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8/16/2019 A Reclamation of Well Being: Visioning a Thriving and Healthy Urban Indigenous Community
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"UUBDINFOU
A RECLAMATIONOF WELL BEING:Visioning a Thrivingand Healthy UrbanIndigenous Community
Toronto’s First Indigenous Health Strategy
20162021
Toronto IndigenousHealth Advisory Circle
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HEALTH STATUS AND SOCIO-DEMOGRAPHIC INFORMATION6GATHERING THE CIRCLE8
CONCEIVING THE TIHS18
TIHAC ADVISORS16
STRATEGIC ALIGNMENT11VISION WHEEL13
OVERARCHING THEMES20
STRATEGIC DIRECTION 124STRATEGIC DIRECTION 226STRATEGIC DIRECTION 330CONCLUSION/NEXT STEPS32
TIMELINE OF INDIGENOUSHEALTH PLANNING IN TORONTO15
ARTISTS’ INSIGHT34
VISION, MISSION ANDOPERATING PRINCIPLES23
INTRODUCTION4CONTENTS
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INDIGENOUSHEALTHIN
INDIGENOUSHANDSThe principle of self-determination has
informed every step in the creation of A
Reclamation of Well Being: Visioning a
Thriving and Healthy Urban Indigenous
Community – Toronto’s first Indigenous
Health Strategy, 2016 – 2021.
Thisstrategywasconceivedbythe
TorontoIndigenousHealthAdvisoryCircle(TIHAC).Asacircleofdedicatedcommunityleaders,TIHACprovidesrecommendationstotheTorontoCentralLHIN(TCLHIN)andTorontoPublicHealth(TPH)onimprovinghealthoutcomesforIndigenouspeopleinToronto.Inaddition,TIHACprovidesbroaderpolicyandadvocacy
directiononimprovingthesocialdeterminantsofIndigenoushealth.InthisfirstIndigenousHealthStrategyforToronto,TIHACrecommendsa
numberofstrategicactivitiesthatwillimpactwhatandhowhealthprogramsandservicesareprovidedinadditiontoaddressinghealthinfluencerssuchastheeducation,housing,foodand justicesystems.
Context
Torontohasthelargestandmost
diverseurbanIndigenouspopulationinOntario(EnvironicsInstitute,2010).ThereislittlelocaldataonIndigenoushealth.However,nationalandFirstNationsdatabasesindicatethatIndigenouspeoplefareworsethanthenon-Indigenouspopulationonamyriadofhealthindicators(Gionet&Roshanasfshar,2013;Oldingetal., 2014).
Indigenous people living in Toronto
face a disproportionate burden of
challenges across the known social
determinants of health, as well as
barriers in accessing health services.Indigenous people experience higher
rates of poverty, unemployment,
homelessness, involvement with
child welfare, food insecurity and
challenges within the education
system – all contributing to poor
health outcomes (McCaskill et al.,
2011; NCCAB, 2013; Olding et al.,
2014; Steward et al., 2013). Despite
these health inequities and hardships,Toronto’s Indigenous community has
tremendous strength and resilience.
Improving Indigenous health
outcomes falls within the mandates
of both TC LHIN and TPH. While both
organizations fund Indigenous health,
TPH also provides various programs
and services accessed by community
members. There are also a number
of health services provided by
Indigenous and other non-Indigenous
organizations in Toronto. However,
much more is needed. Reducinghealth inequities experienced by
Toronto’s Indigenous community
requires a coordinated and wholistic
approach – one that harmonizes
traditional and mainstream health
programs and services.
On December 9th, 2013, Anishnawbe
Health Toronto (AHT) presented
the alarming results of their study,Premature and Preventable Death
Among Members of Toronto’s
Aboriginal Community: Walking in
Their Shoes to Toronto’s Board of
Health. This presentation reinforced
the need for TPH, TC LHIN and
AHT to continue partnering in the
establishment of TIHAC, a permanent,
community-led health advisory circle.
Toronto’s First Indigenous Health Strategy 20162021 5
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HEALTH STATUS AND SOCIO-DEMOGRAPHIC INFORMATION
POPULATION HOMELESSNESS
SIZE OF TORONTO’S INDIGENOUS POPULATION
AccordingtoStatisticCanada’s2011National
HouseholdSurvey:19,265
OurHealthCountsToronto:34,000 to 69,0001
OurHealthCountsstudydocumentshighratesofnon-participationintheNHS.
17.5%GENERAL
POPULATION12
EDUCATION
TorontorespondentsinUrban
AboriginalPeoplesStudywhoreportednegativeexperienceswithelementaryand
secondaryschools:26%10
25% ABORIGINAL
COMMUNITY*11
PERCENTAGEOVERTHE AGEOF15WITHOUTA
CERTIFICATE,DIPLOMAORDEGREEINTORONTO
*OurHealthCountsTorontonotesthatthispercentagemay
besignificantlyhigher.
TARPFOUNDTHAT
19%OFITSRESPONDENTS
COULDSPEAK ANINDIGENOUS
LANGUAGE14
LANGUAGE
1.3%to 2.7%
TOTALPOPULATIONOFTORONTO
MIGRATION AND MOBILITY
PERCENTAGEOFTORONTO’S
INDIGENOUSCOMMUNITYBORNOUTSIDE
OFCITY:
73%13
16%OFHOMELESS
POPULATIONIDENTIFY
ASABORIGINAL2
INCOME(BEFORETAXES)–PERCENTAGEOFINDIGENOUSPOPULATIONLIVINGUNDERLOWINCOMECUTOFF
OurHealthCountsnotesthatthemajorityofIndigenousPeople
livinginTorontodidnotparticipateinthe2011NHSandthosewhodidparticipatehadhigherincomes.ThisparticipationbiasiscreatedbecausethemainNHSrecruitmentmethodistosendmailtofixedaddressesusingthevotingregistrar.Peoplewith
lowincomesaremorelikelytomovefrequentlyorbehomeless,andthereforemaynotreceivethismail.
OurHealthCountsToronto:90%3
AccordingtoStatisticCanada’s2011NationalHouseholdSurvey:26%
4
AGE
39MEDIANAGEIN TORONTO
32MEDIAN AGE
OF ABORIGINALIDENTITY INTORONTO
15%GENERAL
POPULATIONUNDER155
22% ABORIGINALPOPULATIONUNDER156
IDENTITY2011NATIONALHOUSEHOLDSURVEY:
65%
27%1.7%
1.3%
5.2%
First Nations
Multiple Aboriginal Identities
Inuit
Métis
Aboriginal Identities not
included elsewhere 8
DIVERSITYPARTICIPANTSINTHE2010TORONTO
ABORIGINALRESEARCHPROJECTIDENTIFIED AS:
48%
15%10%
11%
5%
10%
Anishnawbe
Métis
Cree
Haudenosaunee
Mi’kimaq
Other 9
TheseestimatesarefromtheNationalHouseholdSurveyandrepresentasocioeconomicallyprivilegedminoritysubpopulationofthetotalIndigenouspopulationofToronto.
6 Toronto’s First Indigenous Health Strategy 20162021
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PARENTING AND CHILDREN
PERCENTAGEOFLONEPARENTSWHO
WEREWOMEN:
84%15
SELF-RATED HEALTH
HAVINGLOWHOUSEHOLDINCOMEWAS A SIGNIFICANT
PREDICTOR OF‘POOR’SELFRATEDHEALTH16
I N T E R G E N E
R A TIO N A L T
R A
U M A
TWO-THIRDSofurbanAboriginalpeoplein
Torontosaythattheyhavebeenaffectedbyresidentialschools,eitherpersonallyorthrougha
familymember17
CHRONIC DISEASE
Aboriginal people with lowincome, less than high school
education or were unemployedhad higher percentages of
being diagnosed with chronicconditions 18
MENTAL HEALTH
14%OFINDIGENOUSMENTAL
HEALTHPATIENTSINHOSPITALSREPORTED
BEINGHOMELESS
8%OFPATIENTSFROMTHEGENERALPOPULATION 19
IN CONTRAST TO
REHABILITATION
Average time in rehabilitationslightly longer for Aboriginal
patients in Toronto thangeneral population
Larger proportion of Aboriginal patients in
rehabilitation for medicallycomplex condition 20
Theserateslikelyunderestimate Aboriginalpatientssinceit
wouldonlyincludeAboriginalpatientswhowereidentifiedinthehospital.SomeAboriginal
patientswillnotdiscloseidentityand/orhealthcareproviderswillnotrecognizeAboriginal
identity.Thisdependsonwhoisgatheringtheinformation.
1RotondiM.EstimationoftheSizeoftheUrban AboriginalPopulationinToronto,ONInterim Analysis–January26,2016
2
StatisticsCanada.(2013).NationalHouseholdSurvey(NHS)AboriginalPopulationProfile(pp.1–95).Ottawa.doi:99-011-X2011007
3SmylieJ.OurHealthCountsTorontoInterim
AnalysisMay3,2016.
4City of Toronto (2013). 2011 National Household
Survey (NHS): Income and Shelter Costs. Toronto, ON.
5CityofToronto(2013).Backgrounder2011Census:AgeandSexCounts.
6StatisticsCanada.(2013).NationalHousehold
Survey(NHS)AboriginalPopulationProfile(pp.1–95).Ottawa.doi:99-011-X2011007
7EnvironicsInstute.(2010).UrbanAboriginal
PeoplesStudy:TorontoReport(pp.1–82).Toronto, ON.
8StatisticsCanada.(2013).NationalHousehold
Survey(NHS)AboriginalPopulationProfile(pp.1–95).Ottawa.doi:99-011-X2011007
9McCaskill,D.,FitzMaurice,K.,&Cidro,J.(2011).TorontoAboriginalResearchProject:FinalReport
(pp.I–XV,17–398).Toronto,ON.10EnvironicsInsitute.(2010).UrbanAboriginalPeoplesStudy:TorontoReport(pp.1–82).Toronto, ON.
11StatisticsCanada.(2013).NationalHouseholdSurvey(NHS)AboriginalPopulationProfile(pp.1–95).Ottawa.doi:99-011-X2011007
12CityofToronto(2013).Backgrounder:2011NationalHouseholdSurvey:LabourForce,Education,PlaceofWork,Commutingand
Mobility.Toronto,ON.
13McCaskill,D.,FitzMaurice,K.,&Cidro,J.(2011).TorontoAboriginalResearchProject:FinalReport(pp.I–XV,17–398).Toronto,ON.
14McCaskill,D.,FitzMaurice,K.,&Cidro,J.(2011).TorontoAboriginalResearchProject:FinalReport(pp.I–XV,17–398).Toronto,ON.
15McCaskill,D.,FitzMaurice,K.,&Cidro,J.(2011).
TorontoAboriginalResearchProject:FinalReport(pp.I–XV,17–398).Toronto,ON.
16
Mehdipanah,R.(2011).UrbanAboriginalHealth:Usingindividualandcontextualapproaches
tobetterunderstandthehealthofAboriginalpopulationslivinginToronto.Waterloo,ON.
17EnvironicsInstute.(2010).UrbanAboriginal
PeoplesStudy:TorontoReport(pp.1–82).Toronto.
18Mehdipanah,R.(2011).UrbanAboriginalHealth:UsingindividualandcontextualapproachestobetterunderstandthehealthofAboriginal
populationslivinginToronto.Waterloo,ON.
19TorontoCentralLHIN.(2011).Profileof AboriginalPatientsfromHospitalsintheToronto
CentralLHIN(Vol.2011,pp.1–12).Toronto,ON.
20TorontoCentralLHIN.(2011).Profileof AboriginalPatientsfromHospitalsintheTorontoCentralLHIN(Vol.2011,pp.1–12).Toronto,ON.
Toronto’s First Indigenous Health Strategy 20162021 7
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Gatheringthe Circle“Thebestwayforthecircletoworktogetheristhroughaharmonizedapproach.ThismeansthatallmeetingsandthewaysweworktogetherareguidedbyEldersandinvolveyouth.Itisintergenerational,involves
healersanddifferentwaysofknowing.”
LeilaMonib,HealthEquitySpecialist,CircleSecretariat,TorontoPublicHealth
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CREATIONOFTHETORONTOINDIGENOUSHEALTHADVISORY
CIRCLE(TIHAC) TheTIHACwasestablishedwitharecognitionthattheTIHSmustbeledby
communitymembersthemselves.
Thisisinlinewiththeprinciple
ofself-determinationandechoesrecommendationsrecentlyreleasedinTruth and ReconciliationCommission of Canada: Calls to
Action (2015)andintheCityofToronto’sStatement of Commitmentto Aboriginal Communities (2010).
ASteeringCommitteecomprisedof AnishnawbeHealthToronto,TPHand
TCLHINoversawthecreationoftheTIHACthroughacommunicationsandoutreachstrategyinformedbytheVisionWheel,astrategicplanningtooladaptedfromthetraditionalMedicineWheel.
AnumberofsourceswereconsultedtodeveloptheTIHACstructure.
GovernancestructuresofsimilarIndigenoushealthinitiativesacrossCanadawerereviewed.Furthermore,communitystakeholderswithinTorontoandOntariowereengaged.
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In2014,TPHandTCLHINmetwiththeleadershipofover15Toronto-based
IndigenousorganizationstogatherrecommendationsonTIHACmembership,
governance,rolesandresponsibilities.
TIHAC is structuredaccording to
community stakeholderrecommendations:
• MeetingsareguidedbyanIndigenousfacilitatorwithextensiveknowledgeofIndigenouscommunitygovernanceandfacilitationbothlocally,provinciallyandnationally.
• Asmall,agilecircleofIndigenous Advisors.
• MembershiprepresentsthediversitywithinToronto’s
Indigenouscommunity.• Advisorsrepresentthemselves
ratherthanthemandatesoftheorganizationstheyworkfor.
• Recommendationsareissuedthroughaconsensusdecision-makingmodel.
• TwoIndigenousEldersareintegraltotheCircleandusecultural
elementssuchasmedicines,ceremonyandtraditionalguidanceatallmeetings.
• Largercommunitymeetingsalwaysincorporateasacredfirefortheduration.
• TIHACisguidedbyanEldersCouncil.
• Youthparticipatethroughanactive YouthCouncil.
• Indigenousworldviewsareintegratedthroughout.
• TPHandTCLHINleadershipparticipateatmeetingsinaconsultativeandlisteningcapacity,notasAdvisors;theyalsoensureactiononrecommendations.
• ReferencegroupsareestablishedtoaddressspecificsocialdeterminantsofIndigenoushealth,asnecessary.
•PTOs(ProvincialTerritorialOrganizations)areconsulted,whenrequired.
TheSteeringCommitteealsometwiththeMinistryofHealthandLong-TermCare,MinistryofAboriginal AffairsandProvincialTerritorialOrganizationstodiscussIndigenous
healthplanninginTorontoandfutureopportunitiesforcollaboration.
TIHAC’smandateisalignedwiththestrategicprioritiesofboththeMinistry
ofHealthandLong-TermCareandtheMinistryofAboriginalAffairsasoutlinedinthe2014mandateletterssenttoeachministrybyPremierKathleenWynne.
Strategic Alignment
ThischartdetailshowtheTIHSisinalignmentwiththeprioritiesidentified
byinternational,national,provincialandlocalstakeholders.
Photo(lefttoright):TroyObed,
KaitlynAdams-Lewis,Sam
Kloetstra,MylesJacko,Connor
PionanndAkeeshaFootman
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STRATEGIC ALIGNMENTSTAKEHOLDER ALIGNMENT WITH TIHS
International
UnitedNationsDeclarationontheRightsofIndigenousPeoples
Indigenousself-determinationandgovernanceintheplanninganddeliveryofculturallysafeprogramsandservices
Federal
Truth and Reconciliation CommissionTo respect Indigenous health care rights, increase access to traditional healing, improve health outcomes, cultural competency training
for health care providers and ensure community engagement in the planning, delivery and evaluation of health programs
To ensure the availability of, or access to, health services for First Nations and Inuit communitiesFirst Nations and Inuit Health Branch
Provincial
Ministry of Health and Long-Term CareEfficient coordination between LHINs and public health, greater access to high quality, client-centred and culturally appropriate
services in line with Excellent Care for All Act , focus on seniors, mental health and addictions
Cross-government coordination, increase in Indigenous decision-making, focus on socio-economic influencers – particularly
education and through Walking Together: Ontario’s Strategy to End Violence Against Aboriginal Women
Focus on equity: closing achievement gap between Aboriginal and non-Aboriginal students
Aboriginal Children and Youth Strategy will guide system transformation of services for Aboriginal children and youth including mental
health, suicide prevention, child welfare and youth justice
Aboriginal component of Ontario’s Long-Term Affordable Housing Strategy
Mandatory Indigenous cultural competency training for all public servants
Advancing cultural competency training, palliative care, mental health & addictions and Indigenous engagement in diabetes
Political Accord with the Premier of Ontario’s office
Delivers programs and services in the area of health, signed an Ontario Metis nation framework agreement with the province in 2008
Ministry of Aboriginal Affairs
Ministry of Education
Ministry of Children and Youth Services
Ministry of Municipal Affairs and Housing
Public Service of Ontario
Provincial Indigenous Health Leads Network
of the LHINS
Chiefs of Ontario
Metis Nation of Ontario
LocalToronto Aboriginal Support Services Council Advancing Indigenous Health issues through policy, advocacy and research
Implementation of Indigenous Health Strategy part of TPH’s Strategic Plan and in line with foundational principles of community
engagement and health equity
Aligns with TC LHIN goal and strategic priorities of a healthier Toronto with positive patient experiences, a population health
approach, health and community care transformation, health equity, Citizens’ Panel and Patients First Indigenous consultations
Statement of Commitment to Aboriginal Communities in Toronto (2010)
Provides advice to Mayor and Council to promote interests of Toronto’s diverse Indigenous community
TPH
TC LHIN
City of Toronto
Aboriginal Affairs Committee of Toronto City
Council
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VISIONINGTHEINDIGENOUSHEALTHSTRATEGY
TheVisionWheelwaskeytothedevelopmentoftheTorontoIndigenousHealthStrategy(TIHS)and
willcontinue toactasroadmapforimplementation,evaluation andrenewal.
TheVisionWheelisadaptedfromthetraditionalMedicineWheelandbasedonteachingsVanessaAmbtman-Smith(formerlyoftheTCLHIN)
receivedfromCreeandOji-CreeElders.
ThereisnoonesymbolorteachingthatrepresentsthediversityacrossIndigenouspeoples.VisioningthroughtheMedicineWheeldoesnotrepresentauniversal“pan-Indigenous
approach.”ThisisaspecificchallengeintheurbanIndigenousenvironmentwherealargenumberofIndigenouspeoplecometogether
frommanydifferentnations.
TheMedicineWheelisbasedonIndigenousculturalvalues,traditionandspirituality.Itsfourdirections(East,South,WestandNorth)symbolizecompleteness,wholeness,connectednessandstrength.In
ordertoachieveoptimalhealthandwellnesstheMedicineWheel’selementsmustbeinbalance–thePhysical,Emotional,Mentaland
Spiritual.TheTIHSVisionWheelbeginsattheeasterndoorwiththevisiontocreateacommunity-drivenandwholisticstrategythatwillimprovehealthservices,qualityofcareandaddressthesocialdeterminantsofIndigenoushealthwiththegoalofimprovinghealthoutcomes.
Meaningfulandrespectfulrelationshipsarethefocusofthesoutherndirection.Inthisphase,TIHACwasdeveloped,aswererelationshipswithvariousstakeholderssuchastheMinistryofHealthandLong-TermCare,MinistryofAboriginalAffairs,Provincial
TerritorialOrganizations,aswellasIndigenousandnon-Indigenousserviceproviders.
Knowledgeisthefocusofthe
westerndirection.NumeroussourcesofevidenceinformedthedevelopmentoftheTIHS:Indigenoushealthdata(andgaps),literature,livedexperience,traditionalteachings,evaluationsandcommunityinput.
Actionisthecentralfeatureofthenortherndirection.Itisthroughactionthatthestrategicdirectionsofthe
TIHSwillberealized.
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HARMONIZEDGOVERNANCE:
TIHAC’STERMSOFREFERENCETIHACisguidedbytheconceptofharmonizedgovernance.ThisreferstotheblendingoftraditionalIndigenouswaysofbeingwithwesternsystems.ThiscommitmentisengrainedinTIHAC’sTermsofReference.
AnElderopensandcloseseachmeetinginatraditionalway.AnEthicalCodeguidesallmeetingsandincludestheroleofElders,how Advisorsworktogether,aswellastraditionalmodestoaddressconflict.
ADVISINGANDINFLUENCING:
TIHAC’SMANDATETIHAChasbeenmeetingregularlysinceMarch,2015.Theirmandateistwofold:
1.Provideoversight,guidanceandadvicetotheTCLHINandTPHintheidentification,planning,implementation,funding,researchandevaluationofculturallybased,culturallysecurehealthprogramsandservicesforthediverseIndigenouscommunityinToronto.
2.ToinfluencepublicpolicythatimpactsIndigenoushealthoutcomes.
ROLEOFSPONSORS
AT TIHACMEETINGSTPHandTCLHINleadershipattendsCirclemeetingsto:
1. ActivelylistentoTIHACdiscussions.
2. ProvideinformationandcontexttoinformTIHACrecommendations.
3. Reportbackonorganizationalfollow-through.
4. BuildtrustandstrongrelationshipswithTIHAC.
5. Shareinformationfromothercommunity/organizationalinitiativestoensurealignmentwithTIHACrecommendations.
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TIMELINE OFINDIGENOUS HEALTH
PLANNING IN TORONTO
INTERNATIONAL
NATIONAL
LOCAL
2008
FirstRoundtableonUrban
AboriginalHealth
Between
2008-2010Four
RoundtablesonUrban
AboriginalHealthin
Torontowereheld
2010
TheGovernmentofCanadaagrees
topay$145Millionvialand
claimtotheMississaugasofNewCredittorectifythe1787 Toronto
Purchase
2010
TorontoCityCouncil
adoptsStatement of
Commitment
to Aboriginal
Communities
in Toronto
2007
2007
UnitedNationsDeclarationoftheRightsofIndigenous
People
2008
TCLHINandTPHcombineIndigenous
engagement
2011
Interim AdvisoryCircle
wascreatedtoprovide
guidanceon
fundingforyouthmentalhealthand
additionsandactivitiesofthe
Roundtable
2012
Youthmentalhealthandaddictions
programmingfunded
2011
Toronto AboriginalResearch
Project(TARP)reportreleased
2012
CreationoftheWell
LivingHouse–anaction
researchcentre
focusedonIndigenoushealthandwell-being
2013
SeventhGenerationMidwivesofToronto
movesintothenewlyopened
TorontoBirthCentrewith
anIndigenousfocusonhealthy
maternalandchildoutcomes
2014
Stakeholderengagementtoinformthe
creationofthepermanent
healthadvisoryCircleandplanning
processfortheTorontoIndigenous
HealthStrategy
2014
Eldersand YouthCouncils
established
2015
MandateofTorontoIndigenous
HealthAdvisoryCirclefinalized
2011
NationalUrban
AboriginalPeoplesStudy
released
2011
Toronto Aboriginal
SocialServicesCouncil(TASSC)
incorporated
2013
AnishnawbeHealthToronto
reportonpremature
andpreventableIndigenous
deathsbrought
toTorontoBoardofHealth
2014
Extensivecommunity
engagementprocess
completedbytheNative
CanadianCentreofTorontotoinformthe
TIHACstrategicplanningprocess
2014
Knowledgeproducts
anddataon Aboriginal
healthcreatedtoguidethe
Circle
2015
TorontoIndigenous
Health Advisory
Circlelaunchandcommunity
feast
2015
TruthandReconciliationCommission-finalreportandcallsto
action
2016
LaunchofToronto
IndigenousHealth
Strategy
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CEREMONIALLAUNCHOFTIHACOn January 23rd, 2015 the TIHAC was officially launched at the Native Canadian
Centre of Toronto. The day was facilitated by Michelle Sault and included a sacred
fire, sunrise ceremony, pipe ceremony and community feast. Elder Kahontakwas
(Diane) Longboat gave each Advisor a symbolic element and cardinal directionto represent their TIHAC role and responsibilities which carries throughout each
meeting and all of the work that the TIHAC does on behalf of the community.
Photos(lefttorightbyrowstartingattop):SaraWolfe,
SarahMidanik,Kenn Richard,Akeesha Footman,
SamKloetstra,Myles Jacko,Joe Hester,Larry Frost,
Kahontakwas(Diane)Longboat,Kawennanoron
(Cindy)White,Amy Desjarlais,Dr. JanetSmylie,Dr. David McKeown,SusanFitzpatrick,EllenBlais,
Leila Monib,MichelleSaultand Dr.Bernice Downey.
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TIHAC ADVISORS: SKILLS, DIRECTIONS AND ELEMENTSNAME DIRECTION ELEMENT
Sara Wolfe, RM
Representsfamilies,mothers,childrenandtheunbornEAST Seedsofanewgenerationinanewera
Sarah Midanik
RepresentsthefoundationalelementsofIndigenouslanguages,culturesandknowledge
systemsthatareessentialtohealthandwellbeing
EAST Basketholdingthosethingsmostsacredtoourfuture
Kenn Richard
Representsadvocacy,heartofthepeople,andthefulfillmentofurbancommunityneedsSOUTH
EaglefeathercarryingtheprayersofthepeopletotheCreatorforabalancedlife
Youth Council: Akeesha Footman, Myles Jacko, Sam Kloetstra, Devin Trottier,
Kaitlyn Adams-Lewis, Daniella Robinson, Connor Pion, Cedar Landon
Carriesthenewgeneration’swishesanddreamsforthefulfillmentofthe8thFireProphecy:theriseofIndigenousNations
SOUTH Fireinthecandle
Larry Frost
CarriesmessagesfromtheTorontoAboriginalSocialServicesCommitteetoTIHACandbackagain;aidedbytheguidanceoftheAncestors’sacreddirection
WEST Blackandwhiteflagsrepresentingtheancestors
Joe HesterUsestoolsleftbytheAncestorsonthepathwayforustopickuptobecomewellandbalancedinourrelationshipswitheachotherandCreation
WESTPipebundleholdingsacredguidancefromthespirit,traditionalknowledgesystemsandsacredceremonies
Elders Council: Kahontakwas (Diane) Longboat, Kawennanoron (Cindy) White,
Amy Desjarlais
Holds the sacred connection to the Spirit during meetings to ensure integrity and transparency
in all relationships and issues, as well as sharing wisdom and teachings to guide the work
NORTH Turtleshellrattlerepresentingtruth
Dr. Janet Smylie
Usesthebestofresearchanddatato“seefarahead”inmeetingtheneedsofToronto’semergingIndigenouspopulation
NORTHGuswenthabelt(tworowwampum)todepictourrolesasIndigenousnationsandCanadiansmutuallysupportingoneanotherbutnotinterferingorseekingtochangeoneanother
TIHAC SUPPORT
Dr David McKeown Ex-OfficioTIHACmember,MedicalOfficerofHealthfortheCityofToronto
Susan Fitzpatrick Ex-OfficioTIHACMember,TCLHINChiefExecutiveOfficer
Ellen Blais TIHAC Secretariat, TC LHIN Aboriginal Health Consultant and Communications Lead
Leila Monib TIHAC Secretariat, TPHHealthEquitySpecialist
Michelle Sault TIHAC Facilitator,PrincipalConsultant,CornerstoneConcepts
Dr. Bernice Downey TIHAC Indigenous Health Governance Consultant Principal, Minoayawin Consulting
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Conceiving the TIHS
“TherehavealwaysbeensystemsofIndigenousgovernance.Weneedtounderstandthatwecangovernourselvessuccessfullyandthatwealwayshave.Wehavestrongsystemicwaysoffiguringoutanswersthatour
communityneeds.”
EllenBlais,AboriginalHealthConsultantLead,TorontoCentralLocalHealthIntegrationNetwork,
andCircleSecretariat
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Overarching Themes
“Youneedtolookatallsocialdeterminantsofhealth.
Youneedtosomehowaffectthoseareasandsectorstorecognizeandcontributetoahealthycommunity.”
JoeHester,ExecutiveDirector,AnishnawbeHealthToronto Photo:NicolePenak,communitymember
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InformedbytheworkofIndigenoushealthspecialist, Dr. BerniceDowney,TIHACwovethreeoverarchingthemesthroughouttheTorontoIndigenousHealthStrategy:
RECLAMATION OFWELLBEING Well-beingwillbereclaimedthroughIndigenous-centricgovernance(selfdetermination)andimprovedaccesstoIndigenoushealingknowledgeandpractice,asarticulatedintheUnited
NationsDeclarationontheRightsofIndigenousPeoples(2007).
BasedonHaudenosauneeand Anishnawbeteachings,theTIHACEthicalCodeofBehaviourforCircleMemberswasdevelopedbytheEldersCouncilandembedsthereclamationoftheserights.
TheEthicalCodeandTIHACTermsofReferenceguideTIHACAdvisorsinhowtointeractwithoneanotherandmakedecisions.
TheVisionWheel(anadaptationofthetraditionalMedicineWheel)hasservedasawell-beingroadmaptodeveloptheTIHS.
SPIRITOFRECONCILIATION:MAKINGITRIGHTIn2015,theTruthandReconciliationCommissionofCanadareleasedtheirfinalreportandCallstoAction
toredressthelegacyofresidentialschoolsandtoadvancetheprocessofCanadianreconciliation.
The Calls to Action for the health
system call upon all levels ofgovernment to:
• Recognizeandimplementthehealth-carerightsofAboriginalpeople.
• Recognize,respectandaddressthedistincthealthneedsoftheMétis,Inuit,andoff-reserve Aboriginalpeoples.
• Recognize the value of Aboriginalhealing practices and use them in
the treatment of Aboriginal patients
in collaboration with Aboriginal
healers and Elders where
requested by Aboriginal patients.
• ConsultwithAboriginalpeoplestoestablishmeasurablegoalsto
identifyandclosehealthoutcomegapsbetweenAboriginalandnon-Aboriginalcommunities,andtopublishannualprogressreports
andassesslong-termtrends.Healthoutcomeindicatorsinclude:infantmortality,maternalhealth,suicide,mentalhealth,addictions,lifeexpectancy,birthrates,infantandchildhealthissues,chronicdiseases,illnessandinjuryindicatorsandtheavailabilityofappropriatehealthservices.OurHealthCounts:UrbanAboriginalHealthDatabaseProjectwillbeaninvaluableresourceasTIHACmeasuresandevaluatesTIHS progress.
TheTIHACGuswenthabelt(alsoknownasthetworowwampum)representstheoriginaltreatiesbetweensettlersandIndigenous
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people.Itservesasareminderthatwearealltreatypeople–withrights,rolesandresponsibilitiesregardingreconciliationandthewell-beingofIndigenouspeople.
REINFORCEAPOPULATIONHEALTHAPPROACH Apopulationhealthapproachexaminesandrespondstohealth
inequitiesamonggroupsinordertoimprovethehealthofthewholepopulation.TIHACreviewedthefindingsofcommunityengagementsessionsledbytheNativeCanadianCentreofTorontoinadditiontoavarietyofWellLivingHouseknowledgeproducts.(Pleaseseetable:WellLivingHouseKnowledgeProducts.)
TheTorontoIndigenousHealthStrategyusesapopulationhealthapproachto:
• AddressthesocialdeterminantsofurbanIndigenoushealththroughactionstoinfluencethehealth, justice,education,housingandfoodsystems.
• Reducehealthinequities–differencesinhealththatareavoidable,unfairandunjust–throughprogramsandservicesthatareculturallysecure,accessibleandaddresshistoricandcurrentwrongs.
WELL LIVING HOUSE KNOWLEDGE PRODUCTS
TIHAC reviewed the following Well Living House documents as part of its priority setting process:
• TheAboriginalPopulationinToronto:ExistingSocio-DemographicandHealthInformation.
• AComparisonofGovernanceStructureswithinAboriginalHealthStrategies:BackgroundandGovernanceConsiderationsintheContextoftheToronto AboriginalHealthStrategy.
• AboriginalHealthProgramsandServicesintheCityofToronto.
• AMapandaComprehensiveListofServiceOrganizations.
• ProgramFundingStreams:TorontoAboriginalHealthandSocialServices.
• BriefingSynthesisofProgramandServiceGapsforAboriginalPopulationsinToronto.
• OurHealthCountsToronto:UrbanAboriginalHealthDatabaseProject,preliminaryfindings.
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MissionToleadtransformationinhealthprogramsandservicestowardwell-beingforIndigenouspeopleinToronto.
VisionWeenvisionathrivingandhealthyIndigenouscommunityinTorontothroughtherespectfulharmonizingofpractices,policiesandresourceallocation.
Operating Principles1. HealthplansaredevelopedwithIndigenousPeoplesasfullpartners.
2. WhereverIndigenousPeoplesgotoaccessprogramsandservices,theyreceiveculturallyappropriate,safeandproficientcare,andallbarrierstooptimalcarehavebeenremoved.
3. Careisplannedtoberesponsivetocommunityneedsandisappropriate,efficient,effectiveandhighqualityatbothsystemsandinterpersonallevels.
4. DedicatedresourcesandfundingforIndigenousHealthprogramsandserviceswillsupportacoordinatedandcollaborativesystem.
5. LeverageandbuildthecapacityofIndigenousleadershipandIndigenouscommunitiestocare
forthemselves.
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STRATEGIC DIRECTION #1 REDUCE HEALTH INEQUITIES FOR INDIGENOUS PEOPLES
Goal: To address barriers, gaps and access to health programs and services for Indigenous people in Toronto
Strategy: How will we do this? Deliverables: How will we know we have been successful? Partners/Stakeholders
Betterintegrationandcollaborationbetweenpreventative,primary,specialtyandacutecaresystemsandIndigenousorganizationsthroughthecreationofnetworksandpathwaysforpersonsneedingcareandserviceproviders
1. Developed/measuredpatientexperiencesthroughapeople’ssurvey.Timelyaccesstoservicesandclient-patientsatisfactionmeasured
2. Statisticallyclinicalsignificantimprovementinaccesstoprimarycare
3. Statisticallyclinicalsignificantimprovementinaccesstomentalhealthandaddictionsservices
4. Establishedandimplementedastandardreferralmechanism.Developedstandarddocumentforreferralandacceptanceofpatients
5. CommunityHealthCentresacceptreferralsfromemergencydepartments
6. Indigenouspopulationidentifiedasapriorityinthestrategic/programplans
offundedorganizations
• TorontoCentralLocalIntegrationNetwork(TCLHIN)
• TorontoPublicHealth(TPH)• OurHealthCounts(OHC)• HealthServiceProviders(HSPs)• HealthQualityOntario(HQO)• MentalHealthandAddictions
ReferenceTable
IncreaseinvestmentinIndigenousculturalproficiencycontinuumandlearningopportunities
1. Arangeoflearningopportunitiesareavailableandarecommensuratewithwhoisbeingtrainedandwithoptionsforincreasedlevelsoflearningbeyondfoundationallearning
2. Measuredtraineeexperience,traineesatisfactionresponseindicatesacceptanceofculturalproficiency
3. Capturednumberofindividualsthatgothroughthetraining
4. Demonstratedincreaseinculturalproficiencyasmeasuredthroughevaluations
5. Devisedsupportsandprogramstointegrateculturalproficiencytrainingforhealthprofessionalsandstudents(nurses,midwives,physicians)
• Non-Indigenouscommunity• TPH• TCLHIN• Relevantuniversitiesandcollegesin
Toronto• HSPs• nonHSPswhohavehealthcarestaff• SouthernOntarioAboriginalHealth
AccessCentre• OntarioAssociationofCommunity
HealthAccessCentres• Relevanthospitalspilotingcultural
proficiencyinitiatives
Increaseinvestmentinculturallysafeprimarycareforchronicdiseases
1. Documentedneedsandunmetneeds
2. Trackedthecurrentinvestmentandreportedonincreasesininvestmentforculturallysafeprimarycareforchronicdiseases
3. Accessmeasuresareinplace
• TCLHIN• HQO• HSPs• OHC
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4. SamestandardofcareforIndigenouspatientsasmainstreamisevidenced
5. Indigenouspopulationidentifiedasapriorityinthestrategic/programplansoffundedorganizations
Developmentofa1-800Indigenoushealingand
caringlineinconjunctionwithaknowledgehubandclearinghouseforprovidersandpatients
1. Completedaneedsassessment
2. Completedanenvironmentalscan
3. Developedalistofresources
4. DevelopedadatabaseofmapsofservicesandAboriginalhealthpractitionersandsensitivedoctors
5. 1-800callcentreestablished
6. Devisedanevaluationmechanismthatincludesfeedbackfromclients/serviceprovidersthatservicesareimprovingandmeetingneeds
• TCLHIN
• TPH
• Indigenouscommunityorganizations
• Non-Indigenouscommunityorganizationsprovidinghealthprogramsandservices
IntegratemoreIndigenoussystemnavigatorsintothe
existingsystem
1. IncreasednumberofIndigenousSystemNavigators
2. Aminimumnumberofemployeesineachfundedagencyareidentifiedand
trainedasaculturallycompetentnavigatorofthehealthsystem3. Aminimumnumberofstaffateachhospitalaretrainedandidentifiedas
culturallysafeandsecurenavigatorsofthehealthcaresystem
4. AminimumofstaffatTorontoPublicHealthareidentifiedasculturallycompetentsystemnavigatorsforIndigenousclients
• TPH
• TCLHIN
• HSPs• HQO
Ensurehealthcarespacesarewelcoming,accessibleandinclusiveofIndigenouspeople
1. Completedabaselinestudytodeterminenumberofwelcoming,accessibleandculturallyinclusivespaces
2. Measuredanincreaseinspacesthatallowforculturalpractices(e.g.smudging)
3. Indigenouspopulationidentifiedasapriorityinthestrategic/programplansoffundedorganizations
• TCLHIN
• TPH
• HQO
• HSPs
Deviseorsupportexistingprogramsforseniorsandfamiliesimpactedbyresidentialschools
1. SupportedtheCallstoActionfoundintheTruthandReconciliationReport
2. Increasednumberofprogramsforfamiliesimpactedbyresidentialschools
• TCLHIN
• TPH
• Indigenouscommunityorganizations
• OrganizationsworkingwithIndigenouscommunitymembers
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STRATEGIC DIRECTION #2 INFLUENCE THE SOCIAL DETERMINANTS OF INDIGENOUS HEALTH
Goal: To influence systems that impact the health of Indigenous people in Toronto
Strategy: How will we do this? Deliverables: How will we know we have been successful? Partners/Stakeholders
HOUSING SYSTEM
AdvocateforlandlordracismtowardIndigenoustenantsbeaddressed
1. Advocacyworkisunderwayanddemonstrable
2. Policyhasbeendevisedandimplementedtoaddressracismwithlandlords
• TPH• BoardofHealth• RelevantCityofTorontodepartments• Landlordandtenantorganizations
InfluencesupportivehousingpolicyforthebenefitofIndigenousyouth,2Spiritandseniorsthatissecure,safeand
addressesrisks
1. Policyhasbeendevelopedandimplementedtoaddresshousing issuesrelatedtotwo-spiritedpeoples,Indigenousyouthandseniors
2. SupportedtherecommendationsintheTruthandReconciliationReport1
• TCLHIN• TorontoCommunityHousing
Corporation(TCHC)• Housingsectororganizations
• TPH• BoardofHealth• HQO• RelevantCitydepartments• RelevantProvincialMinistries• MinistryofCommunityandSocial
Services
InfluencesupportivehousingpolicyforthebenefitofpregnantIndigenouswomenandIndigenouswomeninvolvedwiththechildwelfaresystem
1. PolicyhasbeendevelopedandimplementedtoaddressissuesofIndigenouspregnantwomenandaccesstosupportivehousing,especiallywhileinvolvedwithchildwelfare
2. SupportedtherecommendationsintheTruthandReconciliationReport2
3. Advocacyworkunderwayanddemonstrableregardingthe inclusionaryzoninglawstodedicatehousingunitsfortheIndigenouscommunity
4. SamestandardofcareforIndigenouspatientsasmainstreamisevidenced
5. Indigenouspopulationidentifiedasapriorityinthestrategic/programplansoffundedorganizations
• TCLHIN• TCHC• TPH• Housingsectororganizations• BoardofHealth• HQO• RelevantCitydepartments• RelevantProvincialMinistries• MinistryofCommunityandSocial
Services• NationalAboriginalCouncilof
Midwives(NACM)
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FOOD SYSTEM
Advocateforaffordable,healthyfoodforIndigenouspeopleinTorontousinganIndigenouslens(including
throughtheTorontoFoodStrategy)
1. Creationofcommunitygardeninitiativesaresupported
2. Policiesforgreenspacesforfoodsustainabilityareresearchedandreported
3. Strategiestoincreaseaccesstoaffordable,healthyfooddevelopedand
implemented4. Advocacyworkunderwayanddemonstrableregardingfreeaccessto
prenatalvitamins
• TCLHIN
• HSPs
• SouthernOntarioAboriginalDiabetesInitiative
• TPH-TorontoFoodStrategy,ChronicDiseaseandInjuryPrevention
• HQO
• NekenaanHouse
• CityofTorontoPlanning
EDUCATION SYSTEM
AdvocateforagreaternumberofIndigenousteachers,professorsinthe
educationsystem
1. Advocacyworkisunderwayanddemonstrable • MinistryofEducation
• AllGTAcollegesanduniversities
Advocateforstudentsintheeducationsystemtohaveexperientiallearningopportunities(inadditiontoculturalcompetencytraining)regardingIndigenousceremoniesand/orceremonial
teachings
1. Advocacyworkisunderwayanddemonstrable • TorontoDistrictSchoolBoard(TDSB)
• TorontoCatholicDistrictSchoolBoard(TCDSB)
• MinistryofEducation
• AllGTAcollegesanduniversities
• ConseilscolairededistrictcatholiqueCentre-Sud(CSDCCS)
AdvocateforIndigenous-specificadultlearningcentres
1. Advocacyworkisunderwayanddemonstrable • TDSB
• TCDSB
1http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf 2http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf
Toronto’s First Indigenous Health Strategy 20162021 27
http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdfhttp://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdfhttp://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdfhttp://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf
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EDUCATION SYSTEM (CONTINUED)
Advocate for the development
of a state of the art,
well-equipped, centre of
excellence that prepares
Indigenous youth for entranceinto post-secondary programs
that includes housing,
financial and transportation
support and is infused with
Indigenous world view
1. Advocacyworkisunderwayanddemonstrable • TDSC
• TCDSB
• MinistryofTraining,CollegesandUniversities(MTCU)
• ConseilscolairededistrictcatholiqueCentre-Sud(CSDCCS)
AdvocatefortargetedprogrammingforIndigenousstudentsto
becomepartofschoolbasedsportsteams
1. Advocacyworkisunderwayanddemonstrable • TDSB
• TCDSB
• MTCU
•
RighttoPlay• CanadianLacrosseAssociation
• ConseilscolairededistrictcatholiqueCentre-Sud(CSDCCS)
JUSTICE SYSTEM
AdvocatewithinjusticesystemforculturallyappropriatecourtprocessesforIndigenouswomen
attendingfamilycourt
1. Advocacyworkisunderwayanddemonstrable • MinistryoftheAttorneyGeneral
• Ministry of Child and Youth Services (MCYS)
• ChildProtectionAgencies
• HealthandSocialServiceAgencies
•
AboriginalLegalServicesHUMAN RIGHTS
City-wide campaign to
address the role of racism
with an anti-oppression,
social justice framework
1. Demonstratedsupporttoothersdoingtheworkofaddressingnon-healthrelatedcampaignstoaddressracism
2. Demonstratedsupportforaproposalforprovincewidemandatoryculturalcompetencytraining
• TCLHIN
• TPH
• BoardofHealth
• MOHLTC
• Anti-Racism/HumanRightsorganizationsandinitiatives
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3. ProvidedadvicetotheMinisterofHealthonimpactofracismonthehealthofIndigenouspeople
4. Supportedchallengestotargetseniorleadershiptotakeculturalcompetencylearningopportunities
VIOLENCE
Support programs that
address violence in Toronto
Indigenous community
1. Advocacyworkisunderwayanddemonstrable
2. SupportgiventoagenciesthathaveamandateonviolenceagainstIndigenouswomen&families
3. SupportedthecallstoactionsintheTruthandReconciliationReport3
• TCLHIN
• TPH
• RelevantMinistries
• CommunitygroupsdedicatedtosupportingMissingandMurderedIndigenousWomen(MMIW)
EARLY CHILDHOOD
Expansion of culturally
secure parenting support
programs
1. IncreasednumberandsizeofculturallysecureparentingprogramsforIndigenouscommunity
• TPH
• Indigenousorganizations
• MCYS
3http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf
Toronto’s First Indigenous Health Strategy 20162021 29
http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdfhttp://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf
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STRATEGIC DIRECTION #3 HARMONIZE INDIGENOUS AND MAINSTREAM HEALTH PROGRAMS AND SERVICES
Goal: To close the institutional care gap through harmonized healing spaces and frontline services
Strategy: How will we do this? Deliverables: How will we know we have been successful? Partners/StakeholdersSupportnewandexistingpublichealthpromotionprogramsfocusingonphysicalactivity,healthyeating,mentalhealthpromotion,healthyparenting,youthresilienceandchronicdiseasepreventiontobeculturallyappropriate.
1. BaselinestudytodeterminewhatprogramshavebeentargetedtotheIndigenouscommunity
2. Researchintodataandqualitymeasurementsofexistingprogramsrevealed:
• Improvedaccesstohealthpromotionprograms
• Increasedphysicalactivityforparticipants
• Increasedknowledgeofculturallyappropriatehealthpromotionmessaging
•
Improvedqualityofprograms• Improvedincreaseinself-reportedhealthstatus
• Investmentsinexistingandnewprogramsaddressingchronicdiseaseprevention,mentalhealthpromotion,healthparentingandyouthresiliencefortheIndigenouspopulationareinplace
• TPH
• Indigenouscommunityorganizations
• MOHLTC
• PublicHealthOntario(PHO)
• SOADI(SouthernOntarioAboriginalDiabetesInitiative)
• TorontoCancerPreventionCoalition
• Mentalhealthandaddictionsreferencetable
SupportnewandexistingpalliativecareprogramsforIndigenouspeoplesthatintegrateIndigenousworldview.
1. ImplementedtheTCLHINPalliativeCareStrategy(PCS),whichincludedaspecificAboriginalpalliativecarestrategy
2. Identificationofemergingopportunitiestodevisestrategies
3. Evidenceofco-designofstrategybyIndigenouscommunity
4. Determinedtheproportionofpeoplewhoaredyingwithpalliativecaresupport
5. IncreasedproportionofIndigenouspatientsreceivingculturallysafepalliativecaresupport
6. PalliativeCarestrategiesareinalignmentwithIndigenousmidwiferypractices
7. Identificationoftraditionalresourcescompleted,implementationoffamilygriefpractices
• TCLHIN
• HSPs
• NationalAboriginalCouncilofMidwives(NACM)
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REALIZINGTHE VISION AReclamationofWellBeing:VisioningaThrivingHealthyUrbanIndigenousCommunity:Toronto’sFirstIndigenous
HealthStrategyaffirmsTIHAC’sbeliefthatself-determination
isatthecoreofbuildingastrong,healthy,andresilientIndigenouscommunity.
Toronto’s Indigenous population
is incredibly diverse. There are
Indigenous people who call Toronto
their permanent home and others
who travel between this city and
Indigenous communities to have
their health needs met. As such, thisstrategy recognizes that improving the
health of Indigenous people in Toronto
will require a coordinated effort
between diverse Indigenous leadership
and all levels of government.
TIHAC acknowledges that the legacy
of colonial trauma has resulted
in significant health inequities for
Indigenous people in Toronto. Some
of these inequities stem from the
intergenerational effects of residential
schools, as well as systemic
discrimination and service gaps in the
health care and public health systems.
TIHAC commends TC LHIN and TPH for
working with the community to improve
Indigenous health through culturally
competent services and strategies to
stimulate systemic change.
Actualizing the vision for a healthy
urban Indigenous community requires
a cross-sectoral approach. Along with
TC LHIN and TPH, TIHAC looks forward
to working with provincial ministries,
municipal divisions and Indigenous
Provincial Territorial Organizations.TIHAC will also work with experts
in the fields of education, housing,
justice, child welfare, food security,
human rights, family violence and
early childhood development. Together
we can make it happen.
There is a lot of exciting work
ahead – including the development
of a comprehensive implementation
framework, a communications
strategy and an Indigenized evaluation
plan that will measure our success.
TIHAC expresses gratitude to all of the
community members, agencies and
stakeholders who were instrumental
in creating Toronto’s First Indigenous
Health Strategy 2016-2021.
What is your vision of a healthy and thrivingIndigenous community in Toronto in 2050?
“Iamhopingthatpeoplewillenjoyequity,makealivingandenjoytheirrights.Ihopetheyhaveaccessto
servicesandmostimportantly,toeducation.TheCirclecanlooktotheyouthtoguideourfuture.”
RuthAnneCyr,CommunityElder
“It’salivingprocess,andsoitmoveswiththetime.ThereisacontinualdialogueinthecommunityaboutwhatahealthyIndigenouscommunitycanlooklike.”
JoeHester,ExecutiveDirector,AnishnawbeHealthToronto
“IseeathrivingandhealthyIndigenouscommunitywhereIndigenouspatientscanmoveseamlesslythroughthehealthcaresystem,whereculturalelementsofcareareofferedasachoicewitheveryinteraction,andwhereIndigenouspeoplearedeterminingtheirownpathwaystohealththataremeaningfultothem.”
SusanFitzpatrick,ChiefExecutiveOfficer,TorontoCentralLocal
HealthIntegrationNetwork
“ThisisamodelofIndigenoushealthinIndigenoushands.Wecanonlybesuccessfulwiththecommunity.IthinkthatthisisparticularlytrueoftheIndigenouscommunityifweworkinpartnershipandtakeourleadfrommembersoftheIndigenouscommunitythemselves.”
Dr.DavidMcKeown,MedicalOfficerofHealth,CityofToronto
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TIHACCOMMUNITYLAUNCHAND FEASTPOSTER
ThisposterwasdevelopedbyElder Diane LongboatandtwoIndigenousartists:Joseph Sagaj and Holly Fisher.
GuidedbytheElder’steachings,thecolourfulandcompleximageryreflectsthediversityofToronto’sIndigenouscommunity.TheElderandartistsvisuallydepictedTIHAC’sworkincommunityhealing:spiritually,emotionally,mentallyandphysically.
Moon and StarsThemoonandstarsdepictthevastuniverse.ThisiswhereTIHAC Advisorssituatetheirmindstodocreativeandinnovativework.GrandmotherMoonrepresentstheSacredFeminine,thehealingpowersofwaterandthecycleoffertility.ThesolidyellowlineinvokesGrandfatherSunandrepresentsastrong
commitmenttocommunitywellbeing.
Moon
The TIHAC Community Launch and
Feast fell on the January 23, 2015
new moon. This is when people’s
minds come together in a peaceful and
measured way. New projects grow in
abundance and efficacy, like the face
of Grandmother Moon as she becomes
full. The bright, eclipse-like sliver of
moon represents the brightness of the
Advisors. Many Indigenous Nations
begin midwinter ceremonies on the
January new moon to give thanks for
last year’s abundance and pray thatthe upcoming cycle be just as good.
Stars
Thesestarstaketheshapeofthe‘BigDipper’.ThisformationrepresentstheManandWoman’spipe,inbalancewitheachother.ThesepipesareconnectedtotheNorthStar.TherearesevenstarsinlinewiththeSeven
GrandfatherteachingsandtheSevenGenerationsteachingwhichasksthatweconsiderhowouractionswillimpactthenextsevengenerations.ManyIndigenousbeliefsystemsviewstarsasAncestorswhohavegonetothespiritworld. T
O R O N T O A
B O R I G I N A L
H E
A L T H S
T R A T E G Y
You are invited to the
Community Launch
& Feast of the
Toronto Aboriginal
Health Advisory Circle
on January 23rd at
the Native Canadian
Centre of Toronto.A Celebration of the
Creation of the
Toronto Aboriginal
Health Strategy
7:30 - 8:30 am Sunrise Ceremony and Sacred Fire - James Carpenter
2:00 - 4:00 pm Community Ceremony and Launch - Diane Longboat
with Eagle Staf, Drumming, Singing, Pipe ceremony
4:30 - 6:30 pm Community Feast
6: 30 pm Cl os ing Ce rem on y
COMMUNITY LAUNCH & FEAST
FULL DAY
SCHEDULE
For more info please contact:
Ellen Blais: [email protected] Leila Monib: [email protected]
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Star Blanket Logo
ThestarblanketrepresentstheSevenSacredLawswiththeeighthpointrepresentingAncestralwisdomand
guidance.EachAdvisorsitsatastarpoint;theirdirectionreflectstheskillsandgiftstheybring.Theswirlingcoloursdepictthedynamicnatureoflifeandtheinterconnectionoflife’sessentialelements:earth,fire,airandwater.TheredringaroundthestarsymbolizestheconnectionbetweentheAdvisorswhoworkcollaborativelytogetherandsitwithinthelarger
community.
The Woman on the Cliff
ThiswomanhonourstheimportanceofMotherEarthandwomenasthecreatorsoflifeandcarriersofwater. Asshegazesoffintothesky,shedrums(theheartbeatofMotherEarth)andsingstogivethanks.
Background Colours
Red depicts protection for the Circle’s
work and the community. The red
curve symbolizes Mother Earth – the
sacred land we depend and walk upon.
Purpleisthecolourofpeace.ItrepresentsIndigenouscommunity
leaders.Historically,purplewasreservedforroyalty.
Two Purple Wavy Lines
ThetwopurplelinesatthebottomsymbolizetheGuswenthaBeltof1613.AlsoknownastheTwoRowWampumBelt,thiswastheearliesttreatybetweentheDutchandtheHaudenosaunee,andwastheunderlyingbasisforallfutureHaudenosauneerelationshipswithEuropeanpowers.Theselinesrepresentrespectforthewaysin
whichIndigenousandnon-Indigenouspeopletravelontheriveroflife:Indigenousinacanoeandnon-Indigenousinaship.Ithonourstheprinciplesofnon-interference,peace,friendshipandrespect.
Thebeltendsareunfinishedtosignifyatreatywithoutend.Theresponsibilitiesofthisbeltare
meanttobesharedbyIndigenousandnon-Indigenouspeoples.TIHACrecognizestheTwoRowWampumBeltasrepresentingaharmonizedgovernanceprocessthatincludesIndigenousandnon-Indigenousleadership.
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For more information: