Tansi Nîtôtemtik,
Today ReconciliAction YEG evaluates TRC Call to Action #19, which states:
We call upon the federal government, in consultation with Aboriginal peoples, to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities, and to publish annual progress reports and assess long term trends. Such efforts would focus on indicators such as: infant mortality, maternal health, suicide, mental health, addictions, life expectancy, birth rates, infant and child health issues, chronic diseases, illness and injury incidence, and the availability of appropriate health services.[1]
The Need for Accurate Data
Measuring the current state of Indigenous health in Canada is complicated by a lack of data about Indigenous health outcomes. Indigenous health data collection often misses groups like non-registered First Nations people and Metis or Inuit people living off-reserve.[2] These gaps in information give an incomplete picture of Indigenous health that likely underestimates inequities. The COVID-19 pandemic highlights the problematic nature of this deficiency in data. The federal department of Indigenous Services only captures COVID-19 data from First Nations people living on reserves, which has resulted in an inaccurate representation of how COVID-19 is affecting Indigenous people in Canada.[3]
Despite the lack of accurate data, it is no mystery that Indigenous people in Canada experience worse health outcomes than their non-Indigenous counterparts, ranging from mental health to infectious disease. Just to name a few examples, the Attawapiskat First Nation of James Bay, Ontario had such a high rate of suicide attempts among young people that the Nation declared a state of emergency;[4] Nunatsiavut (the Inuit region of Labrador) has the highest rate of tuberculosis in Canada;[5] and Type 2 diabetes is considered at epidemic levels in many First Nations communities.[6]
(This graphic (2016) demonstrates the immense difference in tuberculosis rates between Indigenous and non-Indigenous peoples, Credit: Public Health Agency of Canada[7] )
Progress on Call to Action #19
In 2018, two projects to identify Indigenous health needs were included in the federal budget: $109 million over ten years was budgeted for an Inuit Health Survey and $6 million over five years was budgeted for a Metis health strategy.[8] There is also a federal initiative called the Health Services Integration Fund (HSIF) aimed to support “collaborative planning and multi-year projects aimed at better meeting the health-care needs of First Nations and Inuit.”[9] However, the amount of funding and scope of the HSIF is unclear.
In May 2020, the Government of Canada pledged $250,000 towards data collection regarding COVID-19 in Indigenous communities. However, the data collected by Indigenous Services Canada was largely discrepant with community reports. [10] As the figure below shows, the ISC figures greatly underestimate the number of COVID-19 cases. In August 2020, the Government then pledged an additional $285.1 million towards the public health response to COVID-19 to First Nations communities, but considering the underestimation in the number of cases, this amount will likely be insufficient.
(Credit: Yellowhead Institute, see footnote 10)
Final Thoughts
The piecemeal nature of the Government’s funding and initiatives towards improving Indigenous health outcomes is disappointing, but unfortunately not surprising. TRC Call to Action #19 asks for measurable goals, and as of yet, basically no measurable goals that have been set. Further, without accurate data collection, accountability for implementing actual change will continue to be very limited. The need for systemic change and measurable outcomes must be prioritized by our Government to ensure that Indigenous health improves in Canada. As a result, Team ReconciliAction YEG is assigning D minus grade to Canada on Call to Action #19. Stay tuned tomorrow as we continue our evaluation of the TRC Calls to Action on Health!
Until next time,
Team ReconciliAction YEG
1Truth and Reconciliation Commission of Canada, Honouring the Truth, Reconciling for the Future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada (Ottawa, Truth and Reconciliation Commission of Canada, 2015).
2National Collaborating Center for Aboriginal Health, “An Overview of Aboriginal Health in Canada” (2013), online (pdf): <www.ccnsa-nccah.ca/docs/context/FS-OverviewAbororiginalHealth-EN.pdf>.
3Raisa Patel, “Canada must improve COVID-19 data collection for Indigenous communities, minister says” CBC News (May 9, 2020) online: <www.cbc.ca/news/politics/indigenous-covid-19-data-collection-1.5563433>.
4Kate Rutherford, “Attawapiskat declares state of emergency over spate of suicide attempts” CBC News, (April 9, 2016), online: <www.cbc.ca/news/canada/sudbury/attawapiskat-suicide-first-nations-emergency-1.3528747>.
5Patterson, S. Finn, K. Barker, “Addressing tuberculosis among Inuit in Canada.” (2018) 44(3/4):82-5 Can Commun Dis Rep., https://doi.org/10.14745/ccdr.v44i34a02.
6Lynden Crowshoe et al., “Type 2 Diabetes and Indigenous Peoples” 42 (2018) S296, https://doi.org/10.1016/j.jcjd.2017.10.022.
7Vachon, V. Gallant & W., “Tuberculosis in Canada, 2016” 2018;44(3/4)Can Commun Dis Rep at 78. https://doi.org/10.14745/ccdr.v44i34a01.
8CBC News, “Beyond 94”, Interactive CBC News (Last updated Sept 11, 2020) online: <newsinteractives.cbc.ca/longform-single/beyond-94?&cta=19 >.
9Government of Canada, “Health Services Integration Fund”, (Mar 8, 2020) online: Indigenous Services Canada <www.sac-isc.gc.ca/eng/1583705358726/1583705378757>.
10Courtney Skye, “Colonialism Of The Curve: Indigenous Communities & Bad Covid Data” (May 12, 2020, online: Yellowhead Institute <yellowheadinstitute.org/2020/05/12/colonialism-of-the-curve-indigenous-communities-and-bad-covid-data/>.