The framework provides guidance to enable communities to adapt, optimize and realign their mental wellness programs and services based on their own priorities.

“We know that community solutions are the key to our success and we know that First Nations cultures must be central and foundational to addressing substance use issues and promoting wellness for individuals, families, and communities,” said AFN Ontario Regional Chief Stan Beardy, who holds the health portfolio.

“First Nations people are taking our health into our own hands, but achieving the envisioned continuum of mental wellness will require sustained leadership, commitment and collaboration by all parties.”

Toronto to develop Aboriginal health strategy

 Toronto has begun work on its first Aboriginal health strategy, which aims to improve overall health outcomes for the local Aboriginal population. The Toronto Central Local Health Integration Network, Toronto Public Health and Anishnawbe Health Toronto have collaborated to create the eight-member Toronto Aboriginal Health Advisory Circle.

The circle will guide the development of the strategy; implement a harmonized governance structure of Aboriginal cultural values and principles with mainstream organizational structures and mechanisms; and decrease the widening health disparity gap between Aboriginal and non- Aboriginal populations.

“In Canada, evidence shows that Aboriginal people fare worse than non-Aboriginal people on a myriad of health and social indicators,” said Dr. David McKeown, Medical Officer of Health, City of Toronto.† “When it comes to the health of Aboriginal people, we are not where we need to be and have much work to do together to improve Aboriginal health.”†

Nova Scotia begins work on palliative care strategy

Nova Scotia’s new palliative care advisory committee has Aboriginal representation. Beverley Madill, First Nations and Inuit home and community care program co-ordinator for Nova Scotia and Newfoundland and Labrador, is among the 25-member committee, which will provide strategic advice and expertise.

Creating an advisory committee was one of the recommendations of the provincial strategy, Integrated Palliative Care: Planning for Action in Nova Scotia, which was released in April 2014. The strategy will increase collaboration among health professionals and community support organizations and advance palliative care in the province.