Racism and a lack of primary health care providers mean that off-reservation First Nations, Metis and Inuit women and girls have poor overall health compared to their non-Indigenous peers, according to a study by the Public Health Agency of Canada.
Compared to non-Indigenous women, those in the three different groups reported a higher prevalence of diagnosed chronic diseases and poorer mental healthincluding mood or anxiety disorders, the study said, noting Canada's colonial history with boarding schools, forced or forced sterilization, and destruction of traditional lands.
The researchers used data for all women ages 15 to 55 from the annual Canadian Community Health Survey between 2015 and 2020. That included 6,000 people from the three different groups and 74,760 non-Indigenous women, all of childbearing age.
“Indigenous women waited longer for basic care, used hospital services more often for non-urgent treatments, and were less likely to see dentists,” according to the study, published Monday in the Canadian Medical Association Journal.
Lead researcher Sebastian Srugo said that while thousands of women across Canada do not have a family doctor, “these conversations are much, much more common among Indigenous women.”
“Even when we compare Indigenous women and people classified as female at birth with non-Indigenous conspecifics of the same age, similar education, similar income and place of residence in the same locality, there are still these gaps,” Srugo said.
Women who were pregnant or who had just given birth were worse off, and it could affect their children years later, he said.
“This is about the cross-generational impact of not having access to that care,” Srugo said. “It's also about a justifiable lack of confidence by Indigenous communities in the healthcare system in Canada.”
GPs could support women with their reproductive decisions and screen them for conditions such as heart disease, depression and cancer, he said.
Several studies have found poorer health outcomes for Indigenous women compared to the general population.
But Srugo said the PHAC study adds to the limited research on First Nations, Metis and Inuit, who have distinct cultures, languages and histories but are typically lumped together as Indigenous peoples.
The study included 2,902 First Nations, 2,345 Metis and 742 Inuit women and girls. Researchers also received input from an advisory committee set up specifically for the project. Members came from four organizations: Les Femmes Michif Otipemisiwak (Women of the Métis Nation), the Native Women's Association of Canada, Pauktuutit Inuit Women of Canada and 2 Spirits in Motion.
While Lee Clark, health director of the Native Women's Association of Canada, commended federal researchers for working with Indigenous organizations, she said her study must not become “just another paper in the stack of evidence” that made little difference in the lives of women who are deprived of equal care.
The researchers themselves pointed to the challenges of accessing health care in a “disjointed legal system that leads to physician transfers for childbirth and universal health care.”
Clark said she hopes the federal government will use the findings to “hold the provinces accountable” to provide targeted programs for women whose needs have been neglected for too long.
Indigenous communities are still deeply affected by the 2020 death of Atikamekw woman Joyce Echaquan at a Quebec hospital, where she filmed staff insulting her while she was dying, she said.
“The majority of people I speak to in the community have stories of blatant racism,” she said of Gatineau, Que. “Colonialism is not historical. He lasts. This damage continues and is still perpetuated. Joyce's example is just one of the examples that has been recorded.”
In a decision earlier this month, an arbitration panel ordered the reinstatement of a nurse who had been discharged from the hospital. A referee wrote that while the staff member made inappropriate comments towards Echaquan, she was not responsible for the bulk of the poor treatment the patient received compared to a nurse's “offensive, vulgar, racist and rude remarks and behavior.” .
This nurse was also fired for telling Echaquan that she was stupid and “better off dead”.
Clark also called on federal and provincial governments to work together to integrate Indigenous practices into health care, including midwifery that uses traditional practices.
“Something like this has been happening in Nova Scotia recently. It has to be everywhere. It needs to be more accepted. The medicalization of childbirth is just a clear sign of colonialism.”
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This report from The Canadian Press was first published on August 28, 2023.
Canadian Press Health Coverage is supported by a partnership with the Canadian Medical Association.
