NUNAVUT
Nunavut fared terribly in a new health report card, calling attention once again to grim living conditions in the territory.
While the Conference Board of Canada focused on analysis and statistics from across the country and the world and notes "poorer health outcomes among the aboriginal populations" may be driving Nunavut's results into the ground, another study, produced for Well Living House, examines racism and colonization and their impact on the health of indigenous peoples in Canada.
"The territories do poorly on most health indicators. However, it's important to keep in mind that socio-economic factors, such as poverty, infrastructure, cost of living, education, and housing, have a huge impact on the health of the population," said Gabriela Prada, director of health innovation, policy and evaluation with the Conference Board of Canada.
The Conference Board's How Canada Performs: Health Report Card is the first such study by the independent, not-for-profit research organization, which "compared Canada, the 10 provinces, three territories, and 15 peer countries."
"The territories have the worst health outcomes in Canada, with Nunavut ranking near or at the bottom on most indicators," the researchers conclude.
Life expectancy, premature mortality, infant mortality, self-reported health status, mortality due to cancer, mortality due to heart disease and stroke, mortality due to respiratory disease, mortality due to diabetes, mortality due to diseases of the nervous system, and suicides were the main indicators in the research.
The infant mortality rate is considered the most important measure of health and well-being.
According to the Conference Board, Nunavut's average infant mortality rate is more than three times higher than the national average, with an average of 18.5 deaths per 1,000 live births between 2009 and 2011.
Nunavut's life expectancy at birth is only 71.8 years - much lower than the national average of 81.5 years. And Nunavut's mark of D on self-reported mental health is not surprising given its phenomenally high suicide rate.
The authors then state "poorer health outcomes among the aboriginal populations may be affecting the overall results in these regions, especially in the Northwest Territories and Nunavut, which have the highest shares of aboriginal people."
That fact isn't news to the researchers responsible for the report released in January titled First Peoples, Second Class Treatment, which examines the role of racism in health outcomes of indigenous peoples.
That study especially points out "the stories of indigenous health in Canada told in the mainstream society are generally not authored by indigenous peoples themselves and are often characterized by racist stereotypes and images."
"At the individual, family and community level, indigenous peoples have been managing racism and its impacts on health and well-being for hundreds of years, demonstrating resilience in the face of violence, cultural genocide, legislated segregation, appropriation of lands and social and economic oppression," state the researchers, affiliated with the Well Living House Action Research Centre for Indigenous Infant, Child, and Family Health and Wellbeing and St. Michael's Hospital in Toronto.
According to the study, "Information about indigenous health cannot be understood outside of the context of colonial policies and practices both past and present," which includes "The Indian Act and related policies and processes, which served to dispossess indigenous peoples of land and disrupt traditional economies, thereby cutting off sources of food and manufacturing food dependence on colonial authorities and impede the transmission of identity and traditional knowledge," as well as "the forced relocation of Inuit peoples and the imposition of permanent settlements, compounded for some communities by the mass slaughter of sled dogs."
The study also states the residential school system, "which subjected generations of children to sexual, emotional, physical, mental, spiritual and cultural abuse," has led directly to poor health.
Finally, the writers note, "research shows that racism against indigenous peoples in the health care system is so pervasive that people strategize around anticipated racism before visiting the emergency department or, in some cases, avoid care altogether."
Noting a trend in recent science, these authors say racial stereotypes also show up in "the idea that genetic predeterminations - as opposed to factors like access to the social determinants of health - are responsible for the health inequities experienced by indigenous peoples ..."
The Conference Board suggests that to improve health outcomes in Nunavut, "efforts must be made to improve socio-economic conditions.
"This will require tailored approaches that are inclusive of aboriginal traditional knowledge, building on strengths that reinforce the sense of community. In particular, this must include programs that help aboriginal youth find purpose, build self-esteem, and assume leadership responsibilities in their communities."
The writers of First Peoples, Second Class Treatment suggest direct involvement of Inuit in all areas of policy and practice is the best strategy moving forward.
