FIRST NATIONS, ABORIGINAL, MÉTIS

Provinces, territories urged to follow B.C. and investigate systemic racism in health care

KRISTY KIRKUP
July 28, 2020 Ottawa

Provinces and territories are facing calls from Indigenous experts to take British Columbia’s lead and consider launching investigations of systemic racism in health care institutions across the country.

Last month, B.C. Health Minister Adrian Dix appointed Mary Ellen Turpel-Lafond to lead an independent investigation into allegations of racism in the province’s health care system.
The investigation stems from allegations that doctors and nurses at one hospital were playing a game to guess blood-alcohol levels among Indigenous patients in an emergency room.
Senator Yvonne Boyer, who is a Métis lawyer and former nurse, said that she has heard similar stories over the span of her career.

Other provinces and territories should look at launching a similar type of investigation, she said.
“I do think the provinces and territories should all be pro-active,” she said, adding that Ottawa could play a leadership role in conducting a Canada-wide exploration of racism in the health care system.

“Once we have this data in, we can really look at how can the laws change to start making more of a society that is going to produce a better health outcome for Indigenous people.”
Prof. Turpel-Lafond at University of British Columbia’s Peter Allard Hall Law School said she is still collecting evidence for B.C.‘s probe but there are early indications that suggest there are systemic concerns.
”The scope of it and the nature of it is something that I’m really picking apart at the moment,” she said in a recent interview.
“But I think it is fair to say that the system, like other major public systems, whether it is the justice system, policing, education … the same sort of poisoned attitudes of negative perception toward Indigenous people have also been present in [health care].”

The Health Minister also acknowledged the existence of systemic racism when the investigation was announced. “Systemic racism hasn’t just existed in our country [province? NK], it exists in our country,” Mr. Dix said.

The terms for the investigation include inquiring on the alleged incidents of Indigenous-specific racism in emergency departments but it also the ability to look at the broader problem in the provincial health system.

Prof. Turpel-Lafond said her work to date suggests that individual and systemic racism is present “in all corners of the health care system in B.C.”
“Some of the more than 3,000 Indigenous respondents to the survey in the past month are reporting experiences in other provinces while they were away for school, visiting family or seeking care elsewhere due to travel over the past number of years,” she said.
“This appears to me to be a national issue. At some point it is inevitable that anti-Indigenous racism, and indeed all forms of racism, must be addressed in a comprehensive way through serious efforts.”
Prof. Turpel-Lafond added that the pandemic presents a critical moment to take a very hard look at the issue, noting the heightened vulnerabilities for Indigenous people.

Canada’s Chief Public Health Officer Theresa Tam has said that First Nations, Inuit and Métis face a higher risk of severe outcomes owing to health inequities and a higher prevalence of underlying medical conditions, as well as challenges of remote and fly-in communities.
Senator Boyer said she has frequently heard from Indigenous women, such as during a study published in 2014 for the Public Safety Department, who reported they would not seek health care because of previous experiences in the system.

“The stories I’ve heard, women have been raped and gone to the hospital … and the nursing staff says ‘What do you expect? You’re a prostitute,” she said.
“The women leave and they don’t seek help. They’re retraumatized.”

Dr. Janet Smylie, one of Canada’s first Métis physicians and a professor in the Dalla Lana School of Public Health at the University of Toronto, pointed to an example where one of her colleagues who is part of a working group of Indigenous health care providers and social service agencies in Toronto had to assist a youth with an easily treatable illness. The patient was near death because they avoided care, she said.
“That’s where we often end up as Indigenous health care providers,” Dr. Smylie said. “Trying to shield our community members from that racism when they need to seek health care in emergency rooms.”

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FNHA, FNHC, FNHDA Support Investigation into Systemic Racism

Coast Salish Territory – The First Nations Health Authority (FNHA), the First Nations Health Council (FNHC) and the First Nations Health Directors Association (FNHDA) welcome the launch of Mary Ellen Turpel-Lafond’s investigation into systemic racism in BC’s health system.

“We welcome this effort to shine light on the systemic racism that still exists in our province and encourage BC Indigenous patients and health workers within the system to trust this process and come forward to tell their truth about racism,” said Charlene Belleau, Chair of the First Nations Health Council.

Turpel-Lafond, a former judge and longtime children’s advocate in BC  will produce a report on racism in the BC health system following allegations that health-care staff in emergency rooms were playing a “game” to guess the blood-alcohol level of Indigenous patients.

“Mary Ellen is doing very important work that will have great impact on the future health and wellbeing of First Nations in B.C. and across Canada. FNHA is extremely pleased to support this work,” said M. Colleen Erickson, Chair of the First Nations Health Authority Board of Directors.

“The FNHA looks forward to the outcomes of the review as a way to accelerate the progress on cultural safety for First Nations of BC,” said Richard Jock, FNHA’s Interim Chief Executive Officer. “It is important people participate in the survey​ as a way to provide their experiences. FNHA will look to provide appropriate ways to support participants who may be triggered by the final report’s disclosures.”

To read more, click on FNHA, FNHC, FNHDA Support Investigation into Systemic Racism

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Joint statement on B.C. Indigenous human rights legislation passing unanimously
Indigenous Relations and Reconciliation

November 26, 2019

Scott Fraser, Minister of Indigenous Relations and Reconciliation; Regional Chief Terry Teegee, BC Assembly of First Nations; Cheryl Casimer, First Nations Summit; Grand Chief Stewart Phillip, Union of BC Indian Chiefs; and Adam Olsen, MLA for Saanich North and the Islands and member of Tsartlip First Nation, have issued the following statement:

“Today, we have made history. British Columbia is the first province in Canada to enshrine the human rights of Indigenous peoples in law. Bill 41, the Declaration on the Rights of Indigenous Peoples act, passed unanimously on Tuesday, Nov. 26, 2019.

“The legislation establishes the United Nations Declaration on the Rights of Indigenous Peoples as the foundational framework for reconciliation in B.C., as called for by the Truth and Reconciliation Commission. The provincial government developed Bill 41 in collaboration with the First Nations Leadership Council, which was acting on the direction of First Nations leaders throughout the province. A commitment to adopting the Declaration is a component of the Confidence and Supply Agreement between the B.C. government and the BC Green Party caucus.

“This legislation advances a path forward to true reconciliation for all of us in B.C. that will uphold Indigenous rights and create stronger communities, stable jobs and economic growth.

“It is time we recognize and safeguard Indigenous peoples’ human rights, so that we may finally move away from conflict, drawn-out court cases and uncertainty, and move forward with collaboration and respect. Ensuring that Indigenous peoples are part of the policy-making and decision-making processes that affect them, their families and their territories is how we will create more certainty and opportunity for Indigenous peoples, B.C. businesses, communities and families everywhere.

“Any future changes to bring provincial laws into harmony with the UN Declaration will be done in consultation and collaboration with Indigenous peoples, with opportunities for engagement with local governments and stakeholders such as business and industry. Changes won’t happen overnight – this will be a gradual, step-by-step process over time.

“The development of an action plan – in collaboration with Indigenous peoples – with regular reporting to monitor progress will provide a transparent and accountable path forward on reconciliation in B.C.

“Working together, we have made significant progress in the past two years and we have seen critical advancements with affordable housing, child welfare, language revitalization and revenue sharing. This legislation will help us build upon this progress and make a real, meaningful difference in the lives of Indigenous families and everyone in B.C.”

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Results Released from Expanded First Nations Health and Wellness Survey

Coast Salish Territory – The First Nations Health Authority (FNHA) has released the results of the most comprehensive First Nations health and wellness survey ever carried out in the province.

The First Nations Regional Health Survey (RHS)​ is the only First Nations-led and governed, nationally-representative population health and wellness survey. This survey, the largest one to incorporate First Nations perspectives on health and wellness, asked about traditional wellness and community strengths in addition to health care access and chronic diseases.

The third phase of the RHS, conducted from 2015 to 2017, collected data from nearly 6,000 respondents from 122 communities. The FNHA heard from community members and regional leaders that they needed high-quality data that could inform evidence-based policy, programs and services. To meet this need, the FNHA funded an expansion of the survey that nearly doubled the number of participating First Nations communities and individuals compared to previous phases of the survey. Due to the expansion, the RHS results are being shared for the first time at the regional level, with one report for each of the five FNHA regions in addition to the provincial report. This fulfils the FNHA’s commitment to return community-generated information to support each region’s health and wellness planning.

“This takes the control out of the hands of institutions and gives it back to the people, which is really aligned with what we are trying to do as an organization,” said Sonia Isaac-Mann, Vice-President of Programs and Services at the FNHA.

The latest survey incorporated new questions that looked more closely at both the social determinants of health and the use of traditional healing practices. This helped to shift the focus away from looking at illness to a wellness-based approach.

“It is time we started looking at how well we are, what is protective, and how we resist poor health,” said Dr. Evan Adams, Chief Medical Officer for the FNHA. “What we do is related to how we’re doing. Time spent connecting to the land, and enjoying traditional diets and ceremonial practices continue to form the foundations of physical, mental, spiritual and emotional well-being.”

The FNHA will now look to reassess priorities as a result of the survey findings. There is a clear preference for more support for traditional healing and wellness practices that build on First Nations knowledge, beliefs, values, practices, medicines and models of health and wellness.

What is next for the RHS?

In keeping with the principles of OCAP®, every First Nations community in BC received printed copies of the regional and provincial reports before the public release of the reports. The RHS team will share the results and gather feedback this fall at regional and community events across the province.

Are you interested in finding out more about how the RHS data can support your community or organization’s planning and decision-making? Contact us at RHS@FNHA.ca.

The FNHA has already committed to the fourth RHS and is planning to begin data collection in the fall of 2020. 

By the Numbers:

• 5,739 province-wide participants

1,515 Children (0-11), 1,198 Youth (12-17), 1,509 Adults (18-54), 1,517 Older Adults (55+)

• 122 Communities

• 204 questions in 26 sections

• 48 data collectors trained from First Nations communities

•​ Provincially:​​​

o 70% of adults said they had often eaten traditional foods in the last year

o 43% of adults said they had used traditional medicine in the past year

o 82% of adults said their mental health was good, very good, or excellent 

o 84% of adults said they felt a strong sense of belonging to their community

o Adults identified their top three determinants of good health as diet, sleep and social supports

o About 5% of the respondents under age 55 speak a traditional language to at least intermediate level

o 41% of adults and 13% of youth smoke tobacco, although rates have continued to decline

o​ 77% of adults participate in at least 150 minutes of physical activity a week