In Canada, health care is socially determined. More precisely, health care for Indigenous communities faces several barriers that generate disproportionate health statistics compared to non-Indigenous Canadians. Indigenous people have a lower life expectancy and are at a greater risk of developing chronic and infectious diseases.

They also experience higher rates of mental health issues, as well as substance abuse and are more likely to be discriminated against by health care professionals.

The Barriers

One of the greatest barriers for Indigenous communities seeking health care is geography, especially for those living off-reserve and in remote areas. In a survey conducted by Statistics Canada, more than half of Inuit respondents reported having to travel more than 1,500 kilometers to access health care. In that same survey, one in five Indigenous people reported experiencing discrimination and racism by health care professionals.

In some cases, this prejudice would lead to inadequate care, misdiagnoses and negatively impact mental health. Health care for Indigenous communities also falls short when it comes to diseases. Indigenous peoples have a higher risk of developing chronic diseases such as diabetes. cardiovascular diseases and respiratory illnesses compared to non-Indigenous Canadians.

This is partially due to the aforementioned health care barriers and can also be attributed to intergenerational trauma and forced erasure of traditional medicinal practices.

The Case of Joyce Echaquan

Joyce Echaquan’s death on September 28, 2020, at the Joliette Hospital Center in Quebec is one fatal instance of racial discrimination against Indigenous peoples by health care professionals. Echaquan, a 37-year-old Atikamekw woman and mother of seven, went to the hospital for severe stomach pain. She recorded hospital staff verbally berating her on her phone and passed away shortly after posting the video to social media.

Her case received widespread media attention and prompted protests, marches and vigils in Montreal and surrounding Quebec cities to bring hospital staff to justice. A call to action in her name, the Joyce’s Principle, “aims to guarantee to all Indigenous people the right of equitable action, without any discrimination, to all social and health services.” The Joyce Principle has since been adopted by the federal government and by universities such as McGill.

The Canadian Medical Association (CMA) covered her story in its historical and ethical review report and apology to Indigenous peoples released in 2023.

Indigenous-Led Initiatives

Indigenous representatives across Canada are calling for more initiatives led by their own communities to ensure that health care is delivered in a culturally safe way. The First Nations Health Authority (FNHA) in British Columbia is one such initiative. It is the only health authority in Canada to operate on a provincial scale and its mission is to establish culturally safe care by managing and funding health programs.

It has been successful in operating clinics and health centers across the province and in encouraging respectful collaboration with Indigenous people since 2013. Similar initiatives, such as the Keewatinohk Inniniw Minoayawin (KIM) in Manitoba and the Sioux Lookout First Nations Health Authority (SLFNHA) in Ontario, aim to provide culturally safe health care at the provincial level, on par with the FNHA.

– Brittany Buscio

Brittany is based in Montreal, Canada and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr