Week 13 Pandemics

Indigenous Peoples & Pandemics

Key Issues in Indigenous Health

• Long-term Structural Inequities: Indigenous communities face long-standing socio-economic and health disparities which increase their vulnerability to infectious diseases, including COVID-19. Systematic factors such as poverty, education gaps, and discrimination compound these issues.

• Crowded Housing: Many Indigenous families live in multi-generational homes, making social distancing challenging. Overcrowding in housing can also lead to increased rates of respiratory infections and other communicable diseases.

• Lack of Access to Clean Water: Inadequate access to clean water is a significant barrier, preventing effective handwashing – a critical public health measure during a pandemic. Many reserves may rely on contaminated water sources or lack plumbing entirely.

• Food Insecurity: Many Indigenous peoples face challenges in accessing nutritious food due to geographical remoteness, economic hardships, and structural barriers in food distribution. This leads to increased reliance on processed foods, which can exacerbate health issues.

• Limited Telecom Infrastructure: The lack of reliable internet and phone services in many areas hampers effective communication about health mandates, vaccine information, and access to telehealth resources required during health crises.

Quotes from Authors

• Government Response: Advocates emphasize the necessity for sustained, long-term measures that address and rectify historical and systemic inequalities present in government health programs aimed at Indigenous peoples.

• Historical Context: Quick government interventions to address immediate crises do not necessarily lead to equitable treatment or improved outcomes for First Nations over time.

COVID-19 Statistics in Indigenous Communities

• Manitoba Case Study: As of December 9, 2020, the total number of confirmed COVID-19 cases on reserves exceeded 5,000. Over three-quarters of those cases were among First Nations, highlighting the disproportionate impact of the pandemic on these communities.

• Secondary Attack Rate: The overall secondary attack rate of COVID-19 for Manitoba was 16%; however, for First Nations, this rate surged to 40%, indicating a higher rate of transmission within these populations.

• Health Disparities: Indigenous populations experienced delayed testing access and significant barriers to healthcare services, exacerbating health outcomes. A third of COVID-19 hospitalizations in Manitoba were among First Nations, with a median death age of 66 compared to 83 for the general population, demonstrating stark health inequities.

Vaccine Distribution and Community Response

• Vaccine Statistics: Early in January, First Nations reported a COVID-19 test positivity rate of 17%, compared to 10.1% in the overall Manitoba population, highlighting the ongoing health crisis in these communities.

• Willingness to Vaccinate: Reports indicated that 75% of American Indian and Alaska Native individuals expressed willingness to receive the COVID-19 vaccine. Nonetheless, hesitation persists, influenced by historical distrust towards governmental and medical systems, which stems from past injustices.

Colonial Impacts and Public Health Governance

• Key Takeaways: The COVID-19 pandemic has exacerbated historical inequalities within Indigenous communities, reinforcing the ongoing threats to Indigenous self-determination. Public health governance is shaped more by historical and existing political and legal relationships rather than just ethical considerations, creating a complex environment for health interventions.

Understanding Pandemics and Their Impact

• Conceptual Overview: The distinction between a pandemic and an epidemic is crucial, particularly regarding their effects on Indigenous peoples. The social structures and political dynamics within these populations critically influence the transmission and impact of diseases.

Historical Context of Disease and Colonialism

• Facilitating Colonial Settlement: Pandemics have facilitated settler colonization throughout history, underpinning narratives such as the ‘vanishing race’ that serve to justify dispossession of Indigenous lands. Diseases like tuberculosis were highlighted as exacerbated by colonial policies that disrupted traditional ways of life.

• Ongoing Colonial Effects: The narrative of declining Indigenous populations linked to disease is often reflective of the disastrous health outcomes promoted by colonial health policies rather than actual population trends.

Governance During COVID-19

• Indigenous nations exercising governance can significantly create effective public health responses tailored to their needs and thus enhance vaccination rates. However, lingering mistrust, rooted in both historical and present-day grievances, fuels hesitancy regarding vaccinations.

Strategic Responses and Recommendations

• Building Trust: It is essential for health professionals to comprehend the historical context of mistrust in Indigenous communities to foster better community engagement during vaccine distribution and public health messaging efforts.

• Culturally Tailored Messaging: Health communications should be personalized and delivered through trusted community leaders or figures to enhance community engagement and promote better health outcomes.

Conclusion

• Moving Forward: Emphasizing Indigenous sovereignty is critical in any health response to effectively address historical injustices and rebuild trust in governance. Addressing systemic failures exposed by pandemic governance is essential to achieve equitable health outcomes for Indigenous peoples.