Health Sciences 3400A/B Lecture Notes - Lecture 8: First Nations, Health Promotion, Health Canada
17 Dec 2016
School
Department
Course
Professor
Health Policy Reading
Aboriginal Health Systems in Canada: Nine Case Studies
Strengths of Aboriginal Systems
• Self empowerment
o They control and own their health services
▪ So it can be a culturally appropriate environment
o The fact that they control their services led to a dramatic lowering of
youth suicide rates
▪ In BC the rates were 800 times the national rate
• This lead the government to implement
o Land claims for Aboriginals
o Achievement of self-government
▪ With political and economic independence
o Band controlled education services
o Band controlled police and fire protection services
o Health services
▪ Divided bands that had funding for
permanent health care providers in their
community
o Presence of a facility designated for cultural use
• Holistic Approach
o They look at health through a broad health determinants approach
o Embrace all life processes
▪ Mental, spiritual, emotional and physical components of health
• Synergy of Traditions and Western Health Philosophies
o Traditional healing practices, which encompass physical, spiritual,
emotional, social, and mental well-being, may be synergistically
combined with western medical approaches to develop uniquely
Aboriginal approaches to health services
o They have community preferences
▪ Which helps them a lot more than modern Western services
• Primary Care
o Access to adequate, culturally appropriate primary care is still an issue in
a lot of communities
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find more resources at oneclass.com
▪ However they are trying to approach health through a promoting
healthy lifestyles way rather than treating illnesses
• Collaborations with Provincial Services
o Working together helps a lot
• Integrated Health Services Delivery
• Administrative reform
o The health system is accountable to both the community and the funders
o Optimal situation
▪ Administrative structures are lean and the number of funding
agreements has been reduced so as to allow flexibility in
allocation of resources and minimize paperwork
• However because first nations receive funding from a
variety of places funding arrangements are still not routine
o We are trying to merge different programs
Health System Challenges
• Health Status
o Aboriginals experience more illness, mortality, injury, addictions and
family violence
o Over crowding problems
▪ Due to inadequate housing and community infrastructure
o Rate significantly lower on all levels of health status
▪ Statistics
• Mortality
o 1993 – 10.8/1000 compared to 6.9/1000
• Life expectancy
o 2000 – 68.9 for males, 76.6 for females
• Smoking
o 62% of First Nations smoked on the reserve in 1997
▪ 70% were under 30 years old
• Alcohol use
o 1991 – 73% of First Nations said alcohol was a
problem in their community and 59% said drugs
was as well
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find more resources at oneclass.com
o 6% were considered alcohol dependant
▪ Compared to the 1.8% total population
• Obesity
o 24.2% of Aboriginal people were obese
• Unemployment rate
o 29% of First nations are not employed in 1996
census
o 22% of Inuit were unemployed
• Education
o 63% of First Nations People completed secondary
school
o 4x more Canadians possessed a university degree –
only 3% of First Nations had one
o Less likely to graduate high school
• Water Systems
o 41.4% of First Nations had piping access in 1999-
2000
• Community Sewage Systems
o 33.6% of First Nations had at least 90% of their
homes connected to community sewage disposal
systems in 1999-2000
• Shelter
o 56.9% of First Nations on reserve were considered
adequate in 1999-2000
o 19% had more than one person per room
• Work Status
o Only 38.1% of Aboriginal people worked the whole
year
o 27.3% were evaluated as having a low income
• Depression
o 2x more common than in non aboriginal people
• Functional status
o 40% reported limitations in physical ability
o This is not fully the health services syste’s fault
▪ SDOH play a huge role
o Barriers to service include
▪ Language
▪ Cultural appropriateness
find more resources at oneclass.com
find more resources at oneclass.com
