First Nations Health And Wellbeing : Government Enacted Health Equity Programming

The health of Aboriginal people in Canada is both a tragedy and a crisis (Aboriginal Affairs and North Development Canada, 2010). Aboriginals have a higher rate of death among aboriginal babies, twice the national average, higher rate of Infectious diseases example gastrointestinal infections to tuberculosis, and chronic and degenerative diseases such as cancer and heart disease are affecting more aboriginal people than they once did (AANDC, 2010). Availability of important medical facility is not enough to accommodate the growing medical needs of Aboriginals. A socioeconomic and cultural issue also hinders the access of aboriginals to access health care in the community.

The disproportionate, poor health outcomes experienced by First Nations Canadians have been attributed to an uncoordinated and fragmented health care system. This system is rooted in colonial legislation and social policies that have created jurisdictional ambiguity and long-standing confusion among federal, provincial and First Nations governments as to who is responsible for First Nations health care (Kelly, 2011; Lavoie, 2013). The responsibility of healthcare resembles a “political football and while it is being passed back and forth, the health status of First Nations people remains the lowest of any segment of the population (Cook, 2011, p. 40). Despite attempts over the last 40 years to address this pressing social issue, the absence

In order to propogate the knowledge of above determinants and improve health status of Canadians, Health Canada has set up a number of community heath organizations and agencies. The work of these agencies can consist of creating awareness, improving socio-economic status, advocating better working conditions and so on. Unfortunately, many groups such as aboriginal people, recent immigrants and people with disabilities experience challenges in accessing these resources and still cotinue to lead an unhealthy life.

The prevalence of diabetes is increasing in Canada, and is growing health concern. This increase is especially apparent in Canadian Aboriginal population where the estimated prevalence of diabetes is three to five times higher than in the general Canadian population. Because of the risk of several health complications such as coronary heart diseases, neuropathy, eye damage, kidney failure, and peripheral arterial diseases, diabetes is a one of the leading causes of mortality and morbidity. Developing health complications increases when diabetes is undiagnosed and represents unseen, but important burden with significant long-term impact on the people’s health status. First Nations individuals have more diabetes risk factors and suffer more diabetes-related health complications than non-Aboriginals. Therefore, accurate data on diabetes prevalence are essential for government, health care and research organizations.

Canada is a ‘high-income nation’, possessing industrialized economies, technologically advanced industries, and high per capita income (Kendall et al. 2016: 24). Resulting in Canada much receiving international scrutiny as it has a vast number of individuals living in relative poverty (Kendall et al. 2016: 29). Particularly as many as five million, or one in seven people live in relative poverty in Canada (Kendall et al. 2016: 29). Constituting relative poverty is living below the standard of living relative to the average individual in Canada (Levine-Rasky 2017). In addition, income inequality acts as a social determinant of health (SDH), as it impacts the economic and social conditions of an individual or a community (Raphael 2016:

In 1967, Tommy Douglas had a great impact in establishing Canada’s universal health care system which guarantees health care to its residents regardless of factors such as race or ethnicity, religion, income, and age (Tommy Douglas: The Father of Medicare, n.d., para.1). In the 1974 Lalonde Report it emphasizes that health services were only one of the many factors that affect health (A New Perspective On the Health of Canadians, 1974). Others factors which include income, food security, the level of education, shelter, status of health, social status, employment and working conditions, and living conditions also contribute to the status of ones’ health. These factors are known as the social determinants of health or one’s socio-economic status that provide an insight to the health of Canadians.

Inequality in health is one of the most controversial topics within Australian Health Care. Inequality in relation to health is defined as being “differences in health status or in the distribution of health determinants between different population groups” (World Health Organization, 2012). Within Australia inequality affects a wide range of population groups; however Indigenous Australians are most widely affected therefore this paper will focus on how inequality has impacted their health. Research shows that Australia’s Indigenous people suffer from a multitude of social and economic inequalities such as inadequate access to nutritious food and health care, being socially and

Health care for First Nations people, specifically for those who live in reserve communities receiving federally run services, has been founded on colonial ideology. This allowed and influenced the beginning of dependency of the First Nations people upon the European policy makers (Browne and Fiske 2001).

Carson, B., Dunbar, T., Chenhall, R. D., & Bailie, R. (2007). Social determinants of Indigenous health. Allen & Unwin.

Colonialism has contributed to multiple issues in the lives of Aboriginal people including inadequate housing and clean resources on Aboriginal reserves. One significant outcome is health problems reserve residents face, including a lower life expectancy and higher mortality rate. “For Aboriginal men on reserve, life expectancy is 67.1 years, while off reserve it’s 72. 1, compared to 76 years for the general population of Canada. For Aboriginal women, it is 73.1, 77.7, and 81.5 respectively” (Frohlich et al. 134). Additionally, more than 50% of off reserve Aboriginal people have at least one chronic condition (Frohlich et al.). Reserves stem from the colonial era, where Aboriginal people were displaced by the government and are a continuous symbol of oppression.

The inequalities in today’s indigenous communities are still strongly evident. Heard, Khoo & Birrell (2009), argued that while there has been an attempt in narrowing the gap between Indigenous and non Indigenous Australians, a barrier still exists in appropriate health care reaching indigenous people. The Indigenous people believe, health is more than the individual, it is

Healthcare is an ever changing entity with an ever changing population of clients. In current day 2016, the United Sates has become a melting pot of many different cultural backgrounds, which has led to changes within the system to accommodate the patient base. Unfortunately, not all changes have been able to effectively reach any and all persons from every background. We still see language and cultural barriers that have direct correlation to the inability to seek healthcare and or the ability to change cultural perspectives to ensure healthy lifestyles. Within this paper, the health of American Indian and Alaskan Native populations will be discussed along with the barriers to care and the

Access to the communities is provided year round by Wasaya Airline and airstrips that are maintained by the Ontario Ministry of Transportation. Of course, each Aboriginal community is unique with its own set of traditions and ways of healing but my observation after working within the communities for over ten years is that they all suffer from improperished conditions and substandard housing. The local economies are primarily based upon government services (Indian and Northern Affairs) (INAC) and small business. Most of the reserves have six hundred people or less, and each community has a nursing station. The nursing stations are well-maintained functional buildings built in or about the early 1960’s and are maintained by Health Canada. First Nations and Inuit Health (FNIH) maintains responsibility for primary care services in the majority of the northwest Ontario reserve communities. In the north, nurses are the primary care givers working in an extended scope of practice, and client care is centrally coordinated by nurses working within interdisciplinary teams. The majority of the nursing and medical staff working for FNIH in the Sioux Lookout zone are Caucasian and do not come from local communities. This could outwardly appear as a reinforcement of power relations in the racial identities. There is only very limited cultural training given to employees when they are employed by FNIH. Medical advice and

Social determinants of health are social, economic and physical factors that affect the health of individuals in any given population. There are fourteen social determinants of health but Income is perhaps the most important of these because it shapes living conditions, influences health related behaviors, and determines food security. In Canada, people with lower incomes are more susceptible to disease/ conditions, higher mortality rate, decreased life expectancy and poorer perceived health than people with high incomes. In numerous Canadian studies and reports, there has been more emphasis on health being based on an individual’s characteristics, choices and behaviours, rather than the role that income plays as a social determinant of health. Although Canada has one of the highest income economies in the world and is comprised of a free health care system, many low income families are a burden on the system because of the physical and mental health issues influenced by income insecurity. Low income individuals are heavier users of health care services because they have lower levels of health and more health problems than do people with higher incomes. This essay will address income as a social determinant of health in three key sections: what is known on the issue, why the issue is important and how can health and public policies address the issue. The main theme that runs through the essay is the income related health inequalities among low income groups compared to

Currently there are many problems and flaws with the way the Canadian government’s policies deal with healthcare, income inequality and poverty. Time to time changes in policies have been made, perhaps to improve these issues, however, the gap between rich and poor keeps increasing and there is very little improvement in healthcare and the economy. In fact, healthcare keeps on becoming costly. Major issues like income inequality and poverty are not being taken care of by the government. According to Dr. Raphael (2002) poverty is caused by several reasons such as inequality in people’s income, weak social services and lack of other social supports (p.VI). He states, “Poverty directly harms the health of those with low incomes while income