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Aboriginal Women's Health Issues

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on 17 October 2016

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Transcript of Aboriginal Women's Health Issues

Aboriginal Women's Health Issues
October 22, 2013

4. Sexual and Reproductive Health
3. Mental Health and Substance Abuse
Aboriginal women are two times more likely to experience depression than Aboriginal men

Post-Traumatic Stress Disorder
• Aboriginal women exposed to violence are two times more likely to develop PTSD than are Aboriginal men exposed to violence
• Many of these women are over prescribed benzodiazepines, leading to severe side effects
Centers of Excellence for Women's Health, 2006.
5. Chronic Disease
• An emerging public health concern Canadians
• Increased rates of morbidity and mortality
• Associated factors include:
Lower quality housing
Lack of access to health care
Lower educational levels
Decreased opportunities of employment

Aboriginal females attempt suicide more often than men
19% females compared to 13% males (HereToHelp, 2008.)
Lack of Resources
• Lack of family members, friends and community
• Fear of having children taken away
• Repeatedly put on waiting lists at mental health clinics
• Often go unheard until a suicide attempt has been made
(Stout, 2010)
Pregnancy and Birth Outcomes
Known risk factors for adverse pregnancy outcome were more common among Aboriginal than non-Aboriginal women (Wenman et al., 2004)
However, there was no statistically significant relation between Aboriginal status and birth outcome

Diet and lifestyle
Female body fat (Leslie, Weiler, & Nyomba, 2007)
Important predictor for illnesses

2/3 of Canadian Aboriginal diabetics are women (Leslie, Weiler, & Nyomba, 2007)
Women suffer from gestational diabetes mellitus (GDM)
Effects on mother and child

Diabetes in the Cree Community in Northern Quebec
Characterized by people with “Serious Addiction and Mental Illness” (Spaxman, 2009)

Downtown Eastside, Vancouver
Survival, Strength, Sisterhood: Power of Women in the Downtown Eastside
~70% of sex workers in the Downtown Eastside are Aboriginal women (Culhane, 2003)

Sheway: a model program for substance-using pregnant women
Focuses on improving infant, child, and maternal health
70% of patients Aboriginal women (Benoit et al., 2003)
Why so successful?
More akin to traditional Aboriginal health structures
Assists in fulfilling basic needs
Everything is available on site (doctors, child development workers)

Conclusion: Resources for Aborginal Women in Montreal
Native Women’s Shelter of Montreal
In house clinics
HIV/AIDS risk reduction counseling
Traditional Healer
Offer accompaniments to appointments for diagnosis, care, treatment and social support

1. Healthcare
Health care promotion programs
Non-insured health benefit (Health Canada, 2004)
Provided largely by the First Nations and Inuit Health Branch (of the Health Canada organization) (Health Canada, 2013)
Barriers to Healthcare
(Health Council of Canada, 2012)
2. Violence
Fact: Aboriginal women are the most at risk group in Canada for issues related to violence (NWAC, 2010)

Rate per 1,000 Female Population age 15 or older Statistics Canada, 2009
Why are Rates of Abuse Higher for Aborginal Women ?
Higher rates of risk factors:
Younger populations
Lower average income
Higher rates of alcohol abuse
More common law relationships
Factors that are linked to violence in indigenous communities:
Discrimination against indigenous peoples
Economic and social deprivation
Alcohol and substance abuse
Intergenerational cycle of violence (Erturk, 2008)

Main Issue with Solving the Problem
Insufficient data
Patriarchal legislation (NWAC, 2009)
Barriers to Getting Support
Legal Issues (NACAFV, 2006)
Breast Cancer
Aboriginal women are more likely to be diagnosed at an advanced stage of breast cancer than non-Aboriginal women
Can you come up with any possible reasons?

Breast Cancer Study
12.8% to 18.6% of Cree women develop GDM compared to 2% to 4% in the general population
1/3 of newborn infants are overweight

• Conducted in Ontario in 2010
FN women were diagnosed with advanced stage breast cancer more often than non-FN women
FN women who were overweight or obese were more likely to be diagnosed at a later stage

Substance Abuse
• Leading factor in teen pregnancy among Aboriginal women
• High rates of substance abuse during pregnancy
Babies with Fetal Alcohol Syndrome
(HereToHelp, 2009)
Violence: Aboriginal women are 3.5 times more likely to experience violence than non-Aboriginal women
(Statistics Canada, 2004)
Mortality due to violence: Aboriginal women are 3 times more likely than other Canadian women to die from violence.(Statistics Canada, 2004)
Spousal assault: Aboriginal women are more than 3 times more likely than non-Aboriginal women to experience spousal assault.
(Statistics Canada, 2004)
Family violence: Aboriginal women are 1.5 times more likely to experience severe forms of family violence than non-Aboriginals (beaten, choked, or being sexually assaulted, etc.)
(Statistics Canada, 2004)
Homicide: The rate of homicide of Aboriginal females is almost seven times higher than those of non-Aboriginal females (between 1997-2000)
(Statistics Canada, 2004)
First Nations women use cervical Pap screens less than non-First Nations women
They also experience higher rates of cervical cancer
First Nations women were more likely to get Pap tests if they completed high school and had a history of suicide and substance addiction (Figs et al., 2012)

Aboriginal IV drug users are becoming HIV positive at twice the rate of non-Aboriginals (Craib et al., 2003)
Aboriginal women represent 45% of positive test results among Aboriginals; whereas, only 20% of the non-Aboriginal population with HIV are female (McCall et al., 2009)
Description of the Issue
There is consistent data that links Aboriginal women to poor health
Roughly 40% of First Nations adults perceive that they have less access to health services
Serious health consequences: Type 2 diabetes, cervical cancer, HIV/AIDS, mental health issues, disability, co-morbidity (FNIGC, 2012)

Aboriginal Population
Aboriginal: First Nations, Métis, & Inuit
Current Population: 1.4 million, 4.3% of Canadian population (Statistics Canada, 2011)

Status vs. Non-Status
Of 1.4 million, 697.5 thousand have Status
What are the health implications of having or not having Status?

Rural vs. Urban | On-reserve vs. Off-reserve
Geographic location very meaningful for health issues and life experience
Access, history, community
Nearly 50% of FN live on reserve
Nearly 75% of Inuit live on reserve (Statistics Canada, 2011)

Social Determinants of Health
Integrated approach
Physical, emotional, mental, and spiritual dimensions
Influenced by a broad range of social determinants
Distal, intermediate, and proximal

Proximal Determinants (Health behaviours, physical and social environment)
Distal Determinants (Historic, political, social, and economic)
Native Friendship Centre of Montreal
Non-profit community development agency
Promote, develop, enhance
Temporary shelter, support, or referral services
Mandate to serve urban Aboriginal people, their families, and those in need of assistance or referral
Projects: Day Centre, Street Patrol, ITYC
Family Violence Resources
The Healing Journey
Aboriginal transition houses and family violence crises lines
Legal aid services, legal clinics and legal information services
Family mediation services
Native courtworker programs
Provincial agencies and government departments
Victim assistance programs
Network Vision
Improve the quality of life of Aboriginal people living in the greater Montreal area
Act as the decisional body and provide opportunities for organizations
Montreal Urban Aboriginal Health Committee
5 year strategic plan
Trying to set up an Urban Aboriginal Health Centre based on the Anishnawbe Health Centre in Toronto

Case Study: Aboriginals and The Downtown Eastside, Vancouver
70% of Vancouver’s Aboriginal population live in the Downtown Eastside (Joseph, 1999)
Aboriginal people make up 40% of the Downtown Eastside residents
1 male:1 female

Intermediate Determinants (Community infrastructure, resources, systems and capacities)
(Loppie, C., & Wien, F., 2009)
(Loppie, C., & Wien, F., 2009)
(Loppie, C., & Wien, F., 2009)
'Health Inequalities and Social Determinants of Aboriginal Peoples' Health'. (Loppie, C., & Wien, F., 2009)
Mental health of residential school survivors:
98% have a mental illness
26.3% have problems with substance abuse
64.2% have Post Traumatic Stress Disorder
30.4% have experienced a major depression
26.1% have chronic depression
(Mood Disorders Society of Canada, 2009)

Clear health disparities
Vary geographically
Interaction between social determinants
Idle No More Movement
Thank You!
Clear health disparities
Vary geographically
Interaction between social determinants
Idle No More Movement
(Statistics Canada, 2009)
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