By Steve Barnes and Jo Snyder
It is well established that a variety of social and economic factors influence our health, things like our income, education, employment status, and even our neighbourhood. And it is also well established that some populations face greater barriers to good health, populations like recent immigrants, women, and racialized Canadians.
But we don’t talk enough, or rather do enough, about the health of Aboriginal Canadians who face some of the most significant barriers to good health and, consequently, experience the greatest health inequities. This is set out in a new report by the Health Council of Canada that shows that the health system itself creates barriers to health for Aboriginal people.
The report shows that Aboriginal people do not feel safe from stereotyping and racism within the health care system. This includes a lack of understanding of both Aboriginal culture, but also the systemic racism within which Canada’s First Nation’s live. Aboriginal people are therefore less likely to seek care and are more likely to be diagnosed at a later stage of illness and to stop treatment before it is completed, meaning that less serious health conditions remain untreated and then become more serious.
This raises important questions about how we can ensure that all people in Canada receive equitable care. The Health Council of Canada report argues that cultural competency – creating health care environments that are free of racism and stereotypes, where Aboriginal people are treated with empathy, dignity, and respect – is critical for ensuring that Aboriginal people receive appropriate health care services. Cultural safety – an outcome that is premised on people receiving care feeling safe at every point and that acknowledges the role of culture and power – also plays an important role in ensuring full health care access.
Canada is a treaty nation. It is shameful that we have made so little progress despite knowing that there is a problem and how to fix it. Health care in Canada is colour coded, but we don’t talk enough about or take enough action on the place of Aboriginal Canadians in that colour code. Of course, health care access is only one piece of this terribly broken puzzle. Many other social determinants of health are made worse by issues of racism in our country: poor housing, lack of access to education and healthy food, and neighbourhoods that discourage community and are run-down and unsafe.
The problem has been clearly acknowledged, so now let’s do something about it.