This month, Indigenous leaders have had a lot to say about actions taken by the federal government. Trudeau’s recent address to the Assembly of First Nations resulted in praise, criticism, and calls for patience. One of the issues that’s been discussed most is health care. And with good reason.
There are major gaps in health status between Indigenous and non-Indigenous people in Canada. This fact cannot be denied. Recent reports have drawn attention to the substandard care available in many remote First Nations communities. Where such inequality exists, there are bound to be serious consequences.
Today, amongst Indigenous people, the rates of many diseases are far above Canadian averages. when it comes to improving overall health on First Nations, lowering these numbers should be one the government’s major priorities.
In this post, we’ll look at five diseases that are having a negative impact on the health of Indigenous peoples. Focusing specifically on remote First Nations communities, we’ll consider whether the federal government is asking the right questions.
Diabetes is on the rise in communities across Canada, but First Nations are being hit particularly hard. Expert Dr. Stewart Harris describes the disease’s rate of increase in the Indigenous population as “horrendously high”. Harris notes that up to 40% of adults living on First Nations reserves have been condition.
In these communities, obesity is common. Nutritious food is frequently unaffordable. And poverty is very often a fact of life. These factors are closely related – and significant.
Consider this: 57% of Canadians admit that they don’t adhere to prescribed self-care plans due to the high costs involved. Medications and other diabetes-management supplies can be expensive. In communities where poverty levels are high, financial burden can be an obstacle to appropriate self care. That is, when access to health services is sufficient to lead to diagnosis in the first place.
But what about prevention? The federal Aboriginal Diabetes Initiative (ADI) is an ongoing program that focuses largely on education. Unfortunately, while preventative education is crucial, current diabetes rates clearly indicate that there’s a lot more work to be done.
Canadian governments may want to focus on tools and worker training that improves remote support for self management. Funding for IT could reduce costs – and, more importantly, complications for patients – in the long run.
According to the Heart Research Institute, Indigenous people are twice as likely to get cardiovascular disease than non-indigenous Canadians. Not only that, but First Nation and Inuit patients generally have heart attacks earlier in life.
Many of the factors that contribute to diabetes can also cause heart disease, and the two often occur together. Patients with both diseases frequently require more health care – including services they may not have access to in the community. They may also need to adhere to complicated self-care plans, which can lead additional challenges. This is yet another reason to focus on prevention.
One contributing factor for many people with heart disease is smoking. Research shows that smoking rates, like heart disease rates, are about twice as high in First Nations communities. Clearly, developing programs that provide education and support for smoking cessation – and other healthy lifestyle choices – has the potential to improve health on First Nations.
Of course, there are challenges. Various social factors help determine whether a person will succeed (or even attempt) to make make healthy decisions. Remoteness is one factor. Setting up sustainable programs in communities that exist far away from city centres can be difficult.
How well can we really prevent heart disease in remote places? And in these regions, is it possible to provide appropriate care and support after a heart attack? In many cases, the answer is yes. Finding ways to connect health care providers – wherever they practice – to patients in the community is the answer.
A recent study indicates that First Nations have lower five-year cancer survival rates than other communities in Canada. This finding applies to 14 of the 15 most common forms of cancer.
Once again, prevention is important. But survival rates often relate to quality of treatment and how late diagnosis occurs. So what can we take away from a large survival rate discrepancy? The results of the study, which was published in Cancer Epidemiology, Biomarkers, and Prevention, raise many questions, but provide few answers.
Another report, also released this year, concluded that cancer rates are higher in First Nations than they are in Ontario’s general population. The findings, discovered through a study by Cancer Care Ontario and the Chiefs of Ontario, weren’t very specific. According to the CBC, there “[wasn’t] enough data to determine how much higher the cancer diagnosis or death rates are”.
The question is, why? Across the country, health care providers see the affects that cancer has on Indigenous patients firsthand. The fact that the results of these studies qualify as news should be surprising. But it’s not.
The recent death of five-year-old Brody Meekis made a lot of headlines. In Sandy Lake First Nation, the boy received treatment that failed to save his life. He succumbed to strep throat – an infection that’s easily treatable with antibiotics in most of the developed world.
Stories involving the spread and improper treatment of infectious diseases in First Nations communities aren’t hard to find. And for every story, there are sobering statistics. For example: the rate of tuberculosis among First Nations people is five times higher that the national average – and it’s 50 times higher among the Inuit population.
In recent years, the international spotlight has also highlighted the growing prevalence of HIV on reserves. HIV rates are eleven times higher on Saskatchewan First Nations than they are in Canada generally.
Factors such as socioeconomic status, living conditions, and access to treatment and diagnostic services all impact the spread of infectious diseases. Justin Trudeau has verbally recognized these factors, as well as a host of others, as they relate to health on First Nations. He has acknowledged the ways in which history continues to perpetuate inequality and create daunting challenges – many of which are health related.
But is recognition enough? Are speeches and meetings really the first steps toward improving the health of people who live on First Nations – and Indigenous people in general?
When it comes to support from Indigenous communities, this has been a year of ups and downs for the Trudeau administration. There’s been plenty of praise for the prime minister’s stated dedication to improving the relationship between Canada and Indigenous peoples.
But when it comes to health care, there have also been criticisms. While combatting the diseases listed above is sure to take time, some Indigenous health care advocates say the government could be doing more. Like, for example, ensuring that Jordan’s Principle is enacted consistently.
Opinions are mixed, but one thing is clear. Canadian governments and the First Nations communities impacted by them will have to work together to create lasting change.
When it comes to health on First Nations, change might mean investing in health services infrastructure in communities. It might mean finding better ways to tailor and present educational programs related to disease prevention. It could also mean investing in cost-effective technologies that connect medical professionals directly to First Nations patients who need support.
We can’t know what the future will hold. But it’s obvious that the time for action is now.
Feature image courtesy of cchana