Future Implications of this issue for Nursing Practice
Personal Health Practices and Coping Skills
Aboriginal Health in Canada
- Through the Residential School system it has led to severe trauma that is currently still being passed through generations beyond the survivor. The type of trauma varies throughout each survivor from depression, anxiety, and substance abuse.
Biology and Genetics
- Social access to health care similarly limited or denied to Aboriginal people through health systems that account for neither culture nor language, or the social or economic determinants of Aboriginal peoples' health. An approach to personal coping mechanisms can be spiritually, psychological, or physical depending on their preference. Also, what is in their best interest in order to heal properly and most efficiently.
Early 1940s, diabetes was rare among the Aboriginal population but has rapidly increased after 1950s....
Why is this?
A phenomenon proposed:
"Thrifty gene effect: genes that enable individuals to collect and process food to deposit fat during periods of food abundance in order to provide for periods of food shortage"
Education and Literacy
- "In the 1870's, the Federal government and churches operated over 130 residential schools for Aboriginal (First Nations, Inuit, and Metis) children across Canada. Aboriginal children were taken from their home, often forcibly removed and separated from their families. Residential schools was to educate, assimilate and integrate Aboriginal people into Canadian society. They were forbidden to speak their language or practice their culture or they were be punished."
Healthy Child Development
The term Aboriginal peoples includes:
• First Nations
• Inuit
• Métis
Each has their own unique culture, spiritual beliefs, and languages.
- “The early child period is considered to be the most important developmental phase throughout the lifespan… healthy early childhood development strongly influences well-being, obesity/stunting, mental health, heart disease, competence in literacy and numeracy, criminality, and economic participation throughout life”- World Health Organization
- “It is a cycle of abuse and its roots lie in factors such as: colonisation, oppression, intergenerational trauma and the ongoing experiences of racism and discrimination”
- “Lateral violence has impacted indigenous peoples throughout the world to the point of where we harm each other in our communities and workplaces on a daily basis.” – Rod Jeffries
Social Support Networks
- "In 2011, 28.9% of the Aboriginal population aged 25 to 64 did not have a high school diploma or equivalent compared to 12.1% for their non-Aboriginal counterparts."
- Today the percentage of Aboriginal people 15 years of age and over who completed less than a high school education is in the order of 50%, compared to 30% for other Canadians. Inadequate education often includes poor literacy and often resulting in low paying jobs.
Social Environments
- Families, friends, communities and culture are all factors that effect health
- In 1951, Aboriginal Children represented 1% of children in care in B.C.
- By 1964 it jumped to 34%
- In 1980s a report from Canadian Council on Social Development found Aboriginal children in care were over represented and accounted for 60-70% of all children in care in Saskatchewan, 50-60% in Manitoba, 40-50% in Alberta
- In 2003 approx. 30-40% of children in foster homes across Canada, were Aboriginal Children.
- Aboriginal Children in care are less likely to be adopted, and when they are the children are likely to be adopted into non-aboriginal families
- Dispossession of cultural traditions, social inequities, prejudice and discrimination have contributed to the challenges that Aboriginal people of Canada are currently facing
- Gaps that are persisting between the social and economic conditions of Aboriginal peoples in Canada and those of the general Canadian Populations continue to pose challenges.
Physical Environments
- play a primary role in determining health populations
- Physical environments for Aboriginal peoples have been largely detrimental to health. e.g. reserves and settlement structure.
- Substantial housing shortages and poor quality of existing homes
- Lack of housing= overcrowding and homelessness
- Crowding has been linked to a number of health outcomes.
- Substance abuse is more prevalant in remote Aboriginal communities compared to the general population of Canada.
- First Nations communities that participated in a survey between 2008 and 2010 reported drug and alcohol abuse as the number one challenge for community wellness
- Death due to alcohol use in Aboriginal peoples is twice the rate of the general population of Canada.
- Suicide rates in Inuit and First Nations people are much higher than the national average.
- Substance abuse may contribute to crime rates.
Employment and Working Conditions
Culture
These statistics from the publication An Overview of Aboriginal Health in Canada show the disparities between Aboriginal people and non Aboriginal people.
-2005 median income for Aboriginal people was almost $10,000 lower ($16,752) than for non-Aboriginal people ($25,955) (p. 4).
-the unemployment rate for Aboriginal people in 2006 was still more than twice that for non-Aboriginal people (13.0% compared to 5.2%) (p. 4).
-Employment status also varies depending on Aboriginal identity, geography, and gender (National Collaborating Centre for Aboriginal Health (NCCAH), 2009-2010, p. 1).
Income and Social Status
- “Some persons or groups may face additional health risks due to a socio-economic environment, which is largely determined by dominant cultural values that contribute to the perpetuation of conditions such as marginalization, stigmatization, loss or devaluation of language and culture and lack of access to culturally appropriate health care and services.”
- •Culture is defined as ones spiritual beliefs, ethnicity, language, geographic origin etc.
- “since 1979, infant mortality rates among First Nations people in 1994 were still twice as high as among the Canadian population as a whole"
- • Loss of culture in the Aboriginal community affected their eating habits, and their current eating habits can greatly impact their health negatively
- "the prevalence of major chronic diseases, including diabetes, heart problems, cancer hypertension and arthritis/rheumatism, is significantly higher in Aboriginal communities and appears to be increasing.”
- Data from Canada's last three censuses show that Aboriginal Peoples are ranked among the poorest of Canadians, an aftereffect of colonialism.
- In 2006, the median income for Aboriginal peoples was 30% lower than the rest of the Canadian population
- Non-Aboriginal people working on urban reserves earn 34% more than First Nations workers, and on rural reserves the difference was an astonishing 88% more.
- 32% of the Aboriginal population does not have a secondary school diploma, compared to 15% of the rest of Canada.
Health Service
Gender
According to the Romanow Report, in regard to Aboriginal health, there is "Fragmented funding for health services, and inadequate access to health care services" (p. 212).
- Some services are provided through the Non-insured Health Benefits (NIHB) program. (Allan & Smylie, 2015, p. 9)
-Racism is prevalent in the healthcare system (Ibid.).
Our presentation on Aboriginal health in Canada is framed by the 12 determinants of health.