Towards Healthier Aboriginal Health Policies? Navigating the Labyrinth for Answers (original) (raw)
Related papers
Towards healthier Indigenous health policies? Navigating the labyrinth for answers
2017
This research is based on two years of community-based participatory research that draws on Indigenous understandings of health policy in five First Nations in Ontario, Canada. While a number of policies have been put in place to increase Indigenous control over community health services, we argue that policies enacted to promote Indigenous self-determination in health care have been counterproductive and detrimental to Indigenous health and wellbeing. Instead, we suggest that Indigenous health policy exists on a continuum and aim to balance the need for including diverse Indigenous groups with comprehensive control from program funding and design to implementation. This poses some difficult questions: How do Indigenous peoples perceive the concept of self-determination, community-controlled health care and the efforts of the Canadian government to form collaborative arrangements between Indigenous communities, organisations and government? What does an inclusive and comprehensive I...
Missing Pathways to Self-Governance: Aboriginal Health Policy in British Columbia
International Indigenous Policy Journal, 2015
This article explores how current policy shifts in British Columbia, Canada highlight an important gap in Canadian self-government discussions to date. The analysis presented draws on insights gained from a larger study that explored the policy contexts influencing the evolving roles of two long-standing urban Aboriginal health centres in British Columbia. We apply a policy framework to analyze current discussions occurring in British Columbia and contrast these with Ontario, Canada and the New Zealand Māori health policy context. Our findings show that New Zealand and Ontario have mechanisms to engage both nation-or tribal-based and urban Indigenous communities in self-government discussions. These mechanisms contrast with the policies influencing discussions in the British Columbian context. We discuss policy implications relevant to other Indigenous policy contexts, jurisdictions, and groups.
First Nations involvement in health policy decision-making : the paradox of meaningful involvement
2016
Alongside consistent reporting on health inequities affecting Indigenous peoples in Canada, Indigenous people have been routinely excluded from health policy decision-making. This pattern of exclusion perpetuates health policy decisions that are often ineffective at addressing the root causes of persistent health inequities. Despite Indigenous peoples’ repeated calls to be meaningfully involved, and the emergence of health policy initiatives that include Indigenous peoples, the influence of neoliberalism and neocolonialism in the Canadian policy sphere continues to undermine self-determination and limit Indigenous peoples’ involvement in health policy processes. Those advocating for Indigenous health equity are left wrestling with the question: What constitutes, and what can foster, meaningful involvement in the contemporary health policy climate? This exploratory qualitative research aims to provide a window of insight into this urgent social justice question by exploring the persp...
Canadian Journal of Public Health, 2016
OBJECTIVES: This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada. METHODS: This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. RESULTS: When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings. CONCLUSIONS: Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.
Policy silences: why Canada needs a National First Nations, Inuit and Métis health policy
International journal of circumpolar health, 2013
Despite attempts, policy silences continue to create barriers to addressing the healthcare needs of First Nations, Inuit and Métis. The purpose of this article is to answer the question, if what we have in Canada is an Aboriginal health policy patchwork that fails to address inequities, then what would a Healthy Aboriginal Health Policy framework look like? The data collected included federal, provincial and territorial health policies and legislation that contain Aboriginal, First Nation, Inuit and/or Métis-specific provisions available on the internet. Key websites included the Parliamentary Library, federal, provincial and territorial health and Aboriginal websites, as well as the Department of Justice Canada, Statistics Canada and the Aboriginal Canada Portal. The Indian Act gives the Governor in Council the authority to make health regulations. The First Nations and Inuit Health Branch (FNIHB) of Health Canada historically provided health services to First Nations and Inuit, as...
International Indigenous Policy Journal, 2019
Indigenous Peoples experience the greatest health inequities in Canada and other colonized countries, yet are routinely excluded from health-related policy decisions. Those advocating for Indigenous health equity are often left wrestling with the question: What constitutes, and what can foster, meaningful involvement of Indigenous Peoples in the contemporary health policy climate? Twenty (n = 20) in-depth, open-ended interviews with Indigenous and non-Indigenous leaders in health and health policy were conducted with a view to understanding what constitutes meaningful involvement of Indigenous Peoples in health policy decision-making. The analysis suggests meaningful involvement requires attuning to underlying power dynamics inherent in policy making and taking action to decolonize and transform the policy system itself. Based on these findings, the authors offer a framework for meaningful involvement.
Challenges in health equity for Indigenous peoples in Canada
The Lancet, 2018
Challenges in health equity for Indigenous peoples in Canada Canada's health-care system, like the country itself, is a complex entity. As the two papers in The Lancet's Series on Canada 1,2 make clear, the country's healthcare landscape is made up of multiple people, places, and policies with often overlapping-and sometimes conflicting-jurisdictions, priorities, paradigms, and practices. These complexities are rooted in Canada's fairly young colonial history that resulted in a nation comprised of a majority of settler and recent immigrants and their descendants, alongside a steady resurgence of Indigenous populations of First Nations, Inuit, and Métis peoples that are growing in numbers, political acumen, and agency. Our response to these Series papers is situated in this context. It is informed by our work as academics and researchers in Indigenous public health. We are, individually, an Indigenous grandmother, a daughter of a recent immigrant, and a descendant of early settlers raising a young family with a non-Canadian partner. Our perspectives represent a small slice of Canada's diverse populations and the complexities of health-care users. The two Series papers raise important points about the strengths of Canada's health-care system and the continuing health inequities the country must find ways to address. Some of the inequity challenges are persistent precisely because of their complexity and opacity. This year marks a decade since the watershed WHO report Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health, 3 which set out a 20-year roadmap for improving health equity globally for marginalised populations and acknowledged complexity as a driver of inequity. Recognising dramatic improvements in health in the last 30 years, the WHO report 3 nevertheless called for action to close the gap of population health inequities existing between and within countries. Canada has led health equity work domestically through its universal health-care system 1 and internationally through alliance building and collective action. 2 Still, deep inequities persist in wellness indicators and access to health care for Indigenous populations in Canada. As Danielle Martin and colleagues 1 point out, pride in the Canadian health-care system is based on an "implicit social contract between governments, healthcare providers, and the public-one that demands a shared and ongoing commitment to equity and solidarity". We remain curious about that implicit social contract: to
Patches of equity : policy and financing of indigenous primary health care providers in Canada
2005
This thesis investigates how the governments of Canada, Australia and New Zealand balance the ideal of indigenous self-determination with other pressures, such as current trends in public administration and accountability, pressures on the health care system, issues of and sensitivities around minority rights, equity in health and cost-efficiency. It is based on four case studies conducted in Australia and New Zealand. The Canadian material is drawn from both the literature and a period of twelve years working in indigenous-controlled health services. All three governments have made some policy commitments to increased indigenous participation and self-determination, in the pursuit of health gains. The goal is a more responsive health care system. Self-determination is often mentioned. In Australia and New Zealand, the commitment extends to primary, secondary and tertiary care. Canada focuses exclusively on improving the responsiveness of on-reserve primary health care services. The...
Indigenous-led health care partnerships in Canada
Canadian Medical Association Journal, 2020
Too many First Nations, Inuit and Métis Peoples in Canada face alarming health inequities, subpar access to health care, and culturally discontinuous services — a legacy of the sociohistorical realities of colonialism and racism that included systematic suppression of traditional Indigenous health knowledge and healing practices. The 2015 Calls to Action of the Truth and Reconciliation Commission of Canada under- scored an urgent need for full health care rights for Indigenous Peoples, the elimination of health disparities, antiracist decolonization of the health sector, and self-determination in use of and access to traditional knowledge, therapies and healing practices. Indeed, Call to Action 22 states, “We call upon those who can effect change within the Canadian health care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.”
Healthcare, 2020
The objective of this review is to document contemporary barriers to accessing healthcare faced by Indigenous people of Canada and approaches taken to mitigate these concerns. A narrative review of the literature was conducted. Barriers to healthcare access and mitigating strategies were aligned into three categories: proximal, intermediate, and distal barriers. Proximal barriers include geography, education attainment, and negative bias among healthcare professionals resulting in a lack of or inadequate immediate care in Indigenous communities. Intermediate barriers comprise of employment and income inequities and health education systems that are not accessible to Indigenous people. Distal barriers include colonialism, racism and social exclusion, resulting in limited involvement of Indigenous people in policy making and planning to address community healthcare needs. Several mitigation strategies initiated across Canada to address the inequitable health concerns include allocatio...