CH 07: Canada's Aboriginal People and Health - The Perpetuation of Inequalities

What does the term Aboriginal peoples refer to in Canada?

It refers to all the original inhabitants of North America and their descendants, including First Nations, Métis, and Inuit, as recognized in the Canadian Constitution Act of 1982.

Approximately how many Aboriginal peoples were in Canada in 2011, and what percentage of the total population did they represent?

About 1.4 million people, representing 4.3% of the total Canadian population.

What proportion of Aboriginal Canadians are First Nations?

60.8%.

How many First Nations bands exist, and what do they represent?

633 bands representing 52 nations/cultural groups and more than 60 languages.

What’s the difference between status and non-status Indians?

• Status Indians are recognized under the Indian Act and entitled to specific legal rights/benefits.

• Non-status Indians identify as Indigenous but are not legally recognized under the Indian Act and lack those rights/benefits.

What percentage of First Nations people are status Indians?

About 75%.

What proportion of First Nations people lived on-reserve in 2011?

Nearly half (49.3%).

How does Aboriginal health compare to that of non-Aboriginal Canadians?

According to sociologist C. Wright Mills, when should health issues be treated as public issues instead of personal troubles?

When large numbers of people experience the same problem, indicating structural or societal causes.

What is the main root of Aboriginal health disparities in Canada?

The colonial history of Canada—policies of dispossession, oppression, and systemic inequality.

What were common experiences of children in residential schools?

Loss of identity, being assigned numbers, physical and sexual abuse, forbidden to speak their language, poor clothing and nutrition, and severe illness.

What are examples of lasting health impacts from residential schools?

Chronic illnesses, respiratory damage, mental illness, eating disorders, and trauma.

What is the life expectancy gap between Aboriginal and non-Aboriginal Canadians?

Between 5 and 14 years lower for Aboriginal peoples.

Which Aboriginal group has the highest life expectancy?

Métis, though still lower than non-Aboriginal Canadians.

What are the infant mortality rates for Aboriginal peoples compared to the general population?

• On-reserve First Nations: 7 per 1,000 (vs 5 per 1,000 in general).

• Nunavut (mostly Inuit): 16 per 1,000.

What major health conditions are Aboriginal peoples more likely to die from?

Cardiovascular disease, accidents, poisoning, respiratory disorders, and cancer.

How do diabetes rates among Aboriginal Canadians compare to the general population?

3 to 5 times higher.

How prevalent is tuberculosis among Aboriginal peoples?

8 to 10 times higher than the national average.

What health issues disproportionately affect Aboriginal women?

Heart disease, cervical/gall bladder cancer, HIV/AIDS, and mental illness.

How much higher are suicide rates among Aboriginal youth compared to non-Aboriginal youth?

4.3 times higher for ages 10–19.

How much higher are Inuit suicide rates compared to the national average?

11 times higher.

What percentage of Aboriginal women face violence compared to non-Aboriginal women?

Aboriginal women face both more frequent and more severe violence and are more likely to be homicide victims.

How do smoking rates compare across Aboriginal groups and non-Aboriginal people?

• On-reserve First Nations: 57%

• Off-reserve First Nations: 32%

• Métis: 30%

• Inuit: 39%

• Non-Aboriginal: 15%

How do alcohol consumption patterns differ among Aboriginal peoples?

While heavy drinking is more common, Inuit (34%) and off-reserve First Nations (29%) were also more likely to abstain compared to 24% of non-Aboriginal people.

What has caused the increase in diabetes rates among Aboriginal peoples since 1940?

The shift from traditional high-protein, low-carb diets to modern processed, carbohydrate-heavy diets.

What caused massive declines in Aboriginal populations after European contact?

Epidemics from imported diseases like smallpox, influenza, and measles.

How does sociology explain modern Aboriginal health disparities?

As outcomes of structural inequalities—poverty, unemployment, poor housing, and systemic racism.

What are the main social determinants of health affecting Aboriginal peoples?

Income, education, employment, housing, water quality, food security, and discrimination.

How much lower was Aboriginal peoples’ median income compared to non-Aboriginal Canadians in 2006?

$18,962 vs. $27,097 — about 30% lower.

What percentage of Aboriginal children live below the poverty line compared to non-Aboriginal children?

40% vs. 15%; for Status First Nations children, 50%.

What are educational disparities between Aboriginal and non-Aboriginal populations (2006)?

Only 7% of First Nations people had university degrees vs. 23% of non-Aboriginal people.

How are Aboriginal housing conditions compared to non-Aboriginal ones?

• 4× more likely to live in overcrowded homes.

• 3× more likely to live in homes needing major repairs.

• 44% of on-reserve homes need major repairs.

How are Inuit housing conditions?

10× more likely to live in crowded homes and 4× more likely to need major repairs.

What was the Kashechewan water crisis?

A 2005 incident in Northern Ontario where contaminated water caused widespread illness, exposing Canada’s failure to ensure safe water on reserves.

How many First Nations communities were under boil-water advisories at the time?

Around 100.

How does poor housing and water quality impact health?

Leads to respiratory disease, tuberculosis, infections, mental health issues, and waterborne illnesses like hepatitis A.

What were the main effects of colonization on Aboriginal peoples in Canada according to the Truth and Reconciliation Commission (TRC, 2015)?

Colonization suppressed Aboriginal cultures and languages, disrupted their governments, destroyed their economies, and confined them to marginal lands. It caused hunger, disease, and poverty, and was a policy of cultural genocide aimed at eliminating Aboriginal peoples as distinct political and cultural entities.

Why is colonialism considered a major determinant of Indigenous health?

Because its legacies—forced relocation, loss of lands/resources, reserve systems, residential schools, cultural suppression, and racism—created lasting health inequities and trauma that persist across generations.

What was the initial relationship between Europeans and Aboriginal peoples before colonial domination intensified?

It was characterized by “cautious co-operation”, mutual recognition, and formal treaties like the Royal Proclamation of 1763, which recognized Aboriginal nations as autonomous political entities with land and governance rights.

How did attitudes toward Aboriginal peoples change during the 1800s?

They shifted from viewing Aboriginal peoples as partners to viewing them as “impediments to progress.” Assimilation policies emerged through compulsory education, economic control, and missionary efforts to “civilize” Indigenous peoples—acts described as cultural genocide.

What were the consequences of forcing Aboriginal peoples onto reserves?

It destroyed their traditional economies tied to the land, reduced access to food and resources, altered diets, and worsened health. The cultural, spiritual, and physical disconnection led to ongoing negative health outcomes.

What did Sir John A. Macdonald’s policies reveal about Canada’s stance toward Aboriginal peoples after Confederation?

Macdonald aimed to “assimilate the Indian people in all respects”, excluding Aboriginal nations from political participation and making them subjects under federal regulation (British North America Act, 1867).

What were some major effects of the Indian Act (1876 and later amendments)?

• Defined who was legally an “Indian.”

• Eliminated traditional governments.

• Confiscated resources.

• Outlawed ceremonies (e.g., potlatch, sun dance).

• Imposed European marriage/parenting standards.

• Required identity cards to leave reserves.
  Overall, it was a tool of assimilation and control.

What was the purpose of the residential school system, and what were its long-term effects?

Residential schools aimed to “civilize” and assimilate Indigenous children by erasing their languages and cultures. They broke family bonds, inflicted psychological trauma, and led to long-lasting intergenerational harm including depression, suicide, substance abuse, and cultural shame.

What were some emotional and psychological impacts on residential school survivors?

Survivors often developed self-hate, shame toward their culture, addiction, self-harm, and depression of spirit from years of cultural erasure and abuse.

How is modern social exclusion and racism connected to colonialism?

They represent the continuation of colonization, as seen in systemic issues like the disproportionately high rates of missing and murdered Indigenous women and the ongoing marginalization of Aboriginal peoples.

How do Aboriginal concepts of health differ from the biomedical model?

Aboriginal health is holistic, integrating the physical, emotional, mental, and spiritual aspects of life. Health comes from balance and harmony within oneself, the community, and nature, symbolized by the medicine wheel.

What does the medicine wheel represent in Indigenous health philosophy?

It symbolizes balance and harmony among the physical, spiritual, emotional, and mental dimensions of life, and interconnectedness with family, community, and the natural world.

According to the Royal Commission on Aboriginal Peoples (RCAP), what is essential for healing in Indigenous communities?

Respect for Aboriginal cultures, traditions, beliefs, and authority over their own health care—integrating traditional medicine and healing practices with modern systems.

What four principles did RCAP recommend for Indigenous health policy?

1. Holism – attention to the whole person in their environment.

2. Equity – equal access and outcomes in health.

3. Control – Aboriginal peoples’ control over health determinants.

4. Diversity – respect for cultural and historical differences among First Nations, Inuit, and Métis.

How does self-determination relate to Indigenous health outcomes?

When communities control their health services and decisions, they experience greater empowerment, cultural connection, and improved health—reducing the negative effects of powerlessness.

What are the three levels of determinants in the Integrated Life Course and Social Determinants Model of Aboriginal Health (ILCSDAH)?

• Proximal: direct factors (e.g., income, housing, food security).

• Intermediate: community infrastructure and cultural continuity.

• Distal: overarching forces like colonialism, racism, and social exclusion, which shape all others.

What are some effects of racism and discrimination in health care?

Racial profiling leads to denial of treatment, misdiagnosis, and fear of seeking medical help. Example: Brian Sinclair, who died after 34 hours without care because hospital staff assumed he was intoxicated.

What were early government health services for Aboriginal peoples like?

They were ad hoc, run by RCMP, missionaries, and later federal agents with little cultural understanding—based on a biomedical model.

What were the three pillars of the 1979 Indian Health Policy?

1. Community development (social, economic, cultural, spiritual).

2. Improved communication and involvement in planning/delivery.

3. Resources for Aboriginal communities to take an active health role.

What did the 1988 Indian Health Transfer Policy achieve?

It allowed communities to design and manage their own health programs, promoting flexibility and cultural relevance—but faced criticism for limited funding, dependence on federal structures, and lack of support for traditional healers.

What was the purpose of the 1998 Gathering Strength—Canada’s Aboriginal Action Plan?

It was a response to RCAP, offering an official apology for residential schools and creating the Aboriginal Healing Foundation (AHF) to promote healing and reconciliation across all Aboriginal groups.

What is the mandate of the First Nations and Inuit Health Branch (FNIHB)?

To collaborate with First Nations and Inuit governments in providing community-based health care, including primary care and support services. Métis and non-status First Nations are excluded and rely on provincial systems.

What did the 1995 Inherent Right to Self-Government Policy recognize?

It affirmed First Nations’ and Inuit constitutional right to self-determination, enabling them to design their own forms of government and health priorities.

What does the “Pathways to Health Equity for Aboriginal Peoples” initiative aim to do?

It funds research and programs addressing health inequities for all Aboriginal groups, focusing on culturally-informed, community-based solutions.

Why do systemic health disparities persist despite reforms?

Because many policies still fail to address the root causes—colonialism, racism, poverty, and loss of self-determination—leaving structural inequities unresolved.