Addressing Systemic Challenges in Indigenous Healthcare in Canada
In Canada, the state of Indigenous healthcare reflects a complex interplay of historical injustices, systemic biases, and geographical challenges. From systemic racism to lack of representation and inadequate resources, Indigenous communities face numerous barriers when accessing quality healthcare services. Understanding these issues is essential for developing effective solutions and promoting health equity. In this blog, I will delve into some of the numerous challenges faced by Indigenous communities in BC and across Canada, particularly in accessing equitable healthcare services.
Systemic Racism: A troubling legacy of racism against Indigenous peoples has deeply impacted their trust in the healthcare system. Stereotyping and bias often lead to substandard treatment, with Indigenous individuals being unfairly labeled as drug addicts or alcoholics. Cultural sensitivity training (to create awareness among employees to appreciate the value of unique cultures no matter their background) within the healthcare field is crucial for addressing these prejudices and ensuring that Indigenous patients receive respectful and appropriate care. Initiatives like cultural competency training and education on Indigenous experiences can help healthcare professionals better understand and cater to the unique needs of Indigenous communities.
“They treated me like crap and I know it was because I was Native.”
— Goodman et al., 2017
Geographic Location: Many Indigenous communities are situated in remote areas, far from urban healthcare centers. This geographical isolation exacerbates disparities in healthcare access, as residents may struggle to reach quality medical facilities. Improving healthcare infrastructure, expanding telehealth services, and increasing the availability of medical specialists are essential steps towards bridging this gap and ensuring equitable access to care for Indigenous populations.
Referral Bias: Research indicates that physicians are less likely to refer Indigenous patients for further testing compared to individuals from other backgrounds (Wylie & McConkey, 2019). Addressing referral bias requires ongoing efforts to raise awareness among healthcare providers and implement policies that prioritize equitable treatment for all patients, regardless of ethnicity.
Lack of Representation: Indigenous peoples are underrepresented in both the healthcare workforce and genomic research. This lack of representation not only hinders cultural understanding but also limits the effectiveness of medical interventions. Increasing diversity in the healthcare workforce, promoting Indigenous leadership in healthcare initiatives, and ensuring meaningful participation of Indigenous communities in research are crucial steps towards addressing this disparity.
Psychosocial Stress: Socioeconomic factors contribute to higher rates of stress, mental illness, and suicide within Indigenous communities. Economic insecurity, limited access to education, and healthcare affordability issues further compound these challenges. Supporting Indigenous communities with job training programs, increasing access to mental health services, and promoting science-based education initiatives are essential for addressing the root causes of psychosocial stress and improving overall health outcomes.
Research Disparities: Historically, medical research has disproportionately focused on white males, leaving Indigenous peoples underrepresented and marginalized. Initiatives like the Silent Genomes Project in British Columbia aim to address this disparity by providing genomic care to Indigenous families and respecting Indigenous rights over genetic material. Empowering Indigenous communities to reclaim their voice in research and ensuring their inclusion in studies are critical steps toward promoting health equity.
Lack of Voice: Indigenous health needs are often misrepresented by decision-makers who lack cultural understanding and insight. Consulting with Indigenous community leaders and incorporating their perspectives into healthcare policies and programs is essential for ensuring that interventions are culturally appropriate and meet the unique needs of Indigenous communities.
Moving Forward: Collaborative efforts between Indigenous communities, healthcare providers, and policymakers are essential for addressing the systemic challenges facing Indigenous healthcare in Canada. Initiatives like the Silent Genomes Project demonstrate the potential for meaningful collaboration and innovation in improving health outcomes for Indigenous peoples. By prioritizing cultural competency, increasing representation, and promoting equitable access to care, we can work towards a healthcare system that truly serves the needs of all Canadians, regardless of ethnicity or background.
Hope you enjoyed this blog, don’t hesitate to reach out to us in case of questions ubc.hih@gmail.com
References:
Goodman, A., Fleming, K., Markwick, N., Morrison, T., Lagimodiere, L., Kerr, T., & Western Aboriginal Harm Reduction Society (2017). "They treated me like crap and I know it was because I was Native": The healthcare experiences of Aboriginal peoples living in Vancouver's inner city. Social science & medicine (1982), 178, 87–94. https://doi.org/10.1016/j.socscimed.2017.01.053
Wylie, L., & McConkey, S. (2019). Insiders’ insight: Discrimination against indigenous peoples through the eyes of health care professionals. Journal of Racial and Ethnic Health Disparities, 6(1), 37-45. https://doi.org/10.1007/s40615-018-0495-9
By: Kimia Nouhi (Co-Founder and Co-President)
