OP-ED: Indigenous Health Disparities

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Clean water (healthy concept)

by Peter Chow

There were 1,673,785  people who identified themselves as an Indigenous person— that is, North American Indian (First Nations people), Métis and Inuit. (2016 census).

Within the Indigenous population, 58% (977,230) were First Nations people, 35% (587,545) were Métis, 3.8% (65,025) were Inuit and 3% were of multiple or other Indigenous identities.

Indigenous people are younger than the non-Aboriginal population. The median age of First Nations people reserve was 25 years in 2006;  Métis, 30;  Inuit, 22;  and non-Indigenous people, 40.8.

Nearly 1.7 million people identified as Indigenous in the 2016 census, Statistics Canada says – a 4.9% share of the total population and a breathtaking 42.5% increase since 2006, a growth rate more than four times that of their non-Indigenous counterparts.

First Nations people living in Canada have higher rates of chronic diseases and have reduced life expectancy than non-Indigenous people.

Higher rates of chronic conditions partly explain the poorer self-reported health among First Nations people and Métis.

56% of First Nations people and 55% of Métis reported being diagnosed with one or more chronic conditions, compared with 41% of non-Indigenous people.

Inuit (43%) were the least likely to report having one or more diagnosed chronic conditions. However, this may be partly due to having less access to doctors who can diagnose their conditions.

83% of non-Indigenous Canadians have a regular medical doctor, compared with 41% of Inuit. In fact, most Inuit communities are served by a nursing station only and accessing hospital services can require extensive travel.

50% of First Nation adults living on-reserve and 43% of First Nation adults living off-reserve smoke;  Métis, 35%; and Inuit, 49%, compared with 15% among non-Indigenous people.

The obesity rate for First Nations people was 26%. It was 22% for Métis, 26% for Inuit and 16% for non-Indigenous people.

Among First Nations people, 25% lived in households that experienced food insecurity, more than three times the proportion of non-Indigenous people at 7%.  15% percent of Métis, and 27% of Inuit also lived in food-insecure households.

The life expectancy for the First Nations people was 72.5 years for males and 77.7 years for females. This was 8.9 and 9.6  years shorter than for non-Indigenous Canadian males and females

For the Métis population, life expectancy was 76.9 years for males and 82.3 years for females—4.5 and 5.0 years shorter, respectively, than for the non-Indigenous population.

Life expectancy for the Inuit population was 70.0 years for Inuit males and 76.1 years for Inuit females, which is 11.4 and 11.2 years shorter than for the non-Indigenous population.

Infant mortality rates were more than twice as high for each Indigenous group, compared with the non-Indigenous population.

Post-neonatal deaths made up nearly half of all infant deaths in the Indigenous population, compared with about one-quarter of all infant deaths in the non-Indigenous population.

Rates of death from sudden infant death syndrome (SIDS) were more than seven times higher in the First Nations and Inuit populations (2.2 and 2.5 per 1,000 live births, respectively) than in the non-Indigenous population (0.3)

SIDS accounted for 24% of First Nations infant deaths and 21% of Inuit infant deaths and was the leading cause of infant mortality in both groups, whereas it accounted for 7% of non-Indigenous infant deaths.

The incidence of diabetes is 17.2% among First Nations individuals living on-reserve, 12.7% among First Nations individuals living off-reserve, 4.7% among Inuit people, and
9.9% among Métis people, compared to 5.0% in the non-Indigenous population.

Heart disease rates for Indigenous people are as much as 50% higher than in the general Canadian population, and the death rate from stroke is twice as high.

Cardiovascular disease affects 7.3% of Indigenous adults and 5.0% of the general Canadian population.

The rate of stroke in Indigenous people is 702.9 per 100,000,   448.3 per 100,000 in non-Indigenous people.

Compared to non-Indigenous adults, First Nations had higher incidence of lung, colon, rectal, kidney, cervix, and liver cancers. First Nations women additionally had higher incidence of stomach, gallbladder, and laryngeal cancers compared to non-Indigenous women.

The most common cancer is lung cancer.  50% of First Nation adults living on-reserve and 43% of First Nation adults living off-reserve smoke.

A similarly concerning pattern of tobacco use is seen among First Nation youth (ages 12 to 17). Smoking rates are 7 and 3 times higher, respectively, in on-reserve (30%) and off-reserve (14%) First Nation youth than in non-Indigenous youth (4%).

In First Nations, an estimated 10% of lung cancer cases are from exposure to radon gas in houses and buildings.

Canada has been ranked as number one in the world for quality of life, according to the U.S. News & World Report. A factor that drove the ranking was Canada’s advanced health care system.

But when it comes to access to health care and health outcomes, the glaring disparities that separate Canada’s Indigenous and non-Indigenous populations cast an ugly shadow on the ranking.

A June 2019 Statistics Canada report indicated that, between 2011–2016, First Nations people experienced a suicide rate that is three times higher than that of the non-Indigenous population.

How can such a disparity exist in a country ranked at the top spot for quality of life?

Suicide rates among Inuit youth in particular are one of the highest in the world, and 11 times greater than the national average.

In some First Nations communities, the suicide rate among youth under the age of 15 is almost 50 times greater than the rate among non-Indigenous youth.

Lower life expectancy and the prevalence of chronic conditions — such as hypertension, obesity, diabetes, and arthritis — also disproportionately burden the Indigenous population.

Tuberculosis, a disease that is both curable and preventable, is reported at a rate that is more than 40 times higher among Indigenous people living on-reserve than among non-Indigenous people.

A vicious cycle of health injustice among Indigenous people was set off by the cultural deprivation and systemic isolation of Indigenous people created by residential schools and colonial practices.

To resolve this issue, it is essential to be aware of Canada’s colonial past and the health inequities we see today.

Overcoming Canada’s health inequities requires implementing policies that specifically address social determinants of health, particularly on reserves and rural areas.

This includes access to clean water, fresh food, better education, better job opportunities, and mental health support systems.

The next time you’re on a reserve, think about where the closest hospital is, or where the closest high school is, or if there is a boil-water advisory, as well as where the closest supermarket is where you can get fresh food.