Anishnawbe Health Toronto

Aboriginal Health:

Educating Minds, Improving Health.

Dr. C. P. Shah Staff Physician Anishnawbe Health Toronto; Professor Emeritus Dalla Lana School of Public Health;

How does Aboriginal Identity Influence Health Care?

• Racism & Discrimantion

• Sterotyping

• Lack of Understanding of:

Impact of Colonialism on Health

Aboriginal Concept of Health and Healing

WHAT DO YOU NEED TO KNOW ABOUT ABORIGINAL PEOPLE?

Overview

Part 1. Colonial & Post-Colonial Administrative Policies and Practices Impacting Health & Health Determinants.

Part 2. Demography, Health Determinants and Health Status of Aboriginal People.

Part 3. Aboriginal Concept of Health and Healing. Access and Barriers to Health Care System. Future Directions to Close the Gap in Health Inequity.

4

The Legacy of the Residential School System:

The following conditions were present in residential schools:

1. Physical, emotional, spiritual harm

2. Educational harm

3. Loss of culture and language

4. Harm to family structures

5. Students were separated from their siblings

6. Students were punished for speaking Aboriginal languages

7. Students were at risk for malnutrition and infectious disease

8. A high proportion suffered various forms of abuse, including physical, emotional, psychological and sexual abuse.

5

Impacts of Colonial Policies:

Loss of Culture

Loss of Language

Loss of Heritage

Loss of Identity

Loss of Parenting Skills

Intergenerational Family Violence

Loss of land & livelihood

Loss of self control & Self determination

6

Part 2. Demography, Health Determinants and Health Status of

Aboriginal People.

7

Population Reporting Aboriginal Ancestry Origin,

Canada, 1901 - 2006

491465

10026751172790

1319890

312766220121

165607

160937128890113724105611

1279410

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

1901 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001 2006

Po

pul

ati

on

Total Population8

SHAH’S DICTUM: ONE

WITH REGARDS TO POSITIVE HEALTH DETERMINANTS:

WHAT NON-ABORIGINAL PEOPLES HAVE, ABORIGINAL PEOPLES HAVE MUCH

LESS OF IT AND ALSO HAVE THE ADDED BURDEN OF: LEGACY OF RESIDENTIAL

SCHOOL & DISCRIMINATION.

9

SHAH’S DICTUM: TWO

WITH REGARDS TO DEATH, DISEASES AND DISABILITY:

ABORIGINAL PEOPLES HAVE TWO TO THREE TIMES MORE

DEATH, DISEASES AND DISABILITY THAN NON-ABORIGINAL PEOPLE,

ABORIGINAL PEOPLES ALSO GET IT EARLY AND IT IS MORE SEVERE IN NATURE

54

16.9

32.434.1

22.2

12.4

6.63.6

11

27.817.918.1

8.4

1.92.3

3.29.35.431.61.20.4

3.311.47

3.41.80.60.40

20

40

15-24 25-34 35-44 45-54 55-64 65+ Age-

Adj.

Can-M

Can-F

FN-M

FN-F

Can-M Can-F FN-M FN-F

Example: Diabetes First Nations and Labrador Inuit to the Canadian Population,

Age-gender-specific and age adjusted prevalence (%)

Source: Young, T.K. et al. and FNIRHS Steering Committee and Canadian data from the NPHS, 1994-95.

Age

Gender

11

Part 3 THE CONCEPT OF HEALTH AND HEALING AMONG ABORIGINAL

PEOPLES

12

MEDICINE WHEEL

13

Physical

Emotional

Mental

Spiritual

Emotional

Culturally Sensitive Programs Needed to Enhance Health

• Spiritual Programs: – Sweat Lodge,

– Shaking Tent

– Full Moon Ceremony

– Naming Ceremony

– Clan Feasts

– Pipe Ceremony

– Vision Quests

– Smudging

– Traditional Teachings

– Cultural Workshops

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What can health care professionals do?

PATIENT-CENTERED COMMUNICATION WILL RESULT IN:

PATIENT-CENTERED COMMUNICATION SKILLS

BUILDS TRUSTING RELATIONSHIP

PATIENT BECOMES A PARTNER IN HEALTH CARE

BETTER PATIENT ADHERENCE TO THERAPEUTIC PLAN

BETTER PATIENT HEALTH OUTCOMES

IMPROVED OVERALL HEALTH

AVAILABLE RESOURCES

• www.aht.ca/aboriginal-cultural-safety-initiave Anishnwabe Health Toronto

• Health Council of Canada: Empathy, Dignity and Respect: Creating Cultural Safety for Aboriginal People in Urban Canada, Dec. 2012

• Thomas King: The Inconvenient Indian, 2012. • www.culturalcompetency.ca: Indigenous Cultural

Competency Training Program, Province of B.C. • Ontario Federation of Indigenous Friendship Center

with Toronto Central LHIN