HHSC after midterm 1

Indigenous peoples of Canada

The 'Indigenous peoples' collectively refers to the original inhabitants of Canada and their descendants, including First Nations, Inuit, Métis, and other distinct groups. In 2016, approximately 1,673,780 Indigenous people lived in Canada, making up 4.9% of the population.

First Nations Overview

First Nations encompasses many distinct cultural groups, with 630 distinct communities and around 60 different languages. In 2016, there were about 977,000 First Nations people in Canada, with 44% living on reserves and 56% living off-reserve, mostly in urban areas.

Inuit Overview

Inuit are the original inhabitants of the Arctic regions of Canada. In 2016, there were around 65,025 Inuit people, with most living in traditional territories like the Inuit Nunangat (northern Labrador, Quebec, Nunavut, northern Northwest Territories, and Yukon). 64% of Inuit people still speak an Inuit language.

Métis Overview

Métis people are of mixed European and First Nations heritage, descendants of 18th-century fur traders and Indigenous people. In 2016, there were about 587,545 Métis people in Canada.

Status vs. Non-Status First Nations People

The 1876 Indian Act defines who is a 'status Indian' and eligible for certain government programs and services. First Nations people must register with the federal government to be considered 'status Indians.' In 2016, 23.8% of First Nations people were not registered or Treaty Indians (non-status).

Métis and Inuit Eligibility for Status

Métis and Inuit are not eligible for 'Indian status' under the Indian Act. Some Inuit people are covered under other land claim agreements.

Health Care for Status Indians

Status Indians receive healthcare through provincial healthcare plans, with additional benefits like prescription drugs, dental care, and mental health services through Health Canada's Non-Insured Health Benefits program. In BC, status Indians register with the First Nations Health Authority since 2013 for healthcare services.

Health Data in Indigenous Populations

Data on Indigenous health is inconsistent and often incomplete due to regional restrictions, missing subpopulations, and misreporting. Despite being one of the most vulnerable populations, insufficient effort has been made to collect comprehensive health data on Indigenous people.

Health Perception in Indigenous Canadians

Indigenous people generally perceive their health to be worse than non-Indigenous people. Only 50% of off-reserve First Nations, 54% of Métis, and 55% of Inuit report 'very good' or 'excellent' health.

Life Expectancy in Indigenous Canadians

Indigenous populations have a lower life expectancy than the Canadian average, with both men and women affected.

Lifestyle Factors in Indigenous Canadians

Indigenous populations report higher rates of daily smoking (30-39%), heavy drinking (26-27%), and inactivity (39-49%) compared to non-Indigenous populations. Obesity rates are higher among Indigenous populations, with 25% of Indigenous people being obese.

Chronic Diseases in Indigenous Canadians

Chronic diseases are prevalent in First Nations populations, including hypertension (21.8%), arthritis (19.9%), allergies (18%), diabetes (16.2%), and heart disease (5.7%). 62.6% of First Nations adults report having at least one chronic condition.

Diabetes in Indigenous Canadians

Diabetes rates, especially Type 2, are significantly higher in First Nations populations, likely influenced by diet, lifestyle, and possibly genetic factors.

Suicide in Indigenous Communities

Suicide rates in First Nations populations are 2-3 times higher than the general population. 11.8% of First Nations adults report having a close friend or relative who committed suicide, and 22% have had thoughts of suicide.

Challenges in Accessing Healthcare

44% of Inuit people have a regular medical doctor, compared to 83% of non-Indigenous people. Many Indigenous communities are located in rural and remote areas, requiring travel to access medical services.

Income Disparity in Indigenous Canadians

In 2005, the average family income for First Nations people was $19,114, over $10,000 less than the non-Indigenous average of $33,394.

Employment in Indigenous Canadians

Indigenous people are less likely to be employed than non-Indigenous people, although the employment gap has been decreasing since 2001.

Education Disparities in Indigenous Canadians

In 2006, 33% of Indigenous adults had less than a high school education, compared to 13% of non-Indigenous adults.

Food Insecurity in Indigenous Communities

Food insecurity is a major issue, with First Nations off-reserve and Métis populations facing food insecurity at twice the rate of non-Indigenous people. Inuit populations face food insecurity nearly 4 times worse than non-Indigenous populations, with Indigenous women disproportionately affected.

Housing Issues in Indigenous Communities

31% of Inuit people live in overcrowded homes (more than one person per room), compared to 3% of non-Indigenous people. While multi-family dwellings are traditional for Inuit, the high rate of overcrowding is likely due to a shortage of housing.

Housing Issues in Indigenous Communities

31% of Inuit people live in overcrowded homes (more than one person per room), compared to 3% of non-Indigenous people. While multi-family dwellings are traditional for Inuit, the high rate of overcrowding is likely due to a shortage of housing.

Food Insecurity in Indigenous Communities

Food insecurity is a major issue, with First Nations off-reserve and Métis populations facing food insecurity at twice the rate of non-Indigenous people. Inuit populations face food insecurity nearly 4 times worse than non-Indigenous populations, with Indigenous women disproportionately affected.

Education Disparities in Indigenous Canadians

In 2006, 33% of Indigenous adults had less than a high school education, compared to 13% of non-Indigenous adults.

Employment in Indigenous Canadians

Indigenous people are less likely to be employed than non-Indigenous people, although the employment gap has been decreasing since 2001.

Income Disparity in Indigenous Canadians

In 2005, the average family income for First Nations people was $19,114, over $10,000 less than the non-Indigenous average of $33,394.

Challenges in Accessing Healthcare

44% of Inuit people have a regular medical doctor, compared to 83% of non-Indigenous people. Many Indigenous communities are located in rural and remote areas, requiring travel to access medical services.

Suicide in Indigenous Communities

Suicide rates in First Nations populations are 2-3 times higher than the general population. 11.8% of First Nations adults report having a close friend or relative who committed suicide, and 22% have had thoughts of suicide.

Diabetes in Indigenous Canadians

Diabetes rates, especially Type 2, are significantly higher in First Nations populations, likely influenced by diet, lifestyle, and possibly genetic factors.

Chronic Diseases in Indigenous Canadians

Chronic diseases are prevalent in First Nations populations, including hypertension (21.8%), arthritis (19.9%), allergies (18%), diabetes (16.2%), and heart disease (5.7%). 62.6% of First Nations adults report having at least one chronic condition.

Lifestyle Factors in Indigenous Canadians

Indigenous populations report higher rates of daily smoking (30-39%), heavy drinking (26-27%), and inactivity (39-49%) compared to non-Indigenous populations. Obesity rates are higher among Indigenous populations, with 25% of Indigenous people being obese.

Life Expectancy in Indigenous Canadians

Indigenous populations have a lower life expectancy than the Canadian average, with both men and women affected.

Health Perception in Indigenous Canadians

Indigenous people generally perceive their health to be worse than non-Indigenous people. Only 50% of off-reserve First Nations, 54% of Métis, and 55% of Inuit report "very good" or "excellent" health.

Health Data in Indigenous Populations

Data on Indigenous health is inconsistent and often incomplete due to regional restrictions, missing subpopulations, and misreporting. Despite being one of the most vulnerable populations, insufficient effort has been made to collect comprehensive health data on Indigenous people.

Health Care for Status Indians

Status Indians receive healthcare through provincial healthcare plans, with additional benefits like prescription drugs, dental care, and mental health services through Health Canada's Non-Insured Health Benefits program. In BC, status Indians register with the First Nations Health Authority since 2013 for healthcare services.

Métis and Inuit Eligibility for Status

Métis and Inuit are not eligible for "Indian status" under the Indian Act. Some Inuit people are covered under other land claim agreements.

Status vs. Non-Status First Nations People

The 1876 Indian Act defines who is a "status Indian" and eligible for certain government programs and services. First Nations people must register with the federal government to be considered "status Indians." In 2016, 23.8% of First Nations people were not registered or Treaty Indians (non-status).

Métis Overview

Métis people are of mixed European and First Nations heritage, descendants of 18th-century fur traders and Indigenous people. In 2016, there were about 587,545 Métis people in Canada.

Inuit Overview

Inuit are the original inhabitants of the Arctic regions of Canada. In 2016, there were around 65,025 Inuit people, with most living in traditional territories like the Inuit Nunangat (northern Labrador, Quebec, Nunavut, northern Northwest Territories, and Yukon). 64% of Inuit people still speak an Inuit language.

First Nations Overview

First Nations encompasses many distinct cultural groups, with 630 distinct communities and around 60 different languages. In 2016, there were about 977,000 First Nations people in Canada, with 44% living on reserves and 56% living off-reserve, mostly in urban areas.

Who are the Indigenous people of Canada?

The 'Indigenous peoples' collectively refers to the original inhabitants of Canada and their descendants, including First Nations, Inuit, Métis, and other distinct groups. In 2016, approximately 1,673,780 Indigenous people lived in Canada, making up 4.9% of the population.

Did the Pope apologize for residential schools?

Pope Benedict XVI expressed "sorrow" and offered "sympathy," but some Indigenous people did not see it as a true apology. In 2015, Prime Minister Justin Trudeau discussed an apology with the Pope, but in 2018, Pope Francis refused to issue an apology.

What compensation was provided for residential school survivors?

In 2005, the Canadian federal government announced a $2 billion compensation package for survivors of residential schools. In 2008, Prime Minister Stephen Harper issued a formal apology to former students.

What were the apologies given for residential schools?

Various apologies were issued over the years: The United Church of Canada (1986), the Missionary Oblates of Mary Immaculate (1991), the Anglican Church (1993), the Presbyterian Church (1994), and the Canadian government (2008) for the impact of residential schools on Indigenous people.

How does language loss relate to colonization in Indigenous communities?

70% of Inuit people still speak their traditional language, but only 12% of off-reserve First Nations people can speak a traditional language due to the loss of cultural practices caused by colonization.

What was the impact of residential schools on Indigenous adults?

Around 76.1% of First Nations adults who attended residential schools reported being diagnosed with at least one chronic health condition. Many also reported higher rates of suicide attempts (15.6%) and psychological distress (6.9%).

How were Indigenous children treated in terms of culture and language at residential schools?

Children were forbidden from speaking their traditional languages and practicing their cultural traditions. They were forced to adopt Christianity and were punished for expressing their own spirituality.

What health effects did Indigenous children suffer in residential schools?

Indigenous children in residential schools faced poor food quality, high rates of tuberculosis, physical abuse, sexual abuse, and medical experiments. Around 3,200 children died due to mistreatment and poor health conditions.

How many Indigenous children attended residential schools in Canada?

An estimated 150,000 Indigenous children were separated from their families to attend residential schools, with the last federally run school closing in 1996.

What was the residential school system in Canada?

The residential school system was established by the Canadian government in the 1870s with the aim of assimilating Indigenous children into Christian Canadian culture. Many schools were operated by religious organizations.

What did the European settlers do to Indigenous people's spirituality and way of life?

European settlers viewed Indigenous spirituality and traditional lifestyles as blasphemous and restricted Indigenous rights, spirituality, political authority, education, traditional healing, and access to land and resources.

What does the term "terra nullius" refer to?

Terra nullius refers to the concept of claiming land as "empty" when it was actually inhabited by Indigenous people. This idea was used by Europeans to justify colonization.

What happened to traditional knowledge and healers during colonization?

Oral knowledge was lost as many traditional healers died from epidemics. The traditional healers could not cope with the new diseases, and some Indigenous people lost faith in their traditional medicine.

How did disease impact Indigenous communities?

Diseases such as smallpox, influenza, and tuberculosis devastated Indigenous communities, causing high mortality rates and weakening their immune systems, making it difficult to hunt or harvest food.

What were some of the early effects of colonization on Indigenous people?

The arrival of Europeans brought diseases like smallpox, influenza, measles, and whooping cough, to which Indigenous people had no immunity. Epidemics spread quickly, causing death and malnutrition.

How did Indigenous people respond to European settlements?

Indigenous people were generally suspicious of the foreigners but were mostly peaceful. They formed relationships with fur traders, although there was resistance to the settlement efforts.

What European activity began in the early 1600s along the Atlantic coast?

Thousands of ships traveled into the Gulf of St. Lawrence and Atlantic coast for fishing and fur trading. Newfoundland became a common fishing area for Europeans.

What happened during Sir Humphrey Gilbert's visit to Newfoundland?

In 1583, Sir Humphrey Gilbert took possession of Newfoundland on behalf of England, although Spanish, Portuguese, and French fishing boats were already in the area. The English settlers drove the Beothuk people inland, ultimately leading to the Beothuk's extinction by 1829.

Who was Giovanni Caboto (John Cabot) and what did he do?

In 1497, Giovanni Caboto, an Italian explorer paid by England, traveled to Newfoundland and Cape Breton, believing he had discovered the Indies. He called the Indigenous people "Indians" and named the land St. John's, but no settlement was built.

What European group first made contact with Indigenous people in Canada?

In the 900s to early 1000s, Vikings explored parts of Canada, including Baffin Island, the Arctic, Greenland, Labrador, and Newfoundland, establishing a small village in Newfoundland. Which area of Canada was the most densely populated by Indigenous people before European contact?

What role did the community play in Indigenous health?

The community had a strong sense of support for each other when ill. Childcare was the responsibility of the extended family, ensuring children learned the knowledge of their entire family and community.

What types of healers were present among Indigenous groups?

There were many traditional healers, including midwives, herbal healers, and spiritual healers. Indigenous communities valued holistic approaches for preventative healthcare.

What health conditions were common among pre-contact Indigenous people?

There were no apparent cases of diabetes or dental caries (cavities), but some evidence of arthritis, abscessed jaw sockets, infectious diseases, and dermatological problems exists.

What was the lifestyle of pre-contact Indigenous people?

Pre-contact Indigenous people lived in hunter-gatherer societies, relying on active lifestyles and healthy diets. They had intimate knowledge of their environment and spirituality, with ample access to land, food, and water. Population density was low, reducing the spread of disease.

What is the theory about the origin of Indigenous people in Canada?

It is suspected that at least 12,000 years ago, the original settlers of the now land of Canada crossed the Bering Land Bridge from Asia. However, this is still debated by Indigenous people, scientists, and historians. Some believe people might have also come across the Pacific Ocean from Asia and the Pacific Islands.

What are the health risks and hospital costs associated with diabetes?

Complications from diabetes lead to increased hospitalizations. Diabetic complications account for a large proportion of health care costs, particularly for conditions like dialysis and eye problems.

What is the cost of diabetes in Canada?

The cost was estimated at $5 billion in 2010. Healthcare costs for people with Type 2 diabetes are 3-4 times higher than for those without diabetes.

What is the difference between Type 1 and Type 2 diabetes?

Type 1: The immune system attacks insulin-producing cells in the pancreas (usually in childhood). Type 2: The body becomes resistant to insulin (typically in adulthood, linked to obesity).

How is diabetes diagnosed?

Symptoms: Increased thirst, frequent urination, weight loss. Blood glucose tests confirm diagnosis, with two abnormal results on separate occasions required for diagnosis.

What are the long-term complications of diabetes?

Macrovascular: Heart disease, stroke. Microvascular: Retinopathy, nephropathy, neuropathy (damage to eyes, kidneys, nerves).

What are the short-term effects of uncontrolled diabetes?

Ketoacidosis: High blood glucose leads to fat breakdown and acid buildup, causing coma or death. Infections: Persistent high blood glucose can cause recurrent infections.

What is the relationship between diabetes and cardiovascular disease?

Insulin resistance leads to dyslipidemia (abnormal cholesterol levels), increasing the risk of cardiovascular disease (e.g., heart disease, strokes).

How does obesity contribute to diabetes?

Obesity causes insulin resistance, leading to increased blood glucose (hyperglycemia), and places stress on the pancreas to produce insulin.

What chronic diseases are linked to obesity?

Diabetes, Hypertension, Heart disease, Stroke, Osteoarthritis, and Cancer (e.g., breast, colorectal, kidney).

What are the obesity rates in Indigenous communities?

35% of Indigenous adults are obese. 62.5% of children under 11 are overweight or obese. Over 50% of First Nations households are food insecure.

How does food insecurity affect obesity?

Food insecurity makes it harder for people to afford healthy food, leading to reliance on cheaper, unhealthy processed foods.

What social factors are linked to obesity?

Education: Lower education levels are associated with higher obesity rates. Income: Poverty is linked to behavior (diet, inactivity) but not directly to obesity. Food Insecurity: Over 12% of households in Canada are food insecure, limiting healthy food access.

How does obesity vary by age group in Canada?

Overweight: 30.5% aged 18-34, 39.9% aged 65+. Obesity: 18.7% aged 18-34, 31.3% aged 50-64, 28.1% aged 65+.

How does obesity prevalence differ by region in Canada?

Highest in Atlantic Canada and northern territories. Lowest in BC (22%). Urban areas like Montreal, Toronto, and Vancouver have the lowest obesity rates.

What is the obesity prevalence in Canada?

61% of Canadians are overweight (including obesity). 26% of adults are obese. 25% of youth are overweight (including obesity). Canada ranks 7th highest globally for obesity prevalence.

What are the limitations of BMI?

BMI doesn't account for muscle mass or bone density, which can overestimate fat in athletes and underestimate it in people with low muscle mass.

How is obesity measured?

1. Body Mass Index (BMI): BMI = mass (kg) / height (m)² - 25.0-29.9 = Overweight, 30.0 and above = Obesity. 2. Bio-impedance: Measures electrical impedance to detect body fat and muscle distribution. 3. Skinfold Thickness: Measures subcutaneous fat using calipers. 4. Waist Circumference: Indicates risk but is prone to error.

What is obesity?

Obesity is a condition where excess body fat accumulates to a point that negatively affects a person's health.

How does the QuitNow! app work?

QuitNow! helps users track their smoking habits and rewards them with money saved, supporting smoking cessation by providing information and encouraging healthier behaviors.

What is the Didget device?

The Didget was a device developed by Nintendo to help children with diabetes monitor their blood glucose levels by incentivizing regular testing with game rewards.

How has gamification been used in fitness and health apps?

Devices like Fitbits and apps like Pokémon Go use gamification to promote physical activity, with studies showing increased physical activity and positive social and mental health benefits.

How does gamification encourage healthy behaviors?

Gamification encourages healthy behaviors by providing rewards, creating competition, and increasing self-efficacy, which can lead to more consistent health-promoting actions.

What is gamification in health promotion?

Gamification applies game elements (points, rewards, competition) to health behaviors to encourage positive actions such as physical activity, healthy eating, and medication adherence.

What models are used in health promotion?

Health promotion uses models of change like the Learning Theory, Consensus Model, Health Belief Model, and Theory of Reasoned Action to understand and influence health behaviors.

What are the approaches to health promotion in the Declaration on Prevention and Promotion?

Approaches include changing risk factors outside the health sector, supporting healthy living, conducting research to build evidence, and ensuring access to clinical prevention services.

What is the Declaration on Prevention and Promotion in Canada?

Released in 2011, this declaration emphasized the importance of health promotion, stating that health is influenced by many factors such as environmental, social, and economic conditions, and recognizing disparities in health across populations.

What is the role of intersectoral collaboration in health promotion?

Health promotion requires collaboration with sectors outside healthcare (e.g., education, housing, and urban planning) to address broader determinants of health.

What is the purpose of the Ottawa Charter?

The Ottawa Charter aims to help achieve health for all by addressing social and environmental factors that affect health and promoting strategies for individual and community empowerment.

What are the prerequisites for health according to the Ottawa Charter?

The seven prerequisites for health identified by the Ottawa Charter are peace, shelter, education, food, income, stable ecosystem, and sustainable resources.

What is the Ottawa Charter for Health Promotion?

Developed in 1986, the Ottawa Charter provides a framework for health promotion, including strategies like building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services.

What were the main outcomes of the Lalonde Report?

The Lalonde Report conceptualized health as being influenced by both healthcare systems and social/environmental factors, encouraging a focus on health promotion and disease prevention.

What was the Lalonde Report's contribution to health promotion in Canada?

The Lalonde Report, published in 1974, highlighted the importance of health promotion and pointed out the limitations of the biomedical model, proposing that public health should address the broader determinants of health.

Where does health promotion fall in the healthcare pyramid?

Health promotion comes before primary care in the healthcare pyramid, addressing prevention and early health management before individuals require clinical treatment.

What is the metaphor of upstream vs downstream interventions?

Upstream interventions involve addressing the root causes of health issues (e.g., improving living conditions), while downstream interventions deal with consequences after a health issue has occurred (e.g., treating a disease after it develops).

What is the difference between upstream and downstream interventions?

Downstream interventions focus on immediate reactions to health problems (e.g., treating the ill), whereas upstream interventions focus on preventing the causes of health issues, such as addressing social determinants of health.

What values are implicit in health promotion?

Health promotion is based on values like equity and social justice, recognizing the influence of the environment on health, empowering people, building capacity, and promoting social participation.