chapter 11 - Indigenous peoples' health in Canada

history of indigenous health

European settlers exposed them to infectious diseases

- now experience health disparities + inequities

health disparities

indicators of preventable + unjust differences in health status

health inequities

conditions that shed light on underlying causes of health disparities

- distribution of social, economic, and political resources

indigenous communities

600+ communities and 70+ languages

- classification system (i.e., on/off-reserve, rural/urban) does not reflect reality

- many ppl transition between these sites to access services + maintain connections

Indigenous perspective of health

tend to be holistic (body-mind-spirit balance)

social determinants of Indigenous peoples' health

1. colonialism

2. self-determination

3. racism

4. land, culture, language

colonialism (determinants of Indigenous health)

oppression and subordination

- ongoing due to maintenance of colonial structures/practices (Indian Act, residential schools, Indian hospitals)

Indian act (colonialism)

controls who falls under category of "Indian"

- reserves impede on traditional community sharing + overcrowded

- goal: assimilation by tearing down Indigenous forms of governance

residential school system (colonialism)

implemented to assimilate Indigenous + eradicate language/traditions/beliefs

- high rates of illness and death

- linked to intergenerational mental health concerns

Indian hospitals

created to protect non-Indigenous from "Indian tuberculosis"

- has resulted in intergenerational trauma + mistrust of healthcare system

self-determination (determinants of Indigenous health)

right to participate in state-recognized decision-making in one's community

- connected to community control/capacity and mental health outcomes

racism (determinants of Indigenous health)

common in healthcare system; overt racism, microaggression, colour blindness

race

social construct

- genetics explains health disparities

- ethnicity is more effective in explaining disparities/inequities

systemic racism

group in power discriminates on the basis of race; occurs when discrimination/prejudice become normalized in society

land (determinants of Indigenous health)

linked w/ community + cultural practices

- barriers to access impacts health

culture (determinants of Indigenous health)

linked w/ belonging + self-esteem

language (determinants of Indigenous health)

linked w/ sense of welcoming + belonging