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Aboriginal health in canada historical cultural and epidemiological perspectives essay

Mark Your Calendar Since the late nineteenth century, the federal government has worked to address the health needs of Aboriginal people.

Introduction to Indigenous peoples in Canada

Although much progress has been made, Aboriginal people as a population do not have the saure level of health as other Canadians. Among other health disparities, they have disproportionately high rates of injury, suicide and diabetes. In remote and isolated areas, where provincially or territorially insured services are not readily available, on-reserve primary and emergency tare services are delivered by the branch.

Non-insured health benefits, such as pharmaceutical and dental coverage, are provided to status First Nations and eligible Inuit irrespective of their residence. Over the last two decades, FNIHB has been working with First Nations and Inuit communities to transfer control of community-based health programs to the communities.

This transfer of control occurs at a pace set by individual communities. The Transfer process allows communities to participate in program design, implementation and operational activities that address their specific needs. Beyond the programs and services offered by Health Canada, the provinces and territories are responsible for providing physician and hospital care to Aboriginal people. This issue of the Health Policy Research Bulletin focuses on collaborative efforts aimed at closing the gaps in health status between Aboriginal people and other Canadians.

It examines the importance of culturally relevant health programs and services and the role that Aboriginal women play in the health of their communities. As well, two case studies highlight some of the ways Health Canada works in partnership with Aboriginal people to improve their overall health status.

The Bulletin is part of a la policy research dissemination program designed to enhance Health Canada's policy-relevant evidence base. A departmental steering committee guides the development of the Bulletin. We welcome your feedback and suggestions. Please forward your comments and any address change; bulletininfo hc-sc.

In Canada, the term Indian has generally been replaced with the term First Nation. First Nation A term that came into common usage in the 1970s to replace the word Indian, which some people found offensive.

Although the term First Nation is widely used, no legal definition of it exists. Status Indians Aboriginal people who are registered or entitled to be registered as "Indians" with the federal government, as determined by certain criteria in the Indian Act.

Non-Status Indians are people who consider themselves Indians or members of a First Nation but whom the federal government does not recognize as Status Indians. In 1985, the federal government amended the Indien Act.

Anisnabe Kekendazone Network Environment for Aboriginal Health Research

Since then, thousands of people who had previously lost their status have been added to the Indian Register. Health Policy Research Bulletin The opinions expressed in these articles, including interpretation of the data, are those of the authors and are not to be aboriginal health in canada historical cultural and epidemiological perspectives essay as official statements of Health Canada.

This publication can be made available in alternative formats upon request. Permission is granted for non-commercial reproduction provided there is a clear acknowledgment of the source. Published under the authority of the Minister of Health.

Publications Mail Agreement Number 4006 9608 Return if undeliverable to: The evidence is fairly overwhelming that the health status of First Nations and Inuit people is not on a par with the rest of Canadians. What are these health disparities and how do you account for them? It's true that First Nations and Inuit people have historically had a poorer health status than other Canadians.

Infectious diseases, injuries, suicide, heart disease and diabetes affect the Aboriginal population at a disproportionate rate see article on page 6. And, while there have been improvements in the life expectancy and infant mortality of Aboriginal people in recent years, their health status remains far below that of the general population. As a result, it continues to be an important focus for researchers and policy makers.

Although there are no clear answers to these continuing disparities, some factors appear relevant. First, Aboriginal people experience inequities in the conditions that determine health, such as lower quality housing, poorer physical environment, lower educational levels, lower socioeconomic status, fewer employment opportunities and weaker community infrastructure.

In order to see sustained health improvements, First Nations and Inuit people need a healthy environment that includes safe housing, clean water and education. Second is geography - many Aboriginal people live in small communities located in rural and remote areas of the country where access to health care services is limited see Figures 1 and 2. Of First Nations and Inuit communities south of the 60th parallel, 77 percent have fewer than 1,000 people.

  • Relational racism refers to racism that occurs in the context of everyday life;
  • The graph is arranged such that the medical diseases are listed on the vertical axis and the potential years of life lost PYLL are listed on the horizontal axis for First Nations and Inuit and Canada;
  • The age standardized death rate for digestive diseases accounts for 33;
  • Aboriginal People Living Off Reserve The 2000-2001 Canadian Community Health Survey CCHS , conducted by Statistics Canada, compared the self-reported health status of Aboriginal people living off reserve with that of the non-Aboriginal population living in the same urban, rural and territorial communities.

The range of basic services offered varies with the degree of isolation and accessibility of the communities. Population Size - First Nations and Inuit Communities To support this part of the article, the pie chart in Figure 1 illustrates the distribution of First Nations and Inuit population by community size. Specifically, the pie chart shows that 77 percent of First Nations and Inuit communities have fewer than 1,000 people.

This chart emphasizes the fact that most First Nations and Inuit people live in small communities. Four types of communities have been defined to reflect varying degrees of isolation and accessibility as follows: Four types of communities have been defined to reflect varying degrees of isolation and accessibility: How can working together with First Nations and Inuit people address these disparities?

Who should be involved? There is great diversity in individual communities and hence in their health service needs. Their participation is essential in addressing disparities in health status. The Eskasoni project in Nova Scotia is an excellent example of a successful multisectoral approach to primary health care see article on page 14.

To accomplish this, the branch works with Aboriginal organizations at the national, provincial, regional and band levels. Each regional FNIHB office has an extensive system of joint committees with the regional First Nations or Inuit groups that plan and manage the programs. As well, most of our programs have First Nations and Inuit representatives on their steering committees.

Aboriginal organizations also work with other branches in Health Canada. For example, Aboriginal aboriginal health in canada historical cultural and epidemiological perspectives essay members are currently participating in an evaluation of the effectiveness of Aboriginal Head Start in Urban and Northern Communities, which is funded by the Population and Public Health Branch see article on page 17.

Why is it so important to have culturally appropriate health services available to First Nations and Inuit People? First Nations and Inuit people view health holistically, as the product of a wide range of interconnected factors, including mental, physical, spiritual and emotional influences, as well as family and community contexts.

Anisnabe Kekendazone Network Environment for Aboriginal Health Research

This perspective on health is not unlike the World Health Organization's definition of health as a "state of complete physical, mental and social well-being". To be effective in restoring or maintaining health, services need to embrace the culture of the people they serve. Therefore, culturally appropriate program design and delivery must be a focus for health programs in any community, taking into account local customs, priorities, language, foods, resources and sensitivities.

Health Canada's Aboriginal Diabetes Initiative is a good example of a culturally sensitive program. It provides a comprehensive, collaborative and integrated approach to decreasing the incidence of diabetes and its associated conditions among Aboriginal people.

ARCHIVED - Closing the Gaps in Aboriginal Health

The article on page 20 elaborates on the importance of culturally relevant health care. In recent years, control over many health programs and services has been transferred from Health Canada to First Nations and Inuit aboriginal health in canada historical cultural and epidemiological perspectives essay.

How did this change come about? The concept of transferring health programs and services has evolved over the past 30 years see article on page 11. Following the 1979 release of the Indian Health Policy, which recognized that First Nations and Inuit people could assume responsibility for administering any or all aspects of their community health programs, Health Canada sponsored a number of demonstration projects in various communities.

These experiences became the basis for the subsequent health services Transfer process, which began in 1989. Evaluations of this process - undertaken in the early and mid-nineties - concluded that it was successful in enabling First Nations and Inuit people to design programs and allocate funds according to community priorities. The Transfer process has had other benefits for communities as well, including an increased awareness of health issues, more integration of programs with the communities' social services, education and justice sectors, and more culturally based programs.

As of January 2002, 70 percent of eligible First Nations and Inuit communities had taken on some degree of responsibility for managing their community health programs.

Of these, 47 percent, representing some 283 communities, had assumed overall management, while 23 percent had taken on more limited control. What types of decisions do policy makers face in providing health services to First Nations and Inuit people? How has past policy research informed these decisions and what type of policy research will be needed to guide future decision making?

Policy makers working in First Nations and Inuit health face the same type of decisions as policy makers working in the general health system. For instance, research on the links between social cohesion and health outcomes has significantly influenced our current policy thinking and has built support for community control of health programs. Finally, we have opportunities to move forward on existing research gaps related to specific topics, such as chronic diseases and environmental contaminants.

We may need to try different ways of conducting research, especially in vey' small communities where conventional approaches may not be appropriate. In the end, our policy decisions must continue to be based on the evidence provided by our research partners and made with the collaboration and participation of First Nations and Inuit individuals, communities and organizations.

First Nations people of all ages have a poorer overall health status than the rest of Canadians. Furthermore, there are major disparities in health status within the First Nations population itself related to gender, age and location of residence. High quality health data is essential to improving the health status of First Nations people.

Footnote 3 The 1999 age-standardized death rates for First Nations people exceeded the 1998 rates for the Canadian population for the following causes of death: After age standardizing the First Nations death rates to the 1991 Canadian population, circulatory diseases surpassed injuries as the leading cause of death.

This aboriginal health in canada historical cultural and epidemiological perspectives essay because the Canadian population as a whole is older than the First Nations population and circulatory diseases are more common in older age groups.

In 1999, the age-standardized death rate from endocrine and immune disorders including deaths related to diabetes was 1. The impact of diabetes in First Nations communities is even more pronounced when considering the age-standardized prevalence "rate" for diabetes among First Nations people.

In all age categories and for both genders, the rate is three to five times higher than that of the Canadian population. Footnote 4 Of particular concern is the increasing incidence rate of Type 2 diabetes, which is now occurring in children as young as 5 to 8 years, although it was previously limited to the adult population. Footnote 5Footnote 6 The First Nations death rate for injuries and poisonings is 2.

In British Columbia, between 1991 and 1997, the First Nations population experienced eight times more fire-related deaths, four times more drownings, five times more homicides and three times more fatal falls than all residents of the province combined. Footnote 7 In 1997, the tuberculosis rate among First Nations was eight times higher than that for the Canadian population. One reason for this is the overcrowded housing conditions in many communities that may increase the risk of exposure to infected individuals see Figure 1.

Communities with overcrowded housing conditions, inadequate sewage disposal and lack of running water are also at increased risk for outbreaks of hepatitis A.

Figure 2 shows the rates of selected infectious diseases for the First Nations and Canadian populations.

The Health of Indigenous Peoples in Canada

One statistic that is not shown is the 1999 incidence rate for chlamydia, which was seven times higher in First Nations living on reserve than for all Canadians. The graph displays the First Nations tuberculosis incidence rate per 100,000 people and the distribution of the First Nations population by community housing density.

On the horizontal axis is persons per room a measure of community housing densityon the left vertical axis is the population in thousands and on the right vertical axis is the tuberculosis incidence rate per 100,000.

The graph shows, for example that less than 10,000 First Nations people live in communities with a housing density of 0.